Transient abdominal ovariopexy for adhesion prevention in patients who underwent surgery for severe pelvic endometriosis
Received 11 December 2003; received in revised form 15 March 2004; accepted 15 March 2004.
Objective
To assess adhesion reformation and subsequent fertility after a transient ovariopexy performed during severe pelvic endometriosis surgery.
Design
Retrospective study.
Setting
University hospital.
Patient(s)
Twenty young women who underwent severe pelvic endometriosis surgery.
Intervention(s)
Unilateral or bilateral transient ovariopexy to the anterior abdominal wall was performed as the last step in the surgical procedure. Median duration of ovariopexy was 4 days.
Main outcome measure(s)
Adhesion reformation and subsequent fertility.
Result(s)
This well-tolerated procedure induced neither specific complication nor prolonged hospital stay. A second-look laparoscopy, performed in eight patients (40%), has shown a reduction of the occurrence, the extent, and the severity of ovarian adhesions. Two thirds of the suspended ovaries had no or smooth adhesions at second-look laparoscopy, even though all ovaries were initially adherent. Fifteen infertile women without male infertility factors tried actively to conceive after surgery. In this group of patients, four conceived spontaneously, and four conceived after IVF (total pregnancy rate = 53.3%). Seven patients delivered, and one pregnancy is ongoing. Median pregnancy delay was 11.5 months (range, 4–24 months).
Conclusion(s)
Transient ovariopexy appears to be a simple, safe, and effective technique in preventing postoperative adhesion reformation in severe pelvic endometriosis.
aService de Gynécologie Obstétrique, Hôpital Bichat-Claude Bernard
bService de Gynécologie Obstétrique, Centre Hospitalier Universitaire Jean Verdier
Reprint requests: Christophe Poncelet, M.D., Ph.D., Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire Jean Verdier, Avenue du 14 Juillet, 93 143 Bondy, France (FAX: 00-33-1-48-02-67-73
ABSTRACT