IMR Press / CEOG / Volume 31 / Issue 1 / pii/2004010

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Original Research

Postoperative adhesion prevention in gynecologic surgery with hyaluronic acid

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1 Obstetric and Gynecology Clinic, University of L’Aquila,Avezzano Hospital, L’Aquila (Italy)
Clin. Exp. Obstet. Gynecol. 2004, 31(1), 39–41;
Published: 10 March 2004
Abstract

Despite improvements in surgical instrumentation and techniques, adhesions continue to form after most procedures. Peritoneal adhesions develop in 60-90% of women who undergo major gynecological operations. This adhesion formation causes significant postoperative morbidity such as bowel obstruction (65%), infertility (15-20%), and chronic pelvic pain (40%). Objective: To demonstrate the efficacy of a hyaluronic acid product (Hyalobarrie® Gel) for the prevention of adhesions in gyne­cological surgery. Materials and Methods: From October 2000 to July 2002, 18 women from 26 to 41 years old (mean age 33.66) underwent myomectomy via laparotomy as their first abdominal operation. Between August 2001 and May 2003, the patients underwent a second-look laparoscopy (7 women, 38.9%, 15 sites, 42.8%) or a second-look laparotomy (11 women, 61.1 %, 20 sites, 57.1 %) during which all the 35 sites corresponding to the previous myomectomies were analyzed. During the second-look procedure the presence, localization and severity of adhesions were evaluated using the Operative Laparoscopy Study Group Classification (OLSG) and American Fertility Society Classification (AFSC). Results: All patients underwent a second-look laparoscopy/laparotomy and only five of 18 (27.7%) showed pelvic adhesions in seven sites (20%) of previous myomectomies. No adhesion was found on the previous sites of myomectomies of pedunculated leiomyomas so, excluding those, adhesions were found in seven of 29 sites of myomectomies (24.1 %). Conclusions: The present study emphasizes the need for improved treatments to prevent adhesions, as there is no doubt that adhe­sions represent one of the major causes of female morbidity.

Keywords
Hyalobarrie® Gel
Adhesion
Myomectomy
Second-look procedures
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