Preliminary uterine artery ligation versus pericervical mechanical tourniquent during abdominal myomectomy

ABSTRACT

Interventions that reduce blood loss during myomectomy are many. The effectiveness and the adverse effects of each are still under investigation. To compare preliminary uterine artery ligation versus pericervical mechanical tourniquet during abdominal myomectomy. Randomized prospective study. Two hundreds and six patients with symptomatic myomas in premenopausal and/or childbearing period attending the gynecology department, Mansoura University Hospital. Clinical examination, urine examination, blood count, liver function tests, kidney function tests and plasma glucose were carried out. Abdominal and transvaginal ultrasound were performed. The studied cases were randomly allocated into two groups; group I; 104 patients underwent preliminary uterine artery ligation and group II; 102 women underwent pericervical mechanical tourniquet during abdominal myomectomy. The operative time and operative blood loss were significantly lower in the uterine artery ligation group [P < 0.001]. Post operative reduction of haemoglobin concentrations and haematocrite values were significantly lower in uterine artery ligation group [P 0.015 for each]. Operative complications [conversion to hysterectomy, urinary tract injury, gastrointestinal were significantly lower in the uterine artery ligation group versus the touriquet [p < 0.001]. Post operative beven the need for blood transfuion and post operative analgesia were significantly highen in touriquet group [p < 0.001]