Uterusarterienembolisation symptomatischer Gebärmuttermyome

Fazit

Mit der UAE steht betroffenen Frauen heute ein etabliertes und anerkanntes interventionell-radiologisches Verfahren zur Verfügung, das in der Lage ist, die oft stark beeinträchtigenden Beschwerden organerhaltend und minimal-invasiv zu heilen. Im langfristigen Verlauf von 10 Jahren profitieren über ¾ aller Frauen von der Behandlung und erleben eine Normalisierung ihrer Lebensqualität. Der vergleichsweise risikoarme Eingriff lässt sich dabei exzellent standardisieren und ist für erfahrene Interventionalisten rasch erlernbar. Vorbereitend ist die Durchführung einer MRT des Beckens einschließlich einer ergänzenden MR-Angiografie anzuraten. Erkenntnisse aus dieser sichern die Diagnose in Abgrenzung zu klinisch und sonografisch oft schwer zu differenzierenden Entitäten, helfen bei der Planung des Eingriffs und dienen der Abschätzung des postinterventionellen Verlaufs und der entsprechenden Beratung der Patientinnen, z. B. bezüglich eines möglichen vermehrten Gewebeabgangs bei Vorliegen großer submuköser Myome. Im Falle eines Kinderwunsches empfiehlt sich zunächst eine fachärztlich-gynäkologische Beratung in entsprechenden Zentren über die Möglichkeit einer operativen Myomentfernung. Ist diese nicht möglich oder mit einem hohen Risiko für eine Hysterektomie verbunden, kann auch diesen Frauen eine UAE angeboten werden. Darüber hinaus spielen Zahl und Größe der Leiomyome eine nur untergeordnete Rolle. Auch ein diffuser Organbefall oder das Vorliegen sehr großer Leiomyome ist effektiv mittels UAE behandelbar.

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