Bestand (1.6 MB) - VVOG

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orale contraceptiva en progestogenen (bv. norethisterone
acetaat 2,5mg/dag) zijn omwille van hun veilig profiel, geringe
nevenwerkingen en kostprijs de eerste keuze, en een
alternatief voor chirurgie of voor postoperatieve nabehandeling.
Ook levonorgestrel releasing-IUD werd recent
voorgesteld voor pijnklachten geassocieerd met rectovaginale
endometriose.
Indien deze medicatie niet aangewezen of onvoldoende
werkzaam is, kan gekozen worden voor GnRH-analogen,
danazol of gestrinone. Recidieven zijn frequent na het
stoppen van de hormonale therapie en er is geen bewijs
van verhoging van de vruchtbaarheid.
Onderzoek naar nieuwe medicatie is gericht op factoren
die de ontwikkeling en progressie van endometriose beinvloeden
en dit omvat progesteronreceptormodulatoren,
gonadotropin releasing hormone (GnRH)-analogen,
aromatase-inhibitoren alsook tumor necrosis factor-a
(TNF-a)-inhibitoren, angiogenesisinhibitoren, matrixmetalloproteïnase-inhibitoren
en oestrogeenreceptor
b-agonisten.
Referenties
Epidemiologie
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Rier SE, et al. Endometriosis in rhesus monkeys (Macaca mulatta) following chronic exposure to
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Infertiliteit
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Diagnose
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Heelkundige behandeling
Abbott J, et al. Laparoscopic excision of endometriosis: A randomized, placebo-controlled trial.
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Brosens IA, et al. Reconstruction of the ovary containing large endometriomas by an
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Canis M, et al. Second-look laparoscopy after laparoscopic cystectomy of large ovarian
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Chapron C, et al. Anatomical distribution of deeply infiltrating endometriosis: Surgical
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Garry R, et al. The effect of endometriosis and its radical laparoscopic excision on quality of life
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Muzii L, et al. Histologic analysis of endometriomas: what the surgeon needs to know. Fertil
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Medische behandeling
Amsterdam LL, et al. Anastrazole and oral contraceptives: A novel treatment for endometriosis.
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