Preliminary uterine artery ligation versus pericervical mechanical tourniquet in reducing hemorrhage during abdominal myomectomy.

OBJECTIVE

To compare the effectiveness of preliminary uterine artery ligation versus pericervical mechanical tourniquet in reducing hemorrhage during myomectomy.

METHODS

A total of 103 patients undergoing myomectomy were randomly allocated to undergo preliminary uterine artery ligation (52 patients) or pericervical tourniquet (51 patients). The primary outcome measure was estimated blood loss. Secondary outcomes included duration of the operation, duration of hospital stay, postoperative hemoglobin, and the need for postoperative analgesia.

RESULTS

Operative blood loss was significantly less with uterine artery ligation compared with tourniquet (433.80+/-285.21 vs 823.23+/-237.33mL, P<0.001). The mean duration of the operation was lower in the uterine artery ligation group compared with the tourniquet group (50.5+/-8.7 vs 76.3+/-9.4 minutes, P<0.001). Postoperative hospital stay was significantly shorter in the uterine artery ligation group compared with the tourniquet group (4.1+/-0.1 vs 5.1+/-0.2 days; P<0.001). Postoperative hemoglobin concentrations and the need for postoperative analgesia were higher in the uterine artery ligation group (P=0.012 and P<0.001, respectively).

CONCLUSION

Uterine artery ligation was more effective than pericervical tourniquet as a preliminary step in reducing blood loss during abdominal myomectomy.