Our Summary

This research paper is a review of several different studies to determine the safety and effectiveness of using a drug called tranexamic acid (TXA) to prevent blood loss during a surgical procedure known as myomectomy.

In the reviewed studies, which included a total of 571 patients, they found that using TXA before surgery significantly reduced the amount of blood loss during and after the operation. Patients who received TXA also had higher levels of hemoglobin and hematocrit (two markers of overall blood health) after surgery.

Plus, the patients who received TXA were able to leave the hospital earlier. There was no significant difference in the length of the operation itself or the need for blood transfusions between the patients who received TXA and those who did not.

Importantly, no patients in either group developed any blood clot-related complications. However, they did find that patients who received TXA were more likely to experience nausea.

Overall, the researchers conclude that using TXA before a myomectomy is generally safe and can greatly decrease the amount of blood loss during and after the operation.

FAQs

  1. What is the purpose of using tranexamic acid (TXA) during a myomectomy?
  2. Were there any significant side effects observed in patients who received TXA before their myomectomy?
  3. What are the benefits of using TXA before a myomectomy procedure, according to the reviewed studies?

Doctor’s Tip

A helpful tip a doctor might give a patient about myomectomy is to discuss the option of using tranexamic acid (TXA) with them before the surgery. TXA has been shown to significantly reduce blood loss during and after the operation, leading to higher levels of hemoglobin and hematocrit post-surgery and potentially allowing for a quicker recovery time. However, patients should be aware that they may experience nausea as a side effect of TXA. It is important to weigh the benefits and risks of using TXA with your doctor to determine if it is the right choice for you.

Suitable For

Patients who are typically recommended for myomectomy are those who have symptomatic uterine fibroids that are causing heavy menstrual bleeding, pelvic pain, pressure, or infertility. These patients may have tried other treatments such as medication or hormone therapy without success, and their symptoms are impacting their quality of life. Additionally, patients who desire to preserve their fertility and have not had success with other minimally invasive procedures may also be recommended for myomectomy.

In particular, patients who are at a higher risk for excessive blood loss during surgery, such as those with larger fibroids or a history of heavy menstrual bleeding, may benefit from the use of TXA to help reduce blood loss and improve their surgical outcomes.

Overall, the use of TXA in myomectomy procedures may be especially beneficial for patients who are at risk for excessive blood loss, as it can help improve their recovery time and reduce the need for blood transfusions. However, it is important for healthcare providers to carefully assess each patient’s individual risk factors and medical history before recommending TXA as a preventative measure for blood loss during myomectomy.

Timeline

Before myomectomy:

  • Patient consults with their healthcare provider to discuss symptoms and treatment options
  • Patient undergoes diagnostic tests such as ultrasound or MRI to confirm the presence of fibroids
  • Patient and healthcare provider decide on surgical intervention, such as myomectomy, as the treatment plan
  • Patient may be prescribed medication to manage symptoms or prepare for surgery

After myomectomy:

  • Patient undergoes the surgical procedure, which involves removing fibroids from the uterus
  • Patient may experience pain, fatigue, and discomfort in the days following surgery
  • Patient is monitored for any potential complications, such as excessive bleeding or infection
  • Patient may be prescribed pain medication and advised to rest and avoid strenuous activities
  • Patient follows up with their healthcare provider for post-operative care and monitoring
  • Patient may experience improvements in symptoms such as heavy menstrual bleeding, pelvic pain, and pressure

Overall, myomectomy can provide relief from symptoms caused by fibroids and improve quality of life for patients.

What to Ask Your Doctor

Some questions a patient should ask their doctor about myomectomy and the use of tranexamic acid (TXA) include:

  1. What is TXA and how does it work to prevent blood loss during myomectomy?
  2. What are the potential benefits of using TXA before myomectomy?
  3. Are there any potential risks or side effects associated with using TXA during myomectomy?
  4. How will TXA be administered before and during the surgery?
  5. Will using TXA affect the length of the operation or my recovery time?
  6. Are there any specific factors or conditions that would make me ineligible for using TXA during myomectomy?
  7. Will I need any additional monitoring or follow-up care if I receive TXA during myomectomy?
  8. Are there any other options or alternatives to using TXA for preventing blood loss during myomectomy?
  9. Can you provide me with more information about the studies and research supporting the use of TXA for myomectomy?
  10. How will using TXA affect my overall surgical experience and outcomes?

Reference

Authors: Baradwan S, Hafidh B, Latifah HM, Gari A, Sabban H, Abduljabbar HH, Tawfiq A, Hakeem GF, Alkaff A, AlSghan R, Alshahrani MS, Badghish E, Abu-Zaid A. Journal: Eur J Obstet Gynecol Reprod Biol. 2022 Sep;276:82-91. doi: 10.1016/j.ejogrb.2022.07.004. Epub 2022 Jul 9. PMID: 35839714