Effectiveness of pericervical tourniquet by Foley catheter reducing blood loss at abdominal myomectomy

Alptekın, Husnu; Efe, Duran

doi:10.12891/ceog16732014

Cited by 17 publications

(9 citation statements)

References 24 publications

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“…Only two case needed blood transfusion in the control group, while there was no need for blood transfusion in the tourniquet and epinephrine groups. This is in agreement with Alpetkin et al [22] study where blood transfusion was necessary in only two patients from the control group. Similarly, Ikechebelu et al [17] study found that mean blood transfusion rate during myomectomy for the tourniquet group was 0.24 unit which was lower than that of the notourniquet group with 1.00 unit transfusion rate.…”

Section: Discussionsupporting

confidence: 93%

“…Similar findings were reported by Alptekin et al [22] study which found that the tourniquet significantly reduced postoperative haemoglobin fall than the control group. Also, Helal et al [21] study found that the mean values for post operative haemoglobin and haemoglobin fall in the tourniquet group were (10.1g/dl, 1.4 g/dl) which are relatively similar to the results of the present study.…”

Section: Discussionsupporting

confidence: 90%

“…In the present study, the mean operative blood loss was 965.89, 552.69 and 241.25 ml in the control, tourniquet and epinephrine groups respectively. This was comparable to Ikechebelu et al [17] study where it was 515.7 ml for the tourniquet group, and to Fletcher et al [7] study where it was 512.7 ml for the tourniquet group, and relatively lower than that of Helal et al [21] study where it was 823.23 ml for the tourniquet group, and higher than Alpetkin et al [22] study with only 286.4 ml for the tourniquet group.…”

Section: Discussionsupporting

confidence: 72%

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Effect of intramyometrial injection of epinephrine during abdominal myomectomy

Abouzeid

2021

Evidence Based Women's Health Journal

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Aim: This study aimed to assess the effectiveness of intramyometrial injection of epinephrine in reducing blood loss in abdominal myomectomy and to compare it with pericervical tourniquet. Materials and Methods: Randomized controlled study carried on sixty patients suffering from symptomatic uterine fibroids and counseled for abdominal myomectomy. The patients were randomized into 3 groups of twenty each: control, tourniquet and epinephrine groups. A comparative analysis of the intra and postoperative outcomes of these groups was performed assessing the duration of operation, the blood loss and the blood transfusion rate. Results: The epinephrine group had a statistically significant lower values of the fall in haemoglobin level and a significantly lower mean operative blood loss than the tourniquet and the control groups. Furthermore, the mean duration of operation was significantly shorter in the epinephrine group. Conclusion: Intramyometrial injection of a solution of bupivacaine (50 ml of 0.25%) plus epinephrine (0.5 ml of 1 mg/ml) is very effective in reducing intraoperative bleeding during abdominal myomectomy. This solution is significantly more effective than using Foley's urethral catheter as a pericervical tourniquet. However it offers no additional benefits over using a pericervical tourniquet regarding the need for blood transfusion.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 72%

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Effect of intramyometrial injection of epinephrine during abdominal myomectomy

Abouzeid

2021

Evidence Based Women's Health Journal

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“…However, there is evidence to suggest that a uterine tourniquet reduces bleeding during a myomectomy ( 14 , 15 , 16 ). Alptekin and Efe ( 17 ) reported a significant difference in blood loss in the no tourniquet use versus that in patients in whom a tourniquet (Foley catheter) was applied before a myomectomy, with mean blood loss of 673.8±172.3 mL and 286.4±137.5 mL, respectively. Taylor et al ( 18 ) first applied triple tourniquets at the level of the uterine cervix to ovary propriums, and they then applied a uterine tourniquet only at the level of the uterine cervix in subsequent studies.…”

Section: Discussionmentioning

confidence: 99%

Can the application of a temporary uterine tourniquet during an abdominal myomectomy reduce bleeding?

Akbaba¹,

Sezgin²,

Sivaslıoğlu³

2022

J Turkish German Gynecol Assoc

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Objective: Uterine fibroids are common, benign uterine tumours. The three most common surgical treatment approaches for uterine fibroids are laparoscopic, robotic and abdominal myomectomies. Bleeding is a risk with all three approaches. The present study compared post-operative and pregnancy outcomes in patients with bilateral uterine artery occlusion who underwent an abdominal myomectomy, with or without a temporary uterine tourniquet. Material and Methods: This retrospective study included patients with intra-mural fibroids (≥5 cm) who underwent an abdominal myomectomy. The patients were divided into two groups according to the use or non-use of a temporary uterine tourniquet. Post-operative and pregnancy outcomes in the tourniquet use and non-use groups were compared. The association of the number of uterine fibroids removed (≤3 vs >3) with laboratory parameters was also evaluated. Results: A total of 84 patients were included, divided into use (n=36) and non-use (n=48) of the temporary tourniquet. There was a statistically significant difference between the groups with >3 myomas removed and with a uterine tourniquet applied and not applied in terms of reduction in hemoglobin and hematocrit, transfusion amounts, operation times and lengths of hospitalization in favour of the uterine tourniquet use group (p=0.019, p=0.023, p=0.012, p=0.044 and p=0.036, respectively). Bilateral uterine arterial occlusion using a temporary uterine tourniquet had no negative effects on pregnancy outcomes. Conclusion: A temporary uterine tourniquet may be an effective method for reducing the amount of perioperative bleeding in patients with multiple, large-sized myomas located close to vascular structures.

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“…Ovarian blood flow was also unaffected, hence ovarian function remained unaffected. 10 The use of diluted vasopressin intramyometrial injection to minimize bleeding during hormonal tourniquet myomectomy surgeries is possible, but the total dose (20 units diluted in 20 mL normal saline) is limited, and intraoperative arterial or central monitoring is required.…”

Section: Medicationsmentioning

confidence: 99%

Procedures to Reduce Haemorrhage during Myomectomy for Fibroids

Winata

Lazarosony

2022

CDK

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<p>Uterine fibroids are the most common solid tumors in the female pelvis. Myomectomy is the first choice of treatment for woman who want to keep their uterus. Haemorrhage, uterine perforation, cervical injury, and metabolic problems from excessive absorption of the distension medium, such as glycine, are risks of hysteroscopic myomectomy. There are several procedures and techniques to reduce haemorrhage during myomectomy for fibroids. Some research demonstrated excellent outcomes with uterine artery ligation.</p><p>Mioma uteri adalah tumor jinak yang paling sering dijumpai pada wanita. Tindakan miomektomi adalah salah satu pilihan terapi pada wanita yang tetap ingin mempertahankan rahim. Perdarahan, perforasi uterus, cedera serviks dan masalah metabolisme akibat penyerapan berlebihan media distensi, seperti glisin, adalah risiko prosedur histeroskopi miomektomi. Beberapa prosedur dan teknik dapat mengurangi perdarahan saat miomektomi pada kasus mioma uteri. Beberapa penelitian menunjukkan hasil yang sangat baik dengan ligasi arteri uterina.</p>

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Effectiveness of pericervical tourniquet by Foley catheter reducing blood loss at abdominal myomectomy

Cited by 17 publications

References 24 publications

Effect of intramyometrial injection of epinephrine during abdominal myomectomy

Effect of intramyometrial injection of epinephrine during abdominal myomectomy

Can the application of a temporary uterine tourniquet during an abdominal myomectomy reduce bleeding?

Procedures to Reduce Haemorrhage during Myomectomy for Fibroids

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