title: A Randomized Trial Comparing Triple versus Single Uterine Tourniquet in Open Myomectomy.
abstract: BACKGROUND
  Single and triple uterine tourniquet significantly reduces blood loss during myomectomy and both are highly effective. Triple tourniquet, however, blocks ovarian circulation and there is doubt that it causes ischemic damage to ovaries. These 2 methods have not been compared by a randomised controlled study yet. The purpose of this study was to compare triple uterine tourniquet with single tourniquet in terms of blood loss during open myomectomy.
  
  
  METHODS
  Women were randomized to triple (n = 24) or to single tourniquet (n = 24) at open myomectomy. All women with a myomatous uterus greater than 12 weeks of gestation were eligible to be part of the study. The primary outcome of the study was the amount of blood loss during surgery. Sample size was set to detect a 250 mL difference in blood loss with 80% power at α = 0.05. We also compared the change in anti-Müllerian Hormone (AMH) levels before and after surgery.
  
  
  RESULTS
  There was no significant difference in the outcome of blood loss between triple and single uterine tourniquet (322 ± 223 vs. 426 ± 355 mL, p = 0.230). Change in AMH was not different between the groups.
  
  
  CONCLUSIONS
  There is no clinically significant difference between triple and single uterine tourniquets on blood loss at open myomectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Ataturk University Faculty of Medicine, Erzurum, Turkey.
authors.forename: Ragip Atakan
authors.initials: RA
authors.lastname: Al
authors.forename: Omer E
authors.initials: OE
authors.lastname: Yapca
authors.forename: Neset
authors.initials: N
authors.lastname: Gumusburun
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000601:surgery; D008875:Middle Aged; D014111:Tourniquets; D016896:Treatment Outcome; D063186:Uterine Myomectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000601:surgery; D014599:Uterus / Q000098:blood supply / Q000601:surgery
chemical_list: D054304:Anti-Mullerian Hormone
keywords: Anti-Mullerian hormone; Blood loss; Fibroids; Myomectomy; Uterine tourniquet