Adhesion formation after laparoscopic excision of endometriosis and lysis of adhesions

Jason D. Parker, Parker JD, Ninet Sinaii, Sinaii N, James H. Segars, Heidi Godoy, Godoy H, Winkel C, Craig Winkel, Craig A. Winkel, Stratton P, Pamela Stratton
Fertility and sterility · 2005 · vol. 84(5) , pp. 1457–1461 · doi:10.1016/j.fertnstert.2005.04.057 · PMID:16275244 · W2078699979
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This prospective trial found that adhesions were more likely to reform after laparoscopic endometriosis excision and lysis, particularly thick adhesions or those involving the ovary.

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Abstract

ObjectiveTo evaluate adhesion reformation after laparoscopic excision of endometriosis and adhesiolysis in women with chronic pelvic pain.DesignProspective clinical trial.SettingUniversity hospital.Patient(s)Thirty-eight women with endometriosis and chronic pelvic pain.Intervention(s)A primary and second-look laparoscopy with adhesiolysis and excision of endometriotic lesions with a neodymium-yttrium argon garnet surgical laser technologies (SLT) contact laser.Main outcome measure(s)Adhesion formation and character (thin, thin and thick, or thick). Location of adhesions at a first laparoscopy was compared with de novo or reformation of adhesions and the location of adhesions at a second surgery.Result(s)Adhesions or adhesions combined with endometriotic lesions were significantly more likely to reform at second surgery compared with sites having only an endometriosis lesion. Thick adhesions were associated with a significantly increased likelihood of an adhesion reforming, compared with thin adhesions or thin and thick adhesions. Lesions or adhesions involving the ovary were more likely to be associated with adhesions at a subsequent surgery, compared with lesions in the adjacent ovarian fossa or fallopian tube.Conclusion(s)Most patients developed adhesions after radical surgical excision of endometriosis for pelvic pain. The high incidence of adhesion formation after surgery for endometriosis underscores the importance of optimizing surgical techniques to potentially reduce adhesion formation.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Endometriosis Laparoscopy Tissue Adhesions Adult Chi-Square Distribution Endometriosis Female Humans Laparoscopy Laparoscopy Pelvic Pain Pelvic Pain Pelvic Pain Prospective Studies Tissue Adhesions Tissue Adhesions Tissue Adhesions

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Cited by (32)

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