Therapeutische Strategien bei Myomen

Der Großteil der diagnostizierten Myome erfordert keine Behandlung, da sie in nahezu allen Fällen gutartig sind. Treten jedoch Beschwerden auf wie z. B. Blutungsanomalien und Schmerzen, stehen einige Therapiemöglichkeiten zur Verfügung. Welche Behandlungsmethode gewählt wird, hängt von verschiedenen Faktoren ab, die im Folgenden, basierend auf Studiendaten, beleuchtet werden.

Kernaussagen

• Uterusmyome gehören zu den häufigsten gutartigen Tumoren bei Frauen und weisen eine Lebenszeitprävalenz von 70–80 % auf.

• Treten Komplikationen und Beschwerden auf, stehen medikamentöse, minimalinvasive und invasive Therapieoptionen zur Verfügung.

• Die Wahl der Therapiemethode hängt von den Beschwerden, der Anzahl und Größe der Myome und dem Wunsch der Patientin ab.

• Nichtsteroidale Antirheumatika und Tranexamsäure oder hormonelle Präparate wie z. B. das Levonorgestrel freisetzende Intrauterinpessar können bei starken Blutungsbeschwerden eingesetzt werden.

• Beim Einsatz von Gonadotropin-Releasing-Hormon-Präparaten muss der Flare-up-Effekt bedacht werden.

• Bei großen, multiplen oder ungünstig gelegenen Myomen ist die offene Myomenukleation die Methode der Wahl.

• Als alternative minimalinvasive Therapiemöglichkeiten erweisen sich die transzervikale Radiofrequenzablation und die laparoskopische Radiofrequenzablation als gute Behandlungsmethoden für Uterusmyome.

• Nach operativen Eingriffen muss der sichere Zeitabstand zwischen einer Myomenukleation und dem Beginn einer Schwangerschaft bedacht werden, um möglichst eine Uterusruptur zu vermeiden.

Schlüsselwörter

Uterusmyome - Myomtherapie - minimalinvasive Chirurgie - Hormontherapie

Publikationsverlauf

Artikel online veröffentlicht:
02. Oktober 2025

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