Endometriosis Pathogenesis, Diagnosis, and Therapeutic Options for Clinical and Ambulatory Care

In the last few years, considerable progress has been made understanding endometriosis and developing diagnostic procedures and therapeutic options. Sophisticated endoscopic instruments allow laparoscopic surgery even in progressed stages and deep infiltrating endometriosis of the bowel and bladder. The introduction of GnRH analogues with add-back medication and the development of new progestins have widened the range of options for effective medical therapy. Nevertheless new prospective studies have demonstrated in the last decade that the success is temporary and the recurrence rates are high even when the surgery was adequate. Often medical treatment is effective during the time of application only. This means that customised long-term therapy concepts based on guidelines developed by medical societies play a central role in the alleviation of pain, the reduction of recurrence rates, the avoidance of repeat operations and the improvement of the patients quality of life.