Transverse Versus Longitudinal Uterine Incision in Abdominal Myomectomy: A Randomized Controlled Trial

Background It has long been believed that longitudinal uterine incision causes less blood loss than transverse incision in myomectomy, yet knowledge of detailed anatomy of vascular supply of a myoma suggests that transverse incision would be a safe choice. Our aim was to compare between transverse and longitudinal uterine incisions in myomectomy. Methods A randomized controlled study in a university affiliated hospital, in which 52 women candidates for abdominal myomectomy were randomized into transverse uterine incision or longitudinal uterine incision groups. Intraoperative blood loss, operative time and postoperative fever were analyzed. Results No statistically significant difference was found between transverse and longitudinal incisions regarding intraoperative blood loss (389.7 ± 98.56 ml vs 485.04 ± 230.6 ml respectively, p value=0.07), operative time (59.96 ± 16.78 min vs 66.58 ± 17.33 min respectively, p value=0.18), and postoperative fever (4% vs 8.33%, p value=0.6). Conclusion Transverse uterine incision does not cause more blood loss than longitudinal incision and is a reasonable option during abdominal myomectomy. Trial registration NCT03009812 at clinicaltrials.gov, registered January 2017