{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:18:36Z","timestamp":1787678316565,"version":"build-2784847793"},"reference-count":30,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gynecol Obstet Invest"],"published-print":{"date-parts":[[2020]]},"abstract":"<b><i>Background and Objectives:<\/i><\/b> A tourniquet has been suggested as a useful means of reducing massive hemorrhage during myomectomy. However, it is not clear whether the restricted perfusion affects the ovaries. In the present study, we examined the effect of a tourniquet on ovarian reserve and blood loss during myomectomy. <b><i>Materials and Methods:<\/i><\/b> In a randomized double-blind clinical trial, fertile nonobese patients scheduled for abdominal myomectomy at Rasool-e-Akram Hospital from February 2018 to June 2019 were randomized to a tourniquet (<i>n<\/i> = 46) or a non-tourniquet group (<i>n<\/i> = 35). Serum levels of anti-M\u00fcllerian hormone (AMH) and follicle-stimulating hormone (FSH) were measured before and 3 months after surgery, blood loss was recorded during surgery, and serum levels of hemoglobin (Hb) were recorded before surgery, 6 h and 3 days after surgery. SPSS version 21 was used for statistical analysis. <b><i>Results:<\/i><\/b> Demographic, obstetric, and myoma characteristics were similar in the 2 groups (<i>p<\/i> &#x3e; 0.05). The mean baseline values of AMH and FSH did not differ between groups (<i>p<\/i> &#x3e; 0.05). After surgery, only FSH was higher in the control group (<i>p<\/i> = 0.043). Despite the time taken to fasten and open the tourniquet, the mean operating time was shorter in the tourniquet group (<i>p<\/i> &#x3c; 0.001). Blood loss was higher in the control group (<i>p<\/i> = 0.005). The drop in Hb levels at 6 h after surgery was higher in the non-tourniquet group (<i>p<\/i> = 0.002). Blood loss was significantly associated with the duration of surgery (<i>r<\/i> = 0.523, <i>p<\/i> &#x3c; 0.001). <b><i>Conclusion:<\/i><\/b> The use of a tourniquet during abdominal myomectomy significantly reduced the mean volume of blood loss compared to the non-tourniquet group, while it did not prolong the duration of surgery, nor reduced the ovarian reserve. A tourniquet is a safe and efficient measure during abdominal myomectomy. <\/jats:p>","DOI":"10.1159\/000510512","type":"journal-article","created":{"date-parts":[[2020,9,16]],"date-time":"2020-09-16T21:00:28Z","timestamp":1600290028000},"page":"396-404","source":"Crossref","is-referenced-by-count":20,"title":["Uterine Isthmus Tourniquet during Abdominal Myomectomy: Support or Hazard? 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