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Geburtshilfe Frauenheilkd 2004; 64(10): R229-R244
DOI: 10.1055/s-2004-830411
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Georg Thieme Verlag KG Stuttgart · New York

Myome - Teil 1

Epidemiologie, Ätiologie und KlinikA. Müller1 , F. Thiel1 , H. Binder1 , R. Strick1 , R. Dittrich1 , P. Oppelt1 , M. W. Beckmann1
  • 1Frauenklinik, Universitätsklinikum Erlangen
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Publication Date:
11 October 2004 (online)

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Epidemiologische Aspekte

Myome des Uterus sind die häufigsten soliden Tumoren der Frau. Sie sind hormonabhängig und durch ein gutartiges Wachstum charakterisiert. Bei ca. 20 - 30 % aller Frauen über 30 Jahre finden sich Myome des Uterus. Die Zahl steigt bei 40-jährigen Frauen auf über 40 % an [[150]]. Bei 1245 durchgeführten Hysterektomien wiesen 69 % der Patientinnen Myome auf [[74]]. Durch ihre Hormonabhängigkeit

Die Hormonabhängigkeit macht die gutartigen Myome zu einem Problem der Frau im reproduktiven Alter.
stellen Myome ein Problem der Frau im reproduktiven Alter dar. Dennoch muss davon ausgegangen werden, dass die meisten Myome klein und asymptomatisch sind und keiner medizinischen Intervention bedürfen. Im Rahmen von Autopsien fanden sich Myome bei 77 % aller Frauen [[25]]. Größere Myome bzw. solche mit entsprechender Lokalisation können symptomatisch werden und sind häufig der Grund für operative Eingriffe [[166]].

Auffällige Myome sind häufig assoziiert mit folgenden Symptomen

Symptome der Myome: Schmerzen, Blutungsunregelmäßigkeiten, rezidivierende Aborte, Sterilität. Die meisten Myome sind asymptomatisch.
: Schmerzen, Blutungsunregelmäßigkeiten, rezidivierenden Aborten und Sterilität [[52], [120]]. Die Probleme, die durch Myome hervorgerufen werden, sind der häufigste Grund für die Entfernung der Gebärmutter. In den USA wie auch in Deutschland sind Myome der Grund für ein Drittel aller durchgeführten Hysterektomien. Dies entspricht jährlich ca. 200 000 Hysterektomien in den USA [[60], [200]]. Im Jahr 2000 war die Diagnose Leiomyome des Uterus mit insgesamt 94 066 auf Rang 13 aller Krankenhausdiagnosen bei Frauen in Deutschland [[175]].

Myome werden bei Schwarzen 2-mal häufiger diagnostiziert als bei Weißen, während die Häufigkeit bei Asiatinnen und Latinos mit der von Weißen vergleichbar ist. Die höchste Inzidenz wird für Weiße zwischen dem 40. und 44. Lebensjahr angegeben. Trotz der hohen durch Myome verursachten Morbidität ist über die komplexe molekulare Ätiologie der uterinen Myome bisher wenig bekannt [[166]].

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Dr. med. Andreas Müller

Frauenklinik, Universitätsklinikum Erlangen

Universitätsstraße 21 - 23

91054 Erlangen

Email: andreas.mueller@gyn.imed.uni-erlangen.de