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Medikamentöse konservative Therapie des Uterus myomatosus

Conservative drug treatment of uterine myoma

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Der Gynäkologe Aims and scope

Zusammenfassung

Die Diagnose Uterus myomatosus stellt derzeit noch die häufigste Indikation zur Hysterektomie dar. Mit dem Ziel eines organerhaltenden Vorgehens steigt jedoch die Nachfrage nach sicheren und effektiven medikamentösen Therapieoptionen. Es werden bereits verschiedene hormonelle und nichthormonelle Therapien eingesetzt, für die Myomtherapie zugelassen sind jedoch nur GnRH(„gonadotropin-releasing hormone“)-Analoga und der selektive Progesteronrezeptormodulator (SPRM) Ulipristalacetat (UPA). Beide Substanzklassen führen innerhalb von Tagen bis Wochen zu einem Blutungsstopp sowie, bei längerfristiger Anwendung, zu einer Reduktion des Myomvolumens. Aufgrund des jeweiligen Nebenwirkungsprofils ist die Anwendung zeitlich begrenzt empfohlen.

Abstract

The diagnosis of uterine myoma is still the most frequent indication for hysterectomy; however, the demand for safe and effective medicinal treatment options increases with the aim of an organ-preserving approach. Various hormone and non-hormone therapies are already successfully used in practice but only gonadotropin-releasing hormone (GnRH) analogues and the selective progesterone receptor modulator (SPRM) ulipristal acetate (UPA) are officially approved for treatment of uterine fibroids. Both substance classes lead to cessation of abnormal uterine bleeding within days to weeks and longer term use leads to a reduction of the myoma volume. Due to the respective side effects, it is recommended to use both substances for a limited time only.

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Authors and Affiliations

  1. Allgemeine Frauenheilkunde und Geburtshilfe, Universitäts-Frauenklinik, 69120, Heidelberg, Deutschland

    Markus Wallwiener MHBA

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  1. Markus Wallwiener MHBA
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Correspondence to Markus Wallwiener MHBA.

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M. Wallwiener erhielt Honoraria für Kongressbeiträge.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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R. Felberbaum, Kempten

W. Küpker, Bühl

T. Strowitzki, Heidelberg

M. Kiechle, München

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Wallwiener, M. Medikamentöse konservative Therapie des Uterus myomatosus. Gynäkologe 52, 280–287 (2019). https://doi.org/10.1007/s00129-019-4399-5

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