Effectiveness of photodynamic ablation for destruction of endometrial explants in a rat endometriosis model.
OBJECTIVE
To evaluate the potential of photodynamic therapy with aminolevulinic acid (ALA-PDT) for ablation of endometrial explants in a rat endometriosis model and to compare the effect of ALA-PDT, electrosurgery, and surgical resection on normal peritoneum.


METHODS
Prospective controlled experimental trial.


METHODS
University medical center.


METHODS
Mature Sprague-Dawley female rats.


METHODS
Induction of endometriosis and subsequent treatment with ALA-PDT; electrosurgery, and simple resection, and ALA-PDT of normal peritoneum.


METHODS
Histopathological assessment.


RESULTS
Systemic ALA followed by exposure to photoactivating light for 10 or 15 minutes resulted in ablation of all explants harvested 3-4 days after treatment. Permanent destruction was confirmed by absence of regrowth by week 3. Exposure of normal peritoneum to ALA-PDT resulted in initial necrosis, with complete recovery by day 16. Adhesions were present on day 16 in 50% of cases after electrosurgery and in 100% of cases after resection. No adhesions were present in ALA-PDT-treated animals.


CONCLUSIONS
Systemic ALA followed by exposure to photoactivating light at relatively low power densities for periods as brief as 10 minutes resulted in ablation of endometriotic explants. Exposure of normal peritoneum to ALA-PDT resulted in complete resurfacing. Both electrosurgery and surgical resection resulted in a greater incidence of surface adhesions.
Krzemien
Alicja A
AA
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Kingston, Ontario, Canada.
Van Vugt
Dean A
DA
Fletcher
William A
WA
Reid
Robert L
RL
D000622:Aminolevulinic Acid / Q000627:therapeutic use*; D000818:Animals; D004598:Electrosurgery / Q000009:adverse effects; D004715:Endometriosis / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005260:Female; D015994:Incidence; D010532:Peritoneal Diseases / Q000453:epidemiology / Q000209:etiology; D010537:Peritoneum / Q000187:drug effects / Q000601:surgery; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011183:Postoperative Complications; D051381:Rats; D017207:Rats, Sprague-Dawley; D012016:Reference Values; D000267:Tissue Adhesions / Q000453:epidemiology / Q000209:etiology
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid