Transient abdominal ovariopexy for adhesion prevention in patients who underwent surgery for severe pelvic endometriosis.
OBJECTIVE
To assess adhesion reformation and subsequent fertility after a transient ovariopexy performed during severe pelvic endometriosis surgery.


METHODS
Retrospective study.


METHODS
University hospital.


METHODS
Twenty young women who underwent severe pelvic endometriosis surgery.


METHODS
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.


METHODS
Adhesion reformation and subsequent fertility.


RESULTS
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).


CONCLUSIONS
Transient ovariopexy appears to be a simple, safe, and effective technique in preventing postoperative adhesion reformation in severe pelvic endometriosis.
Ouahba
Jonathan
J
Service de Gynécologie Obstétrique, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France.
Madelenat
Patrick
P
Poncelet
Christophe
C
D000005:Abdomen / Q000601:surgery*; D000328:Adult; D004715:Endometriosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000503:physiopathology; D010535:Laparoscopy; D010049:Ovarian Diseases / Q000517:prevention & control*; D010053:Ovary / Q000601:surgery*; D010388:Pelvis; D011184:Postoperative Period; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D024162:Second-Look Surgery; D012720:Severity of Illness Index; D013536:Suture Techniques; D000267:Tissue Adhesions / Q000517:prevention & control