The Effect of Intracapsular Injection of Terlipressin Versus Carbitocin on Hemoglobin and Blood Loss During Laparoscopic Myomectomy Operations

The Effect of Intracapsular Injection of Terlipressin Versus Carbitocin on Hemoglobin and Blood Loss During Laparoscopic Myomectomy Operations

The Effect of Intracapsular Injection of Terlipressin Versus Carbitocin on Hemoglobin and Blood Loss During Laparoscopic Myomectomy Operations: Double Blinded Randomized Placebo-Controlled Trial

Our study aims to evaluate the efficacy of intracapsular injection of Terlipressin versus Carbetocin injection on hemoglobin level in women undergoing abdominal laparoscopic myomectomy. Moreover, to evaluate their efficacy in decreasing blood loss on operative time and to describe the injection sequelae for the same population. This clinical study will be conducted in compliance with the clinical study protocol and applicable regulatory requirements.

This study is a prospective, comparative, double-blinded randomized placebo-controlled trial and multi-center study that will be conducted at Wael ElBanna Clinic and the NRC site. The study participants' relevant medical records will be collected and reviewed after obtaining informed consent for the participants. Data will be pooled and presented in aggregate, without the identification of individual subjects. The study materials that will be used will include blood tests and ultrasound. The study will involve three study arms: Arm 1: intramyometrial injection of Terlipressin in women undergoing laparoscopic myomectomy procedure Arm 2: intramyometrial injection of Carbetocin in women undergoing laparoscopic myomectomy procedure Arm 3: intramyometrial injection of saline in women undergoing laparoscopic myomectomy procedure Subjects who meet diagnostic requirements as listed in the inclusion and exclusion criteria will be included in the study. Women will be randomized to one of the three arms using a computer-generated randomization table with a 1:1:1 group allocation.

This study is a prospective, comparative, double-blinded randomized placebo-controlled trial and multi-center study that will be conducted at Wael ElBanna Clinic and the NRC site The study materials that will be used will include blood tests and ultrasound. The study will involve three study arms: Arm 1: intracapsular myomectomy Terlipressin injection in women undergoing laparoscopic myomectomy procedure Arm 2: intracapsular myomectomy Carbetocin injection in women undergoing laparoscopic myomectomy procedure Arm 3: intracapsular myomectomy saline injection in women undergoing laparoscopic myomectomy procedure Subjects who meet diagnostic requirements as listed in the inclusion and exclusion criteria will be included in the study. Women will be randomized to one of the three arms using a computer-generated randomization table with a 1:1:1 group allocation.

intracapsular myomectomy Terlipressin injection in women undergoing laparoscopic myomectomy procedure

intracapsular injection of Terlipressin versus Carbetocin for decreasing blood loss in women undergoing laparoscopic myomectomy

intracapsular injection of Terlipressin versus Carbetocin on change blood loss in patient in laparoscopic myomectomy

measure the amount of blood loss in mm after intracapsular injection of Terlipressin versus Carbetocin versus saline as aplacebo in women undergoing laparoscopic myomectomy

1. To evaluate the efficacy of intracapsular injection of Terlipressin versus Carbetocin on hemoglobin

compare the hemoglobin level before and after operation after intracapsular injection of Terlipressin versus Carbetocin saline as aplacebo in women undergoing laparoscopic myomectomy

2. To evaluate the efficacy of intracapsular injection of Terlipressin versus Carbetocin on operative time

2. To measure the operative time in minutes after intracapsular injection of Terlipressin versus Carbetocin versus saline as aplacebo in women undergoing laparoscopic myomectomy

Inclusion Criteria Women aged 16-45 years Appropriate medical status for laparoscopic surgery (largest myoma ≤15 cm) Baseline hemoglobin ≥9 g/dl No contra-indications to the use of glyopressin or carbitocin Myoma-related symptoms, such as pelvic pressure or pain, menorrhagia, or infertility Not pregnant at the time of presentation (i.e., negative urine pregnancy test or last menstrual period within the last 4 weeks) Exclusion Criteria: Previous myomectomy History of bleeding disorders Concurrent anticoagulation therapy History of Uncontrolled ischaemic heart disease Any pelvic abnormalities requiring concomitant surgery Treatment with a GnRH agonist or ulipristal acetate within three months preceding surgery Inability to understand and provide written informed consent

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Srivastava S, Mahey R, Kachhawa G, Bhatla N, Upadhyay AD, Kriplani A. Comparison of intramyometrial vasopressin plus rectal misoprostol with intramyometrial vasopressin alone to decrease blood loss during laparoscopic myomectomy: Randomized clinical trial. Eur J Obstet Gynecol Reprod Biol. 2018 Sep;228:279-283. doi: 10.1016/j.ejogrb.2018.07.006. Epub 2018 Jul 5.

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