Fluid and pharmacological agents for adhesion prevention after gynaecological surgery

Pharmacological and fluid agents, when used as an adjunct during pelvic surgery for the prevention of adhesions, may not improve pregnancy outcomes or pain. Gels (like hyaluronic acid) and hydroflotation agents appear to be effective for preventing adhesions compared to no treatment .

A Cochrane review included 29 studies with a total of 3 227 subjects. One study examined pelvic pain and found no evidence of a difference between use of hydroflotation agents and no treatment. There was no evidence of benefit from the use of the antiadhesion agents in the live birth rate. The use of antiadhesion gels like hyaluronic acid decreased adhesion formation . When gels were compared with no treatment or with hydroflotation agents at second-look laparoscopy, fewer participants who received a gel showed a worsening adhesion score when compared with those who received no treatment and with those given hydroflotation agents.

Comment: The quality of evidence is downgraded by study limitations (poor reporting of sudy methods) and by imprecise results (limited study size for each comparison).

Ədəbiyyat

1. Metwally M, Watson A, Lilford R, Vandekerckhove P. Fluid and pharmacological agents for adhesion prevention after gynaecological surgery. Cochrane Database Syst Rev. 2006;(2):CD001298 [Review content assessed as up-to-date: 7 April 2014].