الفهرس 
Uterine FibroidOnly 14 pages are availabe for public view
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Abstract
Uterine fibroids are the most frequent benign solid tumors that can be discovered in the female genital tract (Okolo, 2008).The age with highest prevalence (which can reach 70% to 80%) is that of 50 (American Association of Gynecologic Laparoscopists, 2012).
This study was a randomized controlled double blind clinical trial was conducted during the period from October 2017 to December 2018.
The study population was a consecutive series of participants attended the Early Cancer Detection Unit (ECDU) in Ain Shams University Maternity Hospital.
The aim of this study was to compare the efficacy of intrauterine instillation of tranexamic acid in hysteroscopic myomectomy.with total number of participants studied was 80 women, divided into two groups; group (A) included 40 women who received TXA in injected media, and group (B) included 40 women who received placebo in distention media.
The current study found that both groups were similar at the baseline. There were no differences between groups in the demographic characteristics such as; age, with the mean age in TXA group (37.63± 5.3 years ) vs. (37.17 ± 5.41 years ) in the placebo group with P=0.71, BMI (30.8 ± 2.21kg/m2) and (31.1± 2.20kg/m2) in TXA group and placebo respectively. there was no significant difference between both groups regarding the parity with P value=0.71.
In the current study there was no different in size of myoma between both groups the mean size of myoma in TXA group was 2.60±0.72 and in placebo 2.27±0.67.Also there was no difference in the location of myomas inside the uterine cavity between both groups.
As regards the hemoglobin level preoperative and 24 hours post-operative there was a slight difference between the two groups with mean hemoglobin difference in tranexamic acid was 1.11±0.58 where the mean difference in placebo group was 1.46±61, P=0.015. And there was no significant different in the level of heamotocrit between the two groups p=0.49.
No statistically significant differences were found between both groups regarding the volume of distention medium utilized, distention medium deficit ,and the operative time.
In the current study the quality of hysteroscopic view was significantly better in the tranexamic acid group compared to the placebo group( P<0.001) , a good vision of the operative field was found in 60.5% in TXA group compared to 20.5% in the placebo group.
Regarding other surgical outcomes , in this study there was no significant difference in both group, complete resection of myoma occurred in 97.37% of TXA group and in 89.74% of the placebo group with p=0.20
As regards of the surgical complication ,there were 3 participants complicated by of uterine perforation in the placebo group ,and there were no women of uterine perforation in TXA group with p=0.20.
In conclusion, this randomized clinical trial reports that hysteroscopic myomectomy with intrauterine instillation of tranexamic acid resulted in a clear operative field ,and a non blurred environment to achieve good surgical results .
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