Adhesion Prevention and Lysis: Indications for Laparotomy and Laparoscopy

Pelvic organs ideally must be in an adhesion- free environment to function properly. Adhesions may interfere with ovum release, pickup, and transport, resulting in primary or secondary infertility. In fact, pelvic adhesions are a major factor contributing to infertility,1 as they are present in approximately 25% of infertile women.2 In the presence of adhesions, pregnancy rates range between 22% and 64%.1,3 If structures adjacent to pelvic organs are affected by adhesions, malfunction and pain due to peritoneal stretch may result. Adhesions are also a major cause of dyspareunia and partial or complete bowel obstruction. Thus the development and, more importantly, the prevention of postoperative adhesions should be a major consideration of all surgeons.