Diagnosis and treatment of endometriosis according to the S2k guidelines

Endometriosis, a socioeconomically highly relevant disease, is determined by cyclic or acyclic pain symptoms and/or sterility. Despite its significance, the median time to first diagnosis of endometriosis is still between 8 and 12 years. The diagnostic work-up comprises patient history, gynecological examination including rectovaginal palpation, as well as transvaginal and occasionally renal sonography; the diagnosis should be confirmed laparoscopically. Other diagnostic procedures are reserved for specific situations especially when planning an operation. Patients complaining of pain symptoms benefit from medical therapy (hormones, analgesics) as well as from surgery. Complementary therapeutic strategies and the concept of multimodal pain treatment can also be considered. Surgical removal of endometriosis and assisted reproductive techniques should be offered in the case of sterility. This article describes the relevant clinical strategies in the diagnosis and treatment of endometriosis. © 2017, Springer Medizin Verlag GmbH.