Bilateral Uterine Artery Ligation versus Pericervical Mechanical Tourniquet in Decreasing Blood Loss in Trans-Abdominal Myomectomy: Randomized Controlled Trial

Abstract

Fibroids are tumor of the smooth muscles and the connective tissues of the uterus. It is the most common benign pelvic tumor affecting about 20% of women above 35 years of age. The diverse symptomatology of fibroids can be attributed to size, number and location of the tumors. The common symptoms include menorrhagia, infertility, abdominal mass and pressure effects. Recent advances have increased the treatment options available however surgery remains the main stay of treatment especially in symptomatic patients. The most serious complication during abdominal myomectomy is severe intraoperative hemorrhage. Uncontrolled hemorrhage may necessitate hysterectomy. Thus several methods are employed to decrease blood loss during myomectomy operation. This study compared the effect of Preliminary Uterine artery ligation and peri-cervical tourniquet on blood loss during myomectomy operation. The study was conducted in Ain Shams University Maternity Hospital where 100 patients fulfilling the criteria of the study were recruited from the gynecology outpatient clinic of the hospital. After enrollment, an informed written consent was taken from all participants before recruitment in the study, and after explaining the purpose, possible risks and complications (including possibility of blood transfusion and the possible need for hysterectomy) of different procedures carried out in the study.