The effect of uterine artery ligation during myomectomy on complications during and after surgery

Document Type : Original Article

Authors

1 Assistant Professor, Department of General Surgery, Faculty of Medicine, Yasuj University of Medical Science, Yasuj, Iran.

2 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Resident, Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

4 M.Sc. in Molecular Genetics, Molecular Laboratory of Kashan Health Center, Kashan, Iran.

5 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

10.22038/ijogi.2025.79153.6052

Abstract

Introduction: Uterine myoma is a series of masses which are mainly composed of uterine tissue. The presence of these masses causes dysfunction of the reproductive system that in many cases requires surgery. The present study was conducted with aim to compare the outcomes during and after myomectomy in women with and without uterine artery ligation.
Methods: This clinical trial study was conducted on 30 patients aged 29-48 years with symptomatic uterine myoma (intramural myoma) who had referred to Arash Hospital, Tehran, between 2012 and 2013. The subjects were randomly assigned to the two groups: uterine artery ligation and non-ligation. The primary outcome included mean hemoglobin level, mean blood loss during surgery, as well as FSH indices, serum LH estradiol levels, and uterine perfusion parameters (pulsation index and resistance index). Data were analyzed using SPSS statistical software (version 22) and Chi-square and Mann-Whitney tests. P<0.05 was considered significant.
Results: The mean bleeding (p=0.001) and hemoglobin drop (p=0.034) in patients with uterine artery ligation was significantly lower than in women without ligation. The difference in serum levels of FSH, LH, and estradiol was not significant in the two groups before and after surgery and between the two groups (p>0.05). The pulse and resistance index of the two groups increased significantly after the surgery, and the difference between the two groups in terms of resistance index was significant three months after the surgery (p<0.05), but the resistance and pulse index between the two groups did not show a significant difference at other times (p>0.05).
Conclusion: Uterine ligation during myomectomy in women with myoma reduces blood loss during the surgery and reduces hemoglobin levels after the surgery and have no effect on hormones.

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Main Subjects

References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 27, Issue 12
February 2025
Pages 11-19

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