Outcome Measures and Adhesion Formation: Pain and Postsurgical Adhesion

Adhesions within the peritoneal cavity may occur secondary to endometriosis, pelvic inflammatory disease, the presence of foreign material (such as sutures) or any other cause of pelvic inflammation such as perforated appendix, or, most commonly, following intraabdominal surgery. Adhesions are known to be associated with infertility,1 and acute bowel obstruction, and they can dele-teriously alter the efficacy of intraperitoneal chemotherapy. In addition, a major impact is their supposed association with chronic pain of the abdominal and pelvic cavities. Most surgeons and gynecologists no doubt have performed laparotomy or laparoscopy and adhesiolysis for patients with known or suspected adhesions and chronic pain, and indeed many of these patients may have had symptomatic improvement following their surgery. We are uncertain if this results from the surgery itself or is a placebo effect. The aim of this chapter is to consider the available evidence and to try to determine if adhesions do indeed cause pain. Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

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