The effect of iv tranexamic acid on blood loss during myomectomy

Abstract

Regarding myomas presenting with clinical symptoms the rate is about 33% according to literature with the remaining population being incidentally detected. These symptoms may range from variable amounts of uterine bleeding to clinically significant anemia, persistant pelvic pressure, pain, urinary disfunction and infertility (1-7). Symptomatic myomas should be treated or followed according to the individual but when concerning treatment options, there is a wide spectrum available from hormonal or nonhormonal medical alternatives to surgical procedures (8). The suitable treatment method is usually determined by considering several factors such as, patient age, number of myomas, fertility preference and the symptoms of the patient. Myomectomy is the most common treatment method among women who want to remain fertile and/or to protect their uterus. Approximately 1-4% of myomectomy operations end up with hysterectomy due to uncontrollable bleeding (9). Many different methods are used in order to reduce the incidence of uncontrollable bleeding and minimize blood loss (10,11). The use of intraoperative iv tranexamic acid (TXA) is more common than ever in recent years. The fundamental mechanism of action is to reduce bleeding by inhibiting plasminogen activity (12). There are studies in literature suggesting that the use of TXA reduces blood loss during cardiovascular surgery, orthopedic operations, and organ transplantation (13-15). In this study, we have examined the effect of intraoperative intravenous tranexamic acid on blood loss on type 3-6 myomas during myomectomy according to FIGO grading (16) and its postoperative results. Our secondary purpose was to determine whether TXA use changes the need for blood products.

Keywords

• uterine leiomyoma
• myomectomy
• tranexamic acid

References

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