الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Uterine fibroids are the most common benign tumors in women and the leading indication for hysterectomies in the USA. They are benign, fibromuscular tumors. Prevalence data range from 5% to 21% according to age and the population studied. The majority of women are asymptomatic; however, they can cause considerable symptoms. The most frequent symptom is menorrhagia, pelvic pain and pressure, urinary frequency and urgency, and other pelvic symptoms may occur.
Options for medical therapy are currently limited to pre-operative reduction of symptoms related to uterine bleeding and fibroid size. The surgical treatment of this benign tumor in women aged 40 years or more remains a challenge as many patients also suffer from infertility and wish to preserve their uterus for further childbirth, thereby giving them more reasons to choose myomectomy as an alternative to hysterectomy. However, hemorrhage during the operation remains a challenge, thus, several randomized controlled trials of myomectomy with various interventions to reduce blood loss indicated that misoprostol, vasopressin, bupivacaine plus epinephrine, tranexamic acid, gelatin thrombin matrix, pericervical tourniquet, and mesna were correlated with reduction in bleeding during myomectomy.
This study was designed to prospectively compare the effectiveness of pericervical tourniquet versus intra-myometrial injection of epinephrine in reducing blood loss in abdominal myomectomy.
So, the study was done on sixty patients suffering from symptomatic fibroid counselled for abdominal myomectomy operation. They were categorized into the following groups.