Reduction of Blood Loss During Laparoscopic Myomectomy: Uterine Artery Ligation Versus Intra-Vaginal Misoprostol

Abstract

Objectives: This study was designed to compare laparoscopic uterine artery ligation and vaginal misoprostol in reducing intra-operative blood loss during laparoscopic myomectomy and verifies the effect of uterine artery ligation by different methods upon intra-and post-operative complications of laparoscopic myomectomy.Background: laparoscopic myomectomy is a challenging surgical procedure for gynecologists. Material and Methods: The study was prospective clinical randomized trial, where 50 women with symptomatic fibroids managed with laparoscopic myomectomy with either bilateral uterine artery ligation or pre-operative misoprostol, outcome parameters in both groups were operative time, blood loss during surgery, fluid management data and post-operative period. Statistical presentation and analysis of the present study was conducted with SPSS V.20Results: a total of 50 patients of these 30 patients underwent laparoscopic myomectomy and bilateral uterine artery ligation and 20 underwent laparoscopic myomectomy after preoperative vaginal misoprostol the mean intra operative blood loss was 522.5+136.6 versus 193.8+78.7 in misoprostol versus UAL groups and there was a highly significant difference between the two groups as regarding blood loss (less in UAL group), also there was significant as regarding operative time (longer in UAL group).There was no significant difference as regarding intraoperative complications and post-operative period. Conclusion:Bilateral ligation of uterine artery has a more powerful effect than preoperative single dose of misoprostol in reducing blood loss during laparoscopic myomectomy, but bilateral ligation of uterine artery takes a longer time however no significant difference between them as regarding post-operative complications.