Clinical evaluation of endometriosis and differential response to surgical therapy with and without application of Oxiplex/AP* adhesion barrier gel.
OBJECTIVE
To correlate parameters of endometriosis obtained during routine clinical evaluation with the subsequent formation of adhesions following surgical treatment by laparoscopy.


METHODS
Randomized, controlled, double-blind, clinical trial.


METHODS
Tertiary referral centers for the treatment of endometriosis.


METHODS
Thirty-seven patients (65 with adnexa) with stage I-III endometriosis; endometrioma-only patients were excluded.


METHODS
Laparoscopic surgical treatment of endometriosis, followed by randomization to Oxiplex/AP (FzioMed, Inc., San Luis Obispo, California) gel treatment (treated group) of adnexa, or surgery alone (control group); follow-up laparoscopy 6-10 weeks later.


METHODS
Adnexal Americn Fertility Society score, correlated with color and location of endometriosis, as well as stage of disease determined by masked review of videotapes.


RESULTS
Control patients with at least 50% red lesions had a greater increase in ipsilateral adnexal adhesion scores than patients with mostly black or white and/or clear lesions. Treated patients with red lesions had a greater decrease in adnexal adhesion scores than control patients. There was a correlation between baseline endometriosis stage and postoperative adhesion formation in control patients, but not treated patients.


CONCLUSIONS
Patients with red endometriotic lesions had greater increases in their adhesion scores than patients with only black, white, and/or clear lesions. Oxiplex/AP gel was effective in reducing adhesions, compared to surgery alone, in all groups.
diZerega
Gere S
GS
Livingston Reproductive Biology Laboratories, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA. dizerega@usc.edu
Coad
James
J
Donnez
Jacques
J
D002482:Cellulose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003116:Color; D004311:Double-Blind Method; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D005782:Gels / Q000627:therapeutic use; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D000267:Tissue Adhesions / Q000517:prevention & control
D005782:Gels; C406630:Oxiplex; D011092:Polyethylene Glycols; D002482:Cellulose