Color Doppler evaluation of changes in uterine perfusion induced by the use of an absorbable cervical tourniquet during open myomectomy.

PURPOSE: To evaluate the hemodynamic changes in uterine perfusion following the vascular occlusion of the uterine arteries with an absorbable cervical tourniquet applied during open myomectomy.

METHODS: Twenty-eight patients with symptomatic fibroids and a clinical uterine size equivalent to 14 or more weeks' gestation underwent open myomectomy. Patients were randomized to either the tourniquet or the control group. In the tourniquet group, a number 1 polyglactin suture was tied around the cervix to occlude the uterine arteries and left in situ. Doppler flow measurements were obtained at 5 days, 6 weeks, 3 months, and 6 months postoperatively and compared with preoperative values.

RESULTS: Fourteen women were randomized to each group. Data were obtained from 12 patients in the tourniquet group and 11 in the control group. There were no statistically significant differences between the two groups for uterine artery at 5 days, 6 weeks, 3 months, or 6 months postoperatively. However, the peak systolic velocity was significantly reduced in the tourniquet group compared with the control group at 5 days (p < 0.05); thereafter, there were no significant differences between the two groups.

CONCLUSIONS: A polyglactin cervical tourniquet causes only a temporary effect on uterine perfusion, which is consistent with its absorption profile.