The comparison of the outcomes of preoperative uterine artery embolization and intraoperative uterine artery tourniquet techniques in cases undergoing myomectomy due to uterine myoma

Comparison of the outcomes of preoperative uterine artery embolization and ıntraoperative uterine artery tourniquet techniques in patients undergoing myomectomy for uterine myoma AIM: This study aims to compare the hemostatic outcomes of preoperative uterine artery embolization (PUAE) with the intraoperative uterine artery tourniquet method in patients undergoing myomectomy for myoma uteri. MATERIALS AND METHODS: Fifty-four patients aged 18-49 who underwent myomectomy between September 2020 and September 2024 at the Department of Obstetrics and Gynecology, Sakarya University School of Medicine, were included in the study. Preoperative imaging was performed using contrast-enhanced MRI, and surgeries were conducted by the same operators. Parameters such as uterine volume, myoma volume, operative time, blood loss, hemoglobin drop, drainage amount, length of hospital stay, and time to return to daily activities were evaluated. RESULTS: There were no significant differences in demographic data and myoma characteristics between the two groups (p>0.05). However, the tourniquet group had significantly longer operative times, greater blood loss, higher need for tranexamic acid, larger hemoglobin drops, increased drainage amounts, longer hospital stays, and extended recovery times compared to the embolization group (p<0.05). A negative correlation was observed between uterine/myoma volume and hemoglobin drop, while a positive correlation was found between operative time, blood loss, and recovery parameters (p<0.05). CONCLUSION: Preoperative uterine artery embolization was associated with shorter operative times, less intraoperative blood loss, and faster recovery compared to the intraoperative tourniquet method. These findings suggest that UAE is an effective hemostatic option, particularly for patients with larger uterine sizes and a higher risk of bleeding.