Symptoms and General Pathology

All Conditions

Neoplasms

Skin and Connective Tissue Diseases

Hemorrhage

Leiomyoma

Myofibroma

Blood Loss, Surgical

Myoma

Neoplasms, Connective and Soft Tissue

Neoplasms by Histologic Type

Neoplasms, Connective Tissue

Connective Tissue Diseases

Coagulants

All Drugs and Chemicals

Hemostatics

Single tourniquet is tourniquet applied uterine isthmus to occlude the uterine arteries. For this purpose, a small opening is made in the avascular place of the broad ligament on either side of the uterine isthmus superior to the uterine vessels. A pediatric Foley catheter is threaded through the two holes and tied tightly anteriorly around the cervix at the level of the internal os.

Single tourniquet

Triple tourniquet consist of two tourniquet applied both infundibulopelvic ligaments and one uterine isthmus to occlude the left and right ovarian vessels and to occlude the uterine arteries. For this purpose, a small opening is made in the avascular place of the broad ligament on either side of the uterine isthmus superior to the uterine vessels. A pediatric Foley catheter is threaded through the two holes and tied tightly anteriorly around the cervix at the level of the internal os.

Through the same openings in the broad ligament each side a Foley catheter looped around the infundibulopelvic ligament lateral to the fallopian tube and ovary.

Triple tourniquet

Neset Gümüsburun, MD

The aim of study is to compare triple tourniquet vs. single tourniquet to reduce blood loss at open myomectomy.

Single or Triple Uterine Tourniquet at Myomectomy

Triple Tourniquet vs. Single Tourniquet to Reduce Haemorrhage During Myomectomy: a Prospective Randomised Controlled Trial

Anti-Mullerian Hormone levels before surgery, 6 months and 12 months after surgery

Surgical blood loss will be estimated by sum of the volume of suction fluid and blood loss quantitated by gravimetric method.

Suction fluid will be measured at the end of operation and volume of irrigation fluid will be subtracted from total suction volume.

◦Surgical drapes, sponges and towels will be weighted before and just after surgery. The blood loss will be estimated as differences in gram by weighing when 1ml blood supposed as 1.06 gr.

Erythrocyte transfusions will be allowed when haemoglobin dropped below 8 g/dL.

Drain will be removed when discharge drops below 50 ml/day

Including but not limited to fever, pelvic infections, wound infections.

Ragıp Atakan Al

Assoc.Prof

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Infertility

Pain

morcellation hysteroscopy with intravenous sedation and paracervical bloc

morcellation hysteroscopy with only intravenous sedation

vaginal distension with hysteroscope for hysteroscopy morcellation (without speculum or tenaculum forceps)

vaginoscopy

speculum, paracervical block before hysteroscopy morcellation

standard hysteroscopy

Carole KAMGA-NGANDE, MD

This study is a randomized controlled trial take place in a fertility outpatient clinic in an academic hospital. Women between 18 and 52 years old requiring polypectomy or myomectomy by hysteroscopy morcellation for abnormal uterine bleeding or for fertility issue are included. The aim is to evaluate pain perception between vaginal and traditional hysteroscopy for hysteroscopic morcellation. The investigator's hypothesis is that pain perception is lower using vaginoscopy compared to traditional hysteroscopy.

78 participants will be randomised in two groups:

1. traditional hysteroscopy: under intravenous sedation, hysteroscopic morcellation is perform after speculum insertion, vaginal cleansing, and paracervical anesthesia with xylocain 1%.
2. Vaginal hysteroscopy: under intravenous sedation, hysteroscopic morcellation is perform after vaginal cleansing using vaginal distension with saline solution

In addition to pain perception, other outcomes includes: complication rates, time to continue fertility treatment, time to pregnancy

Vaginoscopy Compared to Traditional Hysteroscopy for Hysteroscopy Morcellation in Outpatient Clinic. A Randomized Trial

Pain Perception During Vaginoscopy Compared to Traditional Hysteroscopy for Hysteroscopy Morcellation in Outpatient Clinic: A Randomized Trial

10 point visual analog pain scale: 0 for no pain to 10 for unbearable pain

length of time in minutes between start and end of procedure including morcellation

Presence of jerky abnormal movements or a slow weak pulse rate associated to at least one symptoms: nausea, pale skin, blurred vision, warm feeling or cold sweat.

presence of one or more signs during intervention: extension of the instrument goes beyong the limitation of the uterus, loss of resistance, sudden loss of vision, direct visualisation of the perforation

length of time in months to continue fertility treatment after procedure

length of time in months to be pregnant after procedure

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Single or Triple Uterine Tourniquet at Myomectomy	NCT02392585	Uterine Myoma	Single tourniqu... Triple tourniqu...	18 Years - 48 Years	Ataturk University
Vaginoscopy Compared to Traditional Hysteroscopy for Hysteroscopy Morcellation in Outpatient Clinic. A Randomized Trial	NCT04373694	Leiomyoma of Ut...	vaginoscopy standard hyster...	18 Years - 52 Years	Centre hospitalier de l'Université de Montréal (CHUM)

Spots Global Cancer Trial Database for leiomyoma of uterus