Adhesion formation after laparoscopic excision of endometriosis and lysis of adhesions
Abstract
Objective To evaluate adhesion reformation after laparoscopic excision of endometriosis and adhesiolysis in women with chronic pelvic pain. Design Prospective clinical trial. Setting University 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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Adhesions that are lysed during surgery form again.
“A complicating factor is that adhesions, lysed at surgery, form again (Parker et al., 2005; Table II).”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Parker et al., 2005
Endometriosis is associated with a local inflammatory response and with adhesions, whether spontaneous or reformed after surgery.
“endometriosis is associated with a local inflammatory response and formation of adhesions, be they spontaneous de novo adhesions or adhesions reformed after surgical treatment of endometriosis”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Parker et al., 2005
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Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications
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Self-citation
- Authors
- Parker, J. D., Sinaii, N., Segars, J. H., Godoy, H., Winkel, C., & Stratton, P.
- Affiliations
- National Institutes of Health (US)
- Georgetown University Medical Center (US)
- Corresponding author
- Stratton, Pamela
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2005-11
- Volume
- 84
- Issue
- 5
- Pages
- 1457-1461
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2078699979
- Cited by
- 55
- References
- 29
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 2 · 2023: 3 · 2021: 1 · 2020: 2 · 2019: 1 · 2017: 2 · 2015: 2 · 2014: 1 · 2013: 6 · 2012: 2
- FWCI
- 5.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Keywords
- endometriosis, adhesiolysis, adhesion formation, chronic pelvic pain, laparoscopic resection, second-look laparoscopy, ovarian involvement, postoperative adhesions
- MeSH terms
- Tissue Adhesions, Adult, Endometriosis, Female, Humans, Laparoscopy, Prospective Studies, Chi-Square Distribution, Pelvic Pain
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