Endometriosis is considered a "chameleon" among benign gynaecological diseases, as it is very diverse in its manifestation and clinical symptoms, varies from person to person and is often associated with an unfulfilled desire to have children. In Germany, around one in ten women between the ages of 15 and 45 is affected by endometriosis.
We specialise in the detection and treatment of endometriosis according to the latest scientific findings and guidelines. The Endometriosis Research Foundation (SEF) has confirmed the high quality of our treatment by certifying us as an endometriosis centre. Our competent and experienced team is available for consultation and treatment planning during our special consultation hours.
We offer you state-of-the-art medicine at the highest university level:
- Comprehensive diagnostics with high-resolution imaging procedures
- Customised treatment concept according to your needs and wishes
- Gentle removal of endometriosis lesions using minimally invasive surgical procedures
- Parallel consultation and care at our UniFee Fertility Centre in the event of an unfulfilled desire to have children
- Close interdisciplinary collaboration with our cooperation partners
Our endometriosis centre on film
Contact & Appointments
Medical history form (PDF file):
Please bring the completed medical history form with you to your first appointment with us.
The symptoms of endometriosis are very variable in their form and intensity depending on the localisation and extent of the endometriosis. For this reason, endometriosis is often only recognised and treated at a late stage. Although the disease is benign, it is often chronic and can impair quality of life due to severe pain and the inability to conceive.
One reason for the symptoms is the appearance of endometrium outside the uterus. These endometriosis centres react under the influence of female sex hormones and are therefore subject to the typical monthly rhythm. While the built-up mucous membrane can be discharged via the vagina during menstruation, the small bleedings from the endometriosis lesions remain in the abdomen and can cause pain, but also cysts and adhesions.
Frequent complaints
Endometriosis often causes pain during menstruation (dysmenorrhoea). This can vary in severity and can also be accompanied by heavier bleeding.
Bleeding that is too heavy or too long - especially in conjunction with painful periods - can also indicate endometriosis.
More than 25 per cent of all women with an unfulfilled desire to have children have endometriosis in various stages. The cause is usually the (non-bacterial) inflammation and adhesion of the female reproductive organs caused by the endometriosis lesions: uterus, fallopian tubes and ovaries.
You can find detailed information on the website of the UniFee Fertility Centre.
It is not uncommon for affected women to report recurring lower abdominal pain independent of the menstrual cycle, which is caused by adhesions between different organs.
Another common symptom is pain during sexual intercourse (dyspareunia). As the endometriosis lesions often occur in the area between the uterus and the back of the vagina and cause inflammation there, sexual intercourse can be very uncomfortable for the woman.
If specific organs (bowel, bladder or ureter) are affected, pain may occur during bowel movements (dyschezia) or urination (dysuria).
Diagnostics for endometriosis
At our Endometriosis Centre, we offer all modern diagnostic procedures, if necessary in cooperation with other specialist disciplines at the University Hospital. The admission consultation and gynaecological examination are important components of the diagnosis and provide initial indications as to whether endometriosis may be present. If there is sufficient suspicion of endometriosis, the diagnosis can be confirmed by laparoscopy with tissue removal and subsequent histological examination by the pathology department.
The first step in clarifying a possible endometriosis disease is a detailed discussion about the nature and duration of your symptoms and the course of the disease to date.
Close inspection and palpation of the individual organs and ligaments as part of the gynaecological examination provides a rough picture of the disease. This palpation provides important information about the severity and localisation of the disease.
Each physical examination is followed by an ultrasound examination of the pelvic cavity. The uterus, fallopian tubes and ovaries with possible changes - due to endometriosis - can be visualised here. If additional information is required, a magnetic resonance imaging (MRI) scan in the radiology department can be helpful. An MRI can answer the question of whether there are changes in the kidneys or ureters, for example.
If you are suspected of having endometriosis after the consultation and examination, it is often necessary to confirm this suspicion by taking a sample. To take such a sample, a camera is inserted through the navel under a brief anaesthetic (known as a laparoscopy) and the abnormal tissue is removed. During this routine operation, we can simultaneously assess the extent of the disease and then discuss the next therapeutic steps with you.
Treatment of endometriosis
After careful examination and detailed counselling, we create an individual treatment plan for each patient that takes her needs and wishes into account. Important factors here are the patient's age, her symptoms, any desire to have children and the severity of the disease.
The treatment of endometriosis is usually based on several pillars. In addition to the surgical removal of endometriosis lesions using minimally invasive surgical procedures, drug therapy for this hormone-dependent disease is an important pillar.
To alleviate the symptoms, hormonal therapy can be carried out with or without a combination of pain therapy. The choice of a suitable preparation depends, among other things, on whether or not there is also a desire for contraception or whether or not there are plans to fulfil the desire to have children in the near future. The following are therefore available:
Progestogen monopreparations
They lead to atrophy of the uterine lining (drying out of the endometriosis centres) and to the absence of menstrual bleeding, so that the typical symptoms during menstruation cease. The lower abdominal pain often stops completely. The progestogen monopreparations are available as oral, intradermal or intrauterine preparations. There are also some with and without contraceptive protection.Combined oestrogen-progestogen preparations
These preparations generally correspond to contraceptive pills. They are preferred for endometriosis if contraception is important and/or if the progestogen-only monopreparations are not well tolerated.Gonadotropin-releasing hormone agonists (GnRH agonists)
These preparations are very effective against the symptoms of endometriosis, but are only used for a short time before fertility treatment or immediately after an operation due to side effects such as menopausal symptoms.
It is important that the choice of a suitable preparation is made together with you and that you receive counselling from us regarding the advantages and disadvantages, including side effects. It is also beneficial to liaise closely with colleagues in private practice, who have often already started this type of therapy and will continue to treat you in the further course.
We offer the full range of minimally invasive surgical procedures to remove existing endometriosis lesions:
Conventional laparoscopy (laparoscopy)
Da Vinci surgical robot
Almost every operation for the treatment of endometriosis is performed at our centre using minimally invasive techniques. The advantages for the patient are obvious: fewer scars, less pain, rapid recovery after the operation. But minimally invasive techniques are also advantageous for the surgeon: thanks to ultra-high resolution, a 3D camera and the option of magnification, important structures in the body can be visualised with millimetre precision and spared. The entire team in the operating theatre, from the surgical nursing staff to the anaesthetist, is very familiar with the method, which means that these operations are very routine. This significantly reduces the risk of complications and shortens the operation time. This ultimately benefits our patients.
Interdisciplinary endometriosis board
We have established an endometriosis board for complex issues and major surgical procedures. Here we discuss the best treatment strategy together with surgeons, urologists and radiologists.
More than 25 per cent of all women with an unfulfilled desire to have children have endometriosis in various stages. If you wish to have children, we can arrange an immediate consultation for you at our UniFee Fertility Centre.
Endometriosis and fertility treatment at the University Women's Clinic Ulm - this means a successful symbiosis for our patients: the safety of interdisciplinary treatment at the high scientific level of a university clinic, combined with a trusting atmosphere and personalised service.
For the holistic treatment of our patients, we have access to a broad internal and external network, from the pain outpatient clinic to complementary therapies such as acupuncture and osteopathy. The advantages of this interdisciplinary cooperation are obvious: care is centralised in the Women's Clinic - from here we coordinate the necessary appointments in other departments for you in a timely manner.
Additional services
- Pain therapy for chronic pain
- Accompanying psychosomatic therapy/psychotherapy for long-term pain experiences
- Physiotherapy for the treatment of tension
- Complementary (supportive) therapies such as acupuncture, homeopathy, osteopathy and TCM (Traditional Chinese Medicine)
- Social counselling service for questions about rehabilitation measures and other assistance
Endometriosis is one of the most common gynaecological diseases, affecting up to ten percent of women of childbearing age. Nevertheless, it often takes several years before the correct diagnosis is made. This is not least due to the fact that the symptoms of this benign disease are very variable in their form and intensity.
Endometriosis is the appearance of endometrium outside the uterus, particularly on the peritoneum of the female pelvis. These endometriosis centres react under the influence of female sex hormones and are therefore subject to the typical monthly rhythm. While the built-up mucous membrane can flow out via the vagina during menstruation, the small bleedings from the endometriosis lesions remain in the abdomen and can cause pain and adhesions.
In addition to the peritoneum, pelvic organs such as the ovaries, fallopian tubes, intestines, ureters and bladder are common localisations of endometriosis. However, foci of endometriosis can also be found in the uterine muscles (adenomyosis). Foci outside the abdomen (e.g. lungs, skin) are a rarity.
Despite intensive research, the exact cause of endometriosis remains unclear. One theory is that during menstruation, individual cells travel "backwards" via the fallopian tubes into the abdominal cavity and grow there in the peritoneum or on organs in the pelvis.
A clear genetic inheritance has not yet been proven, but a familial clustering is often observed.
Patients with endometriosis can have difficulties getting pregnant in the normal way. The close cooperation - door to door - with our UniFee Fertility Centre enables you to address this issue during the initial consultation. Very often, endometriosis therapy can make pregnancy possible.
The diagnosis of "endometriosis" can only be confirmed by obtaining a tissue sample (histology) using laparoscopy. However, laparoscopy should be performed with extreme caution, especially in young women (< 20 years). In these cases, treatment is initially carried out using hormone therapy (see above), especially if the gynaecological examination is unremarkable.
For comprehensive interdisciplinary care and treatment, we work closely with the UniFee Fertility Centre at the Women's Clinic, various specialist disciplines at the University Hospital (urology, radiology, surgery, pain outpatient clinic) and external cooperation partners at the Endometriosis Centre. If required, experienced therapists and counsellors from various fields are also available to you as part of an inpatient stay.
Kinderwunsch
UniFee - Kinderwunsch | Fertility and Endocrinology
Clinic for Gynaecology and Obstetrics
Prittwitzstraße 43 | 89075 Ulm
www.unifee.de
Rehabilitation
Social Counselling Service | Ulm University Hospital
Albert-Einstein-Alle 23 | 89081 Ulm
Find out more "
Psychosomatic Medicine
Clinic for Psychosomatic Medicine and Psychotherapy
Albert-Einstein-Allee 23 | 89081 Ulm
www.uniklinik-ulm.de/psychosomatik
Physiotherapy
Clinic for Gynaecology and Obstetrics
Prittwitzstraße 43 | 89075 Ulm
Find out more "
Pain therapy
Clinic for Anaesthesiology
Pain Therapy Section
Albert-Einstein-Allee 23 | 89081 Ulm
www.uniklinik-ulm.de/anaesthesiologie
Surgery
Clinic for General and Visceral Surgery
Albert-Einstein-Allee 23 | 89081 Ulm
www.uniklinik-ulm.de/allgemein-und-viszeralchirurgie
Urology
Clinic for Urology
Albert-Einstein-Allee 23 | 89081 Ulm
www.uniklinik-ulm.de/urologie
Radiology
Clinic for Diagnostic and Interventional Radiology
Albert-Einstein-Allee 23 | 89081 Ulm
www.uniklinik-ulm.de/radiologie
Pathology
Institute of Pathology
Albert-Einstein-Allee 23 | 89070 Ulm
www.uniklinik-ulm.de/pathologie
Homeopathy / Traditional Chinese Medicine
Naturopath Ute Heilmann-Fuchs
Frauenstraße 51 | 89073 Ulm
Phone 0731 / 966510
Osteopathy
Practice for physiotherapy and osteopathy
Steigstraße 1 | 89537 Giengen
Phone 07322 / 9566848
www.heidecker-stein.de
Self-help groups
Endotreff Ulm
FrauENDOmäne, would you like to talk about endometriosis and get help, information and tips? Then you've come to the right place. Our meetings take place every 1st Friday of the even month. We look forward to meeting you.
If you have any questions about the meeting, please contact our member Manuela: endotreff.ulm@gmail.com
Landesnetzwerk Endometriose Baden-Württemberg
Contact: Rosi Batzler | endo@basieg.de
www.basieg.de/lnw/
The Landesnetzwerk Endometriose BW is a self-help initiative at state level in Baden-Württemberg that has been in existence for 15 years. The initiative is an association of affected women to publicise the disease and the possibilities of self-help at state level in Baden-Württemberg and to further expand and develop the possibilities of self-help.
Our centre has been certified as a clinical endometriosis centre (level II) by the Endometriosis Research Foundation (SEF) since November 2014. The award is proof of a high level of quality in the diagnosis and treatment of endometriosis.
