title: Effect of endometrioma cyst fluid exposure on peritoneal adhesion formation in a rabbit model.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University of Virginia Health System, Charlottesville, Virginia.
authors.forename: Laura Proud
authors.initials: LP
authors.lastname: Smith
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Williams
authors.forename: Joseph O'Brien
authors.initials: JO
authors.lastname: Doyle
authors.forename: Wendy B
authors.initials: WB
authors.lastname: Closshey
authors.forename: William K
authors.initials: WK
authors.lastname: Brix
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Pastore
mesh_terms: 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