Three-dimensional power Doppler study of changes in uterine vascularity after absorbable cervical tourniquet during open myomectomy.
OBJECTIVE
To evaluate the effect of an absorbable polyglactin tie (i.e., cervical tourniquet) on postoperative uterine artery blood flow using three-dimensional (3D) power Doppler.


METHODS
Forty-four patients with symptomatic uterine myomas warranting surgical treatment were randomized to either receive absorbable cervical tourniquets group 1 or not group 2. Resistance index, pulsatility index, and peak systolic velocity of the uterine artery as well as 3D power Doppler study of uterine vascularity in terms of VI, FI, vascularization flow index (VFI) were performed preoperatively and at 1 and 3 months, postoperatively. Estimated myoma and uterine volume, operative time were compared in both groups.


RESULTS
No significant difference in the characteristics of myomas, regarding number, size, and location of the largest myoma, between the two studied groups. No significant differences between the two groups for uterine artery RIs, PIs, and PSV at 1 and 3 months, postoperatively. The myometrial VI, FI and VFI in the study group were comparable to those in the control group. No sequential change in FI was noted in either group.


CONCLUSIONS
Absorbable cervical tourniquet during open myomectomy did not compromise uterine perfusion as evaluated by 3D power Doppler study.
El Behery
Manal M
MM
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University Hospitals, Zagazig, Egypt. mbhry@hotmail.com
Zaitoun
Moustafa M
MM
Siam
Soha
S
Sohasaim
Ibraheim
Moustafa A
MA
D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007889:Leiomyoma / Q000601:surgery*; D011098:Polyglactin 910; D011446:Prospective Studies; D012039:Regional Blood Flow; D014111:Tourniquets; D018608:Ultrasonography, Doppler; D055988:Uterine Artery / Q000502:physiology*; D014594:Uterine Neoplasms / Q000601:surgery*; D014599:Uterus / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*
D011098:Polyglactin 910