Applications of Tranexamic acid in benign gynecology

Purpose of review Bleeding at the time of benign gynecologic surgery, as well as from benign gynecologic conditions, is a major source of morbidity for many women. Few nonhormonal medical options exist for the treatment of heavy menstrual bleeding, and to reduce surgical bleeding during major gynecologic surgery. Interest in Tranexamic acid (TXA) as a means to reduce surgical blood loss has been growing across many surgical specialties. This review focuses on applications for TXA as a means to reduce heavy menstrual bleeding (HMB) as well as to reduce surgical bleeding during benign gynecologic surgery. Recent findings Tranexamic acid is an effective treatment to reduce the volume of bleeding during menstruation. Tranexamic acid was found to be superior to both placebo and oral progestins, and as good as combined oral contraceptives at reducing menstrual blood volume. Tranexamic acid has also been show to reduce the volume of bleeding during abdominal myomectomy as well as hysterectomy. There is a major need for prospective studies evaluating the utility of TXA for reducing blood loss during benign gynecologic surgery. Summary Tranexamic acid has been found to be an excellent affordable nonhormonal treatment option for women with HMB and should be considered during major gynecologic surgery.
Source: Current Opinion in Obstetrics and Gynecology - Category: OBGYN Tags: MINIMALLY INVASIVE GYNECOLOGIC PROCEDURES: Edited by Matthew Siedhoff Source Type: research

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Publication date: Available online 12 September 2019Source: The LancetAuthor(s): Kevin Cooper, Suzanne Breeman, Neil W Scott, Graham Scotland, Justin Clark, Jed Hawe, Robert Hawthorn, Kevin Phillips, Graeme MacLennan, Samantha Wileman, Kirsty McCormack, Rodolfo Hernández, John Norrie, Siladitya Bhattacharya, HEALTH Study GroupSummaryBackgroundHeavy menstrual bleeding affects 25% of women in the UK, many of whom require surgery to treat it. Hysterectomy is effective but has more complications than endometrial ablation, which is less invasive but ultimately leads to hysterectomy in 20% of women. We compared laparoscop...
Source: The Lancet - Category: General Medicine Source Type: research
The problem affects a quarter of women in the UK and many end up having surgery to treat it.
Source: BBC News | Health | UK Edition - Category: Consumer Health News Source Type: news
ConclusionSince technical difficulties with a limited number of hands, some complex surgery like radical hysterectomy has rarely been performed through LESS approach[1]. The dissection of vesicocevical and parametrial space are critical to radical hysterectomy, dissatisfied exposure during the procedure are the majority difficulties[2]. In the video, surgery for cervical cancer was performed successfully and also met the FIGO standards for radical hysterectomy (Type C). Our video demonstrated that the varied and flexible suspension played a significant role to provide a clear vision and sufficiently exposure, it was feasib...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
CONCLUSIONS: According to our analysis, NSRH surgery after NAC via balloon occluded arterial infusion brings beneficial results to patients with bulky IB2 to IIB cervical cancers. PMID: 31497250 [PubMed]
Source: Oncotarget - Category: Cancer & Oncology Tags: Oncotarget Source Type: research
sca T Abstract OBJECTIVES: Prenatal diagnosis of Placenta Accreta Spectrum (PAS) has been associated with reduced maternal morbidity. The introduction of new imaging signs is crucial in identifying women affected by this condition. The aim of our study is to evaluate the diagnostic accuracy of a new ultrasound sign, which it has been named "intracervical lakes", in predicting presence and outcome of PAS disorders. METHODS: retrospective multicentric study conducted in three Italian tertiary units from January 2015 to September 2018 including all women with placenta previa. The primary aim was to exp...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
In this study, we conducted a retrospective investigation of all cases of placenta previa and accreta that were treated at a tertiary-level hospital to assess the effectiveness of balloon catheterisation at different levels. We evaluated the surgical and neonatal outcomes of 586 cases of placenta previa and accreta that were treated at our facility. This is the largest study of its kind. Depending on the severity and position of accreta, patients underwent balloon catheter placement in the aorta (n = 252) or common iliac artery (n = 38) before delivery by caesarean section. Data were collected r...
Source: Journal of Obstetrics and Gynaecology - Category: OBGYN Tags: J Obstet Gynaecol Source Type: research
Conclusions: Between January and December 2018, 33 patients underwent surgery between two units. Indications for surgery included dysfunctional uterine bleeding, endometrial hyperplasia, pelvic pain, post-menopausal bleeding, prophylactic surgery in BRCA positive patients and one grade 1 stage 1 endometrial cancer in whom laparoscopic hysterectomy was technically difficult and complicated by previous midline laparotomy. Ages ranged from 35-75 and BMI from 20-53.Mean operation time was 68.5 minutes and mean blood loss intraoperatively was 269mls. 15.2% (n = 5) had a blood loss equal or more than 500&thi...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
Adenomyosis is a benign lesion within the myometrium associated with heavy menstrual bleeding (HMB) and dysmenorrhea, and commonly co-exists with uterine fibroids (UF). Adenomyosis is also present in 15-57% of hysterectomy specimens with leiomyoma (Genc M, et al, 2015; Taran FA, et al, 2010). This analysis evaluated the efficacy and safety of elagolix, an oral, gonadotropin-releasing hormone receptor antagonist, with add-back therapy in a subset of women with UF, HMB and co-existing adenomyosis.
Source: Fertility and Sterility - Category: Reproduction Medicine Authors: Tags: Prize paper session Source Type: research
We report the second pregnancy-associated acute myocardial infarction case successfully treated with ticagrelor before and after primary percutaneous coronary intervention with drug eluting stent implantation on left coronary artery, but also the first report on use of bridging antiplatelet therapy with tirofiban during temporary withdrawal of ticagrelor because of a C-section.
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
CONCLUSIONS: Endometrial resection and ablation offers an alternative to hysterectomy as a surgical treatment for heavy menstrual bleeding. Both procedures are effective, and satisfaction rates are high. Although hysterectomy offers permanent and immediate relief from heavy menstrual bleeding, it is associated with a longer operating time and recovery period. Hysterectomy also has higher rates of postoperative complications such as sepsis, blood transfusion and haematoma (vault and wound). The initial cost of endometrial destruction is lower than that of hysterectomy but, because retreatment is often necessary, the cost di...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
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