Effect of endometrioma cyst fluid exposure on peritoneal adhesion formation in a rabbit model.
OBJECTIVE
To determine whether copious lavage and suction of human endometrioma fluid placed in the peritoneal cavity of rabbits reduces adhesion formation compared to no lavage.


METHODS
Prospective, randomized, blinded study.


METHODS
Academic research environment.


METHODS
Twenty-four female New Zealand white rabbits.


METHODS
Rabbits randomized into three groups: [1] laparoscopy with instillation of human endometrioma material, no lavage; [2] laparoscopy with instillation of human endometrioma material, followed by clearance of all visible endometrioma fluid by saline lavage and suction; [3] laparoscopy alone.


METHODS
Six weeks after laparoscopy, adhesions scored by laparotomy using standard visual assessment scoring system and histologic microscopic evaluation. Data evaluated using Kruskal-Wallis and median nonparametric tests.


RESULTS
For groups 1, 2, and 3, respectively, mean total clinical adhesion scores were 0.67 (95% confidence interval [CI] -0.87, 2.2), 3.67 (95% CI 1.27, 6.07), and 0 (95% CI 0, 0). Group 2 had statistically significantly higher mean adhesion scores compared to group 1. Histologic adhesion scores followed the trend of clinical adhesion scores.


CONCLUSIONS
In this rabbit model, human endometrioma fluid exposure in the peritoneal cavity is not associated with adhesion formation. Instillation of endometrioma fluid followed by copious saline lavage is strongly associated with adhesion formation.
Smith
Laura Proud
LP
Department of Obstetrics and Gynecology, University of Virginia Health System, Charlottesville, Virginia.
Williams
Christopher D
CD
Doyle
Joseph O'Brien
JO
Closshey
Wendy B
WB
Brix
William K
WK
Pastore
Lisa M
LM
D000818:Animals; D020420:Cyst Fluid; D004195:Disease Models, Animal; D004715:Endometriosis / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D010529:Peritoneal Cavity / Q000473:pathology; D010532:Peritoneal Diseases / Q000209:etiology / Q000473:pathology*; D010533:Peritoneal Lavage / Q000379:methods; D011446:Prospective Studies; D011817:Rabbits; D000267:Tissue Adhesions / Q000209:etiology / Q000473:pathology