Efficacy of Prophylactic Intracervical Injection of Vasopressin during Laparoscopic Myomectomy: A Double-Blind Randomized Controlled Trial

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 205–216

DOI: 10.46882/2026/IJOG/000494

Original Research Article

Title: Efficacy of Prophylactic Intracervical Injection of Vasopressin during Laparoscopic Myomectomy: A Double-Blind Randomized Controlled Trial

Names of Authors: Chidi E. Eze¹, Aisha M. Umar²

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
² Department of Obstetrics and Gynecology, Federal Medical Centre, Katsina, Nigeria

Abstract:
Intraoperative blood loss during laparoscopic myomectomy can complicate visual fields and increase conversion rates to open laparotomy. This double-blind, placebo-controlled randomized trial investigated the efficacy and safety of a prophylactic intracervical/perimyometrial injection of diluted vasopressin in reducing blood loss during laparoscopic uterine leiomyoma excision. One hundred and twenty women scheduled for laparoscopic myomectomy for intramural or subserosal fibroids (at least one fibroid ≥ 6 cm) were randomized to receive either 20 units of vasopressin diluted in 100 mL of 0.9% saline (n = 60) or 100 mL of a pure saline placebo (n = 60) injected into the myometrium surrounding the target lesions prior to uterine incision. The primary endpoint evaluated was total intraoperative blood loss. The mean intraoperative blood loss was significantly lower in the vasopressin group compared to the placebo group (142.5 ± 50.4 mL vs. 310.8 ± 95.6 mL, p < 0.001). The requirement for intraoperative blood transfusions was also lower in the vasopressin cohort (0.0% vs. 6.7%, p = 0.043). Furthermore, the mean operative duration was significantly reduced by vasopressin administration due to improved visual fields (58.4 ± 14.2 minutes vs. 76.5 ± 18.4 minutes, p < 0.001). Transient intraoperative cardiovascular fluctuations (mild bradycardia or elevated blood pressure) occurred in 8.3% of the vasopressin group but resolved spontaneously within 5 minutes. Prophylactic injection of diluted vasopressin significantly limits surgical hemorrhage, shortens operative times, and eliminates blood transfusion requirements during laparoscopic myomectomy without causing serious adverse systemic effects.

Keywords: Laparoscopic Myomectomy; Vasopressin; Intraoperative Blood Loss; Uterine Fibroids; Blood Transfusion; Operative Time.

Manuscript Timeline: Received: May 05, 2026; Revised: June 28, 2026; Accepted: July 20, 2026; Published: August 08, 2026.

Citation: Eze CE, Umar AM. Efficacy of Prophylactic Intracervical Injection of Vasopressin during Laparoscopic Myomectomy: A Double-Blind Randomized Controlled Trial. International Journal of Obstetrics and Gynecology. 2026; 14(8): 205–216.

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