Intrauterine Oxytocin Instillation Hypothesized to Reduce Bleeding in Hysteroscopic Myomectomy

Symptomatic myomas are often treated with hysteroscopic myomectomy, the gold standard for submucous fibroids. However, this procedure carries risks of significant intraoperative bleeding, excessive fluid absorption, and intravasation syndrome, particularly during prolonged operations requiring high-pressure irrigation. Current methods to control bleeding are often insufficient. Oxytocin, known for its uterine contractile and vasoconstrictive effects via oxytocin receptors in the myometrium, is proposed as a novel intrauterine instillation to reduce uterine perfusion and improve surgical conditions.

This research record outlines the rationale for a proposed trial investigating the hemostatic effect of intrauterine instillation of oxytocin during hysteroscopic myomectomy. The study aims to evaluate whether local administration can reduce intraoperative bleeding, decrease distention medium requirements, improve visibility, and shorten operation time. No specific protocol details (e.g., dose, route, n, endpoints) for the proposed trial are provided in this abstract, as it describes a hypothesis rather than a completed study.

This research record does not present specific findings from a completed study. Instead, it hypothesizes that intrauterine instillation of oxytocin could lead to reduced intraoperative bleeding, decreased need for distention medium, improved surgical visibility, and shorter operation times during hysteroscopic myomectomy. The mechanism is attributed to oxytocin's action on oxytocin receptors in the myometrium and fibroid tissue, inducing uterine contraction and vasoconstriction, thereby reducing uterine perfusion. The text explicitly states that there are no previous studies on the hemostatic effect of intrauterine instillation of oxytocin in this context.