To compare the efficacy of Intramyometrial Vasopressin plus Rectal Misoprostol with Intramyometrial Vasopressin alone to decrease blood loss during Laparoscopic Myomectomy: A Randomised Clinical Trial

Uterineleiomyomas are the most common benign tumors of the uterus in women ofreproductive age group, with a cumulative incidence of 70%. Symptomatic fibroids can b treated either by medical or surgical management. Fibroidsare the leading indication for hysterectomy worldwide. Myomectomy,however, remains the gold standard for symptomatic women who desire uterinepreservation. A major problem that myomectomy poses is excessiveblood loss from the increased uterine vasculature. Anumber of interventions have been used to decrease the blood loss duringmyomectomy. Signiï¬cantreductions in blood loss with misoprostol, vasopressin, bupivacaine plus epinephrine,tranexamic acid, pericervical tourniquet and gelatin-thrombin matrix have beendemonstrated in various clinical trials. InIndia, no studies have been conducted to compare the efficacy of differentcombination regimens to control haemorrhage during laparoscopic myomectomy.Thus, we proposed to investigate the efficacy of a single preoperative dose ofper rectal misoprostol along with intramyometrial vasopressin overintramyometrial vasopressin alone to decrease blood loss in patients undergoinglaparoscopic myomectomy.