[Clinical aspects of endometriosis]

Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity. Its pathogenesis ist still not definitely clear. The incidence today is stated very differently, most studies report an incidence of 10-15% for women in their reproductive age. The leading symptoms are as dysmenorrhoea and chronic pelvic pain, which do not have to occur synchronously with the menstrual cycle. Endometriosis is a chronic, progressive disease and may lead to severe destructions of reproductive organs and infertility in advanced stages. Clinical symptoms are often uncharacteristic, and imaging techniques may not be able to give the correct diagnosis; furthermore, there is often no direct relationship between the extent of the disease and the severity of the symptoms. Differential diagnosis other inflammatory diseases as far as malignant tumors. Therefore early indication of surgical affirmation and therapy of endometriosis by laparoscopic techniques is recommended as soon as symptoms occur, even in adolescent girls. Endometriosis genitalis externa is presenting as peritoneal or ovarian implants of different shape, as endometriotic cyst of the ovaries or as deep nodal implants in the spatium rectovaginale, which possibly represent different entities.