Reducing Blood Loss During Myomectomy:Uterine Artery Ligation Vs Pericervical Tourniquet

Summary

The goal of this clinical trial is to compare two surgical techniques for reducing blood loss during transabdominal myomectomy in women with symptomatic uterine fibroids. The main question it aims to answer is whether bilateral uterine artery ligation reduces intraoperative blood loss more effectively than pericervical mechanical tourniquet application, without increasing operative complications. Researchers will compare bilateral uterine artery ligation with pericervical mechanical tourniquet application during open myomectomy to evaluate blood loss and surgical safety. Participants will undergo elective transabdominal myomectomy and will be randomly assigned to one of the two vascular control techniques before myoma enucleation.

Eligibility

* Inclusion Criteria:

  * Female participants aged 25 to 48 years
  * Body mass index less than 35 kg/m²
  * Symptomatic uterine myomas requiring surgical treatment
  * Intramural myomas classified as FIGO types 3 to 6
  * Diagnosis confirmed by transvaginal ultrasound and/or magnetic resonance imaging
  * Maximum diameter of the largest myoma 20 cm or less
  * Scheduled for elective transabdominal myomectomy
  * Able and willing to provide written informed consent
* Exclusion Criteria:

  * Submucosal, intracavitary, pedunculated subserosal, cervical, or adnexal myomas
  * FIGO types 0, 1, 2, 7, or 8 myomas
  * History of pelvic inflammatory disease or peritonitis
  * Previous abdominal or pelvic surgery for non-obstetric causes
  * Previous uterine surgery
  * Use of hormonal therapy within the previous 3 months
  * Known bleeding disorder
  * Use of anticoagulant or antiplatelet therapy
  * Preoperative hemoglobin less than 10 g/dL
  * Body mass index 35 kg/m² or greater
  * Intraoperative conversion from myomectomy to hysterectomy

Conditions3

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