RecruitingNot ApplicableNCT07526311

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

Bilateral Uterine Artery Ligation Versus Pericervical Mechanical Tourniquet Application in Reducing Intraoperative Blood Loss During Transabdominal Myomectomy.

Sponsor

Cairo University

Enrollment

40 participants

Start Date

Apr 10, 2026

Study Type

INTERVENTIONAL

Conditions

Myoma;Uterus

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

Sex: FEMALEMin Age: 25 YearsMax Age: 48 Years

Inclusion Criteria8

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 Criteria11

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

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Interventions

PROCEDUREBilateral Uterine Artery Ligation

A surgical hemostatic procedure performed before myoma enucleation during transabdominal myomectomy to reduce uterine arterial blood flow and intraoperative bleeding. Bilateral ligation is carried out at the level of the internal cervical os using absorbable sutures as part of the assigned vascular control technique.

PROCEDUREPericervical Mechanical Tourniquet Application

A temporary mechanical vascular control technique performed before myoma enucleation during transabdominal myomectomy to reduce uterine blood flow and intraoperative bleeding. A sterile Foley catheter is placed around the cervico-isthmic region at the level of the internal os and removed after uterine repair and hemostasis are completed