Hemostatic Effect of Intrauterine Instillation of Oxytocin in Hysteroscopic Myomectomy: A Randomized Double Blinded Control Trial

Abstract

Introduction: Progesterone and oestrogen can have an impact on benign smooth muscle tumours of the uterus called uterine myomas. The majority of fibroids don’t cause any symptoms and don’t need to be treated or investigated further. Fibroids originate in the smooth muscles of the uterus and move to an area of decreased resistance, where they can either stay intra-myometrial or develop into subserosal or submucous myomas. Aim of the Work: This study’s primary goal was to find out if oxytocin intrauterine infusion into the distention medium during hysteroscopic myomectomy would lessen blood loss and enhance surgical visibility. Patients and Methods: This clinical trial was undertaken at the Early Cancer Detection Unit (ECDU) at Ain Shams University hospitals using a randomised controlled double blind design. Sixty women who were scheduled for a hysteroscopic myomectomy were enrolled in this study and split into two equal groups: Group A (Oxytocin group): 10 IU of oxytocin were administered for every 1000 millilitres of the distending medium during the hysteroscopic myomectomy performed on 30 women. Group B (Placebo group): Thirty women had hysteroscopic myomectomy, and for every 1000 millilitres of the distending medium, a sterile bacteriostatic water ampule was used. Results: There was no statistically significant difference between the groups’ demographic (age) and surgical (myoma size, number, and duration of operation) data, nor were there any differences in intraoperative fluids. Each group’s Hgb and Hct decrease exhibited a significant difference, with the control group exhibiting a greater mean difference than the oxytocin group. Our findings demonstrated that there was a statistically significant difference in post-operative Hgb and HCT between groups, and that groups were similar in terms of needing blood transfusions and needing a second operation. When it came to the surgeon’s assessment of the visual fluid clarity, the groups were equivalent, but there was a statistically significant difference in the surgeons’ ratings of bleeding. According to our findings, there was no statistically significant variation in the number of uterine and medical difficulties across the groups, and the groups’ levels of complications were comparable. Conclusion: During diagnostic hysteroscopy, complications frequently arise. During a hysteroscopic myomectomy, oxytocin is infused intrauterine into the distention medium to minimise blood loss and enhance operative visibility. To confirm these results, more research using a range of doses and techniques is required.