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ISSN: 1643-8876
Menopause Review/Przegląd Menopauzalny
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1/2024
vol. 23
 
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abstract:
Original paper

To B or not to B: the application of uterine compression sutures to reduce blood loss after myomectomy

Almandouh H. Bosilah
1
,
Mohamed Hussein
2
,
Mahmoud Abdelwahed Alboghdady
3
,
Ahmed Zaky
2
,
Ahmed Shafik Almorsy
4
,
Wael Soliman Taha
2
,
Mohammed Farouk Abd El Azeem
2
,
Amr Mohamed Sholkamy
2
,
Wael Abd Elatief Khafagy
5
,
Muhamed Ahmed Abdelmoaty
2
,
Ibrahim Mohamed Abo Eldahab
2
,
Bahaa Eldin Elmohamady Mohamed
2
,
Yasser Mohamed Said Diab
2
,
Ahmed Hashim Mohammed
6
,
Ahmed Samir Hamid Shaaban
2
,
Elsayed Mohammad Taha
2
,
Adel Aly Elboghdady
2
,
Sileem Ahmed Sileem
6
,
Hany Gaber Essawy
7
,
Elmetwally Farouk Elshahat
2
,
Ghada Ibrahim Elsaid Soror
8
,
Hamza Mohamed Abdelmohsen Mohamed
7

1.
Obstetrics and Gynecology Department, Faculty of Medicine Damietta University, Damietta, Egypt
2.
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
3.
Obstetrics and Gynecology, International Islamic Centre for Population Studies and Research, Al-Azhar University, Cairo, Egypt
4.
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University Damietta, Damietta, Egypt
5.
Department of Obstetrics and Gynecology, ART Unit, International Islamic Institute, Al-Azhar University, Cairo, Egypt
6.
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
7.
Obstetrics and Gynecology Minia University, Minya, Egypt
8.
Department of Obstetrics and Gynecology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
Menopause Rev 2024; 23(1): 21-24
DOI: https://doi.org/10.5114/pm.2024.136954
Online publish date: 2024/03/28
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Introduction
The aim was to assess the hemostatic impact of B-Lynch sutures following an open myomectomy for efficacy.

Material and methods
In this prospective clinical research, performed in Alazhar university hospitals (Al-Hussain, Damietta, Assiut) and Minia University Maternity Hospital, 250 women scheduled for open myomectomy between January 2021 and January 2023 had multiple fibroid uteri with uterine sizes corresponding to 12–22 weeks. There were two groups of women. Group I (125) underwent standard open myomectomy surgery, whereas Group II (125) underwent normal open laparotomy surgery followed by B-Lynch sutures. Certain inclusion and exclusion criteria were applied to every patient. We recorded vital data, length of the procedure, complications (bleeding during the procedure, bleeding from multiple bites, bladder injury, fever, wound infection), complete blood count before and after surgery, need for blood transfusion, postoperative vital data, time until ambulation, passing flatus, and ability to eat and drink, as well as the amount of blood lost during and after the procedure.

Results
There was no statistically significant difference between the two groups in age, parity, weight, number of fibroids, or uterine size as measured by ultrasonography. Between groups I and II, there was a significant difference in the average intraoperative blood loss (Group I lost 562.6 ml, whereas Group II lost 411.3 ml) as well as the mean blood loss following surgery (205 ±82 ml in Group I and 117 ±41 ml in Group II). No significant difference was observed in the mean length of hospital stay between groups I and II (2 ±0.3 days and 2 ±0.6 days, respectively).

Conclusions
Using a B-Lynch suture can help minimize blood loss during and after an open myomectomy. Therefore, if the uterus is large and has a lot of fibroids, it is recommended to be done frequently.

keywords:

fibroid, open myomectomy, B-Lynch
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