Our Summary

This study looks at whether a drug called tranexamic acid (TA) can reduce the amount of blood loss during and after the surgical removal of fibroids (non-cancerous growths in the uterus). The researchers looked at past studies up until June 3, 2017, which included women of childbearing age who had this surgery, and either received TA or a different treatment. They found that TA significantly lowered the amount of blood lost during and after the surgery compared to no treatment or a placebo. However, it didn’t make a significant difference in the need for blood transfusions. Furthermore, for women who had a different type of fibroid removal surgery (hysteroscopic myomectomy), TA didn’t improve the need for blood transfusions and actually resulted in lower levels of hemoglobin (a protein that carries oxygen in the blood) after the surgery compared to another drug, oxytocin. Overall, TA seems to help reduce blood loss in certain types of fibroid removal surgeries, but not in others.

FAQs

  1. What is the purpose of tranexamic acid (TA) in the surgical removal of fibroids?
  2. Does tranexamic acid (TA) reduce the need for blood transfusions during fibroid removal surgeries?
  3. Does the effectiveness of tranexamic acid (TA) vary depending on the type of fibroid removal surgery?

Doctor’s Tip

A doctor might tell a patient undergoing myomectomy to discuss with them the option of using tranexamic acid to help reduce blood loss during and after the surgery. This medication has been shown to be effective in lowering blood loss in certain types of fibroid removal surgeries, potentially reducing the need for blood transfusions. It is important to have a conversation with your healthcare provider about the potential benefits and risks of using tranexamic acid during your procedure.

Suitable For

Patients who are typically recommended myomectomy are those who have symptomatic fibroids that are causing heavy menstrual bleeding, pelvic pain, or pressure on the bladder or bowel. Myomectomy may be recommended for women who wish to preserve their fertility and have not responded to other conservative treatment options. Additionally, myomectomy may be recommended for women who have large fibroids that are causing significant symptoms and impacting their quality of life.

Timeline

Before myomectomy:

  1. Patient experiences symptoms such as heavy menstrual bleeding, pelvic pain, and pressure.
  2. Patient consults with a healthcare provider who recommends a myomectomy to remove fibroids.
  3. Patient undergoes pre-operative testing and preparation for surgery, which may include blood tests, imaging studies, and a physical examination.
  4. Patient discusses the risks and benefits of the surgery with their healthcare provider and signs a consent form.
  5. Patient may be advised to stop certain medications or make lifestyle changes before the surgery.

After myomectomy:

  1. Patient undergoes the myomectomy procedure to remove the fibroids from the uterus.
  2. Patient is monitored in the recovery room and may stay in the hospital for a few days for observation.
  3. Patient may experience pain, swelling, and discomfort in the days following the surgery.
  4. Patient is prescribed pain medication and given instructions on how to care for the surgical incision.
  5. Patient may need to follow up with their healthcare provider for post-operative appointments to monitor healing and recovery.
  6. Patient may experience improvements in symptoms such as heavy menstrual bleeding and pelvic pain after the fibroids are removed.

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. What are the different types of myomectomy procedures and which one is most suitable for me?
  4. How will my recovery process be like after the surgery?
  5. Will I experience any long-term effects or complications from the surgery?
  6. What is the role of tranexamic acid in reducing blood loss during and after the surgery?
  7. Are there any alternative treatments or medications that can achieve the same effect as tranexamic acid?
  8. Will I need a blood transfusion during or after the surgery?
  9. How will the use of tranexamic acid affect my overall outcome and recovery compared to other options?
  10. Are there any specific precautions or follow-up care I need to take after receiving tranexamic acid during the surgery?

Reference

Authors: Fusca L, Perelman I, Fergusson D, Boutet M, Chen I. Journal: J Obstet Gynaecol Can. 2019 Aug;41(8):1185-1192.e1. doi: 10.1016/j.jogc.2018.04.007. Epub 2018 Oct 29. PMID: 30385210