Zusammenfassung
Uterusmyome sind gutartige Tumoren der Uterusmuskulatur, die bei mehr als einem Drittel der Frauen auftreten. Als Behandlungsmöglichkeiten stehen neben der chirurgischen Entfernung die medikamentösen, v. a. endokrinen Therapien sowie die minimal-invasiven radiologischen Interventionen zur Verfügung. In der Übersicht sollen die einzelnen Therapieansätze erklärt, diskutiert und bewertet werden.
Abstract
Myomas of the uterus are benign tumors which very often occur among fertile women. In addition to surgical intervention other treatment modalities include medicinal (endocrine) and radiological interventions. This overview will review, discuss and evaluate these modalities.
Literatur
Carbonell Esteve JL et al (2008) Mifepristone for the treatment of uterine leiomyomas: a randomized controlled trial. Obstet Gynecol 112(5):1029–1036
Donnez J et al (2012) Ulipristal acetate versus leuprolide acetate for uterine fibroids. N Engl J Med 366(5):421–432
Donnez J et al (2012) Ulipristal acetate versus placebo for fibroid treatment before surgery. N Engl J Med 366(5):409–420
Eckey T et al (2011) Non-invasive thermoablation of symptomatic uterine fibroids with magnetic resonance-guided high-energy ultrasound. Radiologe 51(7):610–619
Engman M et al (2009) Mifepristone for treatment of uterine leiomyoma. A prospective randomized placebo controlled trial. Hum Reprod 24(8):1870–1879
Felberbaum RE et al (2001) Preoperative reduction of uterine fibroids in only 16 days by administration of a gonadotrophin-releasing hormone antagonist (Cetrotide). Reprod Biomed 3(1):14–18
Fennessy FM et al (2007) Uterine leiomyomas: MR imaging-guided focused ultrasound surgery — results of different treatment protocols. Radiology 243(3):885–893
Fiscella K et al (2006) Effect of mifepristone for symptomatic leiomyomata on quality of life and uterine size: a randomized controlled trial. Obstet Gynecol 108(6):1381–1387
Flierman PA et al (2005) Rapid reduction of leiomyoma volume during treatment with the GnRH antagonist ganirelix. BJOG 112(5):638–642
Grigorieva V et al (2003) Use of a levonorgestrel-releasing intrauterine system to treat bleeding related to uterine leiomyomas. Fertil Steril 79(5):1194–1198
Gupta JK et al (2012) Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database Syst Rev 5:CD005073
Hilário SG et al (2009) Action of aromatase inhibitor for treatment of uterine leiomyoma in perimenopausal patients. Fertil Steril 91(1):240–243
Jirecek S et al (2004) Raloxifene prevents the growth of uterine leiomyomas in premenopausal women. Fertil Steril 81(1):132–136
Lethaby A et al (2001) Pre-operative GnRH analogue therapy before hysterectomy or myomectomy for uterine fibroids. Cochrane Database Syst Rev 2:CD000547
Magalhães J et al (2007) Uterine volume and menstrual patterns in users of the levonorgestrel-releasing intrauterine system with idiopathic menorrhagia or menorrhagia due to leiomyomas. Contraception 75(3):193–198
Mara M et al (2006) Uterine fibroid embolization versus myomectomy in women wishing to preserve fertility: preliminary results of a randomized controlled trial. Eur J Obstet Gynecol Reprod Biol 126(2):226–233
Marshall LM et al (1998) A prospective study of reproductive factors and oral contraceptive use in relation to the risk of uterine leiomyomata. Fertil Steril 70(3):432–439
Palomba S et al (2002) Effectiveness of combined GnRH analogue plus raloxifene administration in the treatment of uterine leiomyomas: a prospective, randomized, single-blind, placebo-controlled clinical trial. Hum Reprod 17(12):3213–3219
Palomba S et al. (2002) Raloxifene administration in premenopausal women with uterine leiomyomas: a pilot study. J Clin Endocrinol Metab 87(8):3603–3608
Parsanezhad ME et al. (2010) A randomized, controlled clinical trial comparing the effects of aromatase inhibitor (letrozole) and gonadotropin-releasing hormone agonist (triptorelin) on uterine leiomyoma volume and hormonal status. Fertil Steril 93(1):192–198
Rabe T et al. (2012) Ulipristalacetat bei symptomatischem Uterus myomatosus und bei myombedingter Hypermenorrhoe. J Reproduktionsmed Endokrinol 9(2):106–126
Steinauer J et al. (2004) Systematic review of mifepristone for the treatment of uterine leiomyomata. Obstet Gynecol 103(6):1331–1336
Tropeano G et al. (2012) Is myomectomy always the best choice for infertile women with symptomatic uterine fibroids? J Obstet Gynaecol Res 38(4):733–736
Tropeano G et al. (2008) Non-surgical management of uterine fibroids. Hum Reprod 14(3):259–274
Tropeano G et al. (2004) Uterine artery embolization for fibroids does not have adverse effects on ovarian reserve in regularly cycling women younger than 40 years. Fertil Steril 81(4):1055–1061
Wise LA et al. (2004) Reproductive factors, hormonal contraception, and risk of uterine leiomyomata in African-American women: a prospective study. Am J Epidemiol 159(2):113–123
Zapata LB et al. (2010) Intrauterine device use among women with uterine fibroids: a systematic review. Contraception 82(1):41–55
Interessenkonflikt
Keine Angaben
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wöckel, A., Scholz, C., Hancke, K. et al. Uterine Leiomyome. Gynäkologe 45, 835–840 (2012). https://doi.org/10.1007/s00129-012-2993-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00129-012-2993-x