Adhesion Prevention in Endometriosis: A Neglected Critical Challenge

Edgardo Somigliana, Paola Vigano, Paola Viganò, Laura Benaglia, Andrea Busnelli, Paolo Vercellini, Luigi Fedele
Journal of minimally invasive gynecology · 2012 · vol. 19(4) , pp. 415–421 · doi:10.1016/j.jmig.2012.03.004 · PMID:22575862 · W2143468132
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This paper reviews the critical and overlooked challenge of adhesion prevention in endometriosis, highlighting its significant impact on patient health and quality of life.

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Abstract

Prevention of adhesions, whether de novo or by re-formation, is one of the most important and surprisingly neglected aspect of the treatment of endometriosis. Adhesions may cause infertility, dyspareunia, chronic pelvic pain but also intestinal obstruction and complications at subsequent surgery. They may play a role in the development of some forms of the disease such as ovarian endometriomas and possibly also deep invasive nodules. Three randomized controlled trials have been published documenting some partial success with Interceed, Oxiplex/AP gel or Adept solution in reducing adhesions extent at second look laparoscopy performed a few weeks after initial surgery. However, data on relevant long-term outcomes such as fertility, pelvic pain or disease recurrences or other adhesions-related complications is lacking. Noteworthy, endometriosis is a chronic inflammatory disorder and the insult causing adhesions is expected to persist after surgery. Therefore preventing adhesion formation with exclusively agents at the time of surgery may be insufficient. Future studies should focus on a 2-step strategy that includes measures applied at the time of surgery and subsequent administration of agents able to prevent the development of new adhesions.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Tissue Adhesions Cellulose Cellulose Cellulose Cellulose, Oxidized Cellulose, Oxidized Dialysis Solutions Dialysis Solutions Endometriosis Female Glucans Glucans Glucose Glucose Humans Icodextrin Polyethylene Glycols Polyethylene Glycols Secondary Prevention

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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Cited by (50)

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