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Uterusmyome—Behandlungsoptionen aus der Sicht des Gynäkologen

  • Uterusembolisation
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Zusammenfassung

Uterusmyome sind die häufigste benigne Raumforderung im weiblichen Genitaltrakt, 20% aller Frauen über 35 Jahren sind davon betroffen. Meist sind sie asymptomatisch, Myome können jedoch auch zu Meno-, Metrorrhagien, Hyper- und Dysmenorrhoe sowie Beschwerden bei Miktion und Defäkation führen. Während bei fehlender klinischer Symptomatik und insuspektem Befund kein therapeutischer Handlungsbedarf besteht, wird bei klinischer Symptomatik die Indikation zur therapeutischen Intervention gestellt. Neben der medikamentösen Therapie mit Gestagenen und GnRH-(Gonadotropine-releasing-hormone-)Analoga ist die Operation das Verfahren der Wahl. Während bei abgeschlossener Familienplanung eine Hysterektomie sinnvoll ist, wird bei Wunsch nach Organerhalt eine Myomenukleation durchgeführt, wobei endoskopische Verfahren und ein abdominaler Zugangsweg gewählt werden können. Die radiologisch interventionelle Myomembolisation stellt aufgrund ihrer geringeren Invasivität eine interessante Alternative dar.

Abstract

Uterine fibroids are the most common benign tumour affecting the female reproductive tract, 20% of all women older than 35 years are afflicted. Patients with fibroids tend to be asymptomatic, but fibroids may lead to meno-, metrorrhagia, hyper- and dysmenorrhoea and urination and defecation problems. If the fibroids do not cause any clinical symptoms and if there is no suspicion of a malignant tumor, there is no need for therapeutic intervention. Otherwise, besides the medical management with gestagenes and GnRH (gonadotropin-releasing hormone) analog, surgery represents the classical treatment. Hysterectomy is the common approach for women with completed family planning. For women who wish to conserve their fertility enucleation of the fibroids can be considered. These surgical procedures can be performed endoscopically or abdominally. Uterine artery embolisation, a radiological intervention, is less invasive and represents an interesting therapeutic alternative.

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Authors and Affiliations

  1. Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Großhadern, Ludwig-Maximilians-Universität München

    K. Middendorf, A. Burges, A. Strauss & H. Hepp

  2. Klink und Poliklinik für Frauenheilkunde und Geburtshilfe, Großhadern, Klinikum der Universität, Marchioninistr. 15, 81377 , München

    K. Middendorf

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  1. K. Middendorf
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  2. A. Burges
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  3. A. Strauss
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  4. H. Hepp
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Correspondence to K. Middendorf.

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Middendorf, K., Burges, A., Strauss, A. et al. Uterusmyome—Behandlungsoptionen aus der Sicht des Gynäkologen. Radiologe 43, 615–623 (2003). https://doi.org/10.1007/s00117-003-0936-1

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  • DOI: https://doi.org/10.1007/s00117-003-0936-1

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