Assessment of the feasibility of bipolar coagulation use to reduce hemorrhage in myomectomy performed by minilaparotomy

Abstract

The major problem with myomectomy is excessive bleeding from increased uterine blood supply, and this can be a life-threatening condition and prolong postoperative stay. The aim of our study was to evaluate our experience in symptomatic myoma excision with bipolar electrode by mini-laparotomy; we compared 67 procedures with bipolar electrode, in normal saline as distension fluid, to 42 cases performed with unipolar electrode. All participants were pre-menopausal women who had symptomatic myomas ≤ 10 cm and had similar demographic characteristics. According to our findings we observed a mean of 159.04 ml (SD 50.59) of blood loss during the unipolar method and a mean of 104.47 ml (SD 50.55) during the bipolar method. Postoperative complications were more frequent in the unipolar group. The group treated with bipolar coagulation was associated with less recurrence of myoma, independent of their location, and an increased postoperative pregnancy rate. In our experience the use of bipolar coagulation led to a satisfactory improvement of the surgical treatment of symptomatic myoma in women who wished to retain their uteri.