Chronic pelvic pain. Differential diagnosis of endometriosis

Endometriosis is also still a common cause, alongside infertility, of sometimes pronounced pain in the abdominal area, particularly in the pelvis. The most important thing for treating physicians is to consider this differential diagnosis and to initiate appropriate diagnostics. After a careful medical history and the resulting suspicion of endometriosis, a diagnostic laparoscopy should be considered. This ensures a diagnosis, histological confirmation, and the initiation of specific treatment. This is the only way to reduce and even avoid serious progression and chronic pain. The longer it takes to make a diagnosis, the worse the patient's quality of life, which is limited by pain, and the more advanced the disease, the more radical and extensive the therapies. Multimodal pain therapy including complementary therapeutic approaches and early radical surgery can prevent chronic progression, social isolation, loss of partner, and job. Laparoscopic surgical therapy is particularly important for extragenital, symptomatic endometriosis. In addition, with timely therapeutic measures, an improvement in fertility can always be expected in up to 25% of mostly young, childless women within the first 24 months. After successful conservative or surgical treatment, adequate follow-up care continue to be an important to ensure that patients remain pain-free.