Our Summary

This research paper is about finding the best ways to control bleeding during a common type of surgery called laparoscopic myomectomy, which is used to remove uterine fibroids (non-cancerous growths in the womb). The researchers found that using a substance called vasopressin and a type of stitching material known as barbed sutures can help reduce blood loss during the operation. However, using a drug called tranexamic acid (TXA) didn’t make much difference. They also found that blocking the blood supply to the uterus (uterine artery occlusion) or rapidly blocking blood vessels in emergencies (embolization techniques) might also help control bleeding. But more research is needed to confirm how well these methods work.

FAQs

  1. What is the main goal of the research paper on laparoscopic myomectomy?
  2. What substances or techniques were found to be effective in controlling bleeding during a laparoscopic myomectomy?
  3. What is the effectiveness of tranexamic acid (TXA) in controlling blood loss during the operation?

Doctor’s Tip

A helpful tip a doctor might tell a patient about myomectomy is to discuss with your surgeon the different methods they will use to control bleeding during the surgery. It is important to ask about the potential risks and benefits of each method and how it may affect your recovery. Additionally, make sure to follow your surgeon’s pre-operative instructions to help reduce the risk of complications during and after the procedure.

Suitable For

Patients who are typically recommended for a myomectomy are those with symptomatic uterine fibroids who wish to preserve their fertility or avoid a hysterectomy. Symptoms of uterine fibroids may include heavy menstrual bleeding, pelvic pain or pressure, frequent urination, and difficulty getting pregnant. Myomectomy may be recommended for patients who have tried other treatments for fibroids, such as medication or hormonal therapy, and have not found relief. Additionally, patients who have large fibroids that are causing significant symptoms or complications, such as pelvic pain or pressure, may also be recommended for a myomectomy.

Overall, the decision to recommend a myomectomy will depend on the individual patient’s symptoms, medical history, and goals for treatment. It is important for patients to discuss their options with their healthcare provider to determine the best course of action for their specific situation.

Timeline

Before myomectomy:

  1. Patient consults with a gynecologist about symptoms such as heavy menstrual bleeding, pelvic pain, or pressure.
  2. Gynecologist performs a physical exam and may order imaging tests to confirm the presence of uterine fibroids.
  3. Patient discusses treatment options with the gynecologist, including myomectomy as a surgical option.
  4. Patient undergoes pre-operative evaluation, which may include blood tests, imaging studies, and other pre-operative preparations.

After myomectomy:

  1. Patient undergoes laparoscopic myomectomy surgery to remove uterine fibroids.
  2. During surgery, vasopressin and barbed sutures are used to control bleeding.
  3. Patient may experience post-operative pain and discomfort, which can be managed with pain medication.
  4. Patient is monitored for any complications, such as infection or excessive bleeding.
  5. Patient may be discharged from the hospital within a few days after surgery, depending on the recovery process.
  6. Patient may need to follow up with the gynecologist for post-operative care and monitoring of any potential recurrence of fibroids.

What to Ask Your Doctor

  1. What is a myomectomy and why do I need it?
  2. What are the risks and benefits of undergoing a myomectomy?
  3. Are there alternative treatment options available for my condition?
  4. How will my recovery process look like and how long will it take?
  5. What are the potential complications associated with a myomectomy?
  6. Will I be able to have children after undergoing a myomectomy?
  7. What type of anesthesia will be used during the surgery?
  8. What surgical techniques will be used during the myomectomy?
  9. How will bleeding be controlled during the surgery?
  10. What is the success rate of the procedure and what are the chances of the fibroids recurring in the future?

Reference

Authors: Barbosa PA, Villaescusa M, Andres MP, Fernandes LFC, Abrão MS. Journal: Curr Opin Obstet Gynecol. 2021 Aug 1;33(4):255-261. doi: 10.1097/GCO.0000000000000725. PMID: 34148975