title: A randomized controlled study of the efficacy of misoprostol and hyaluronic acid in preventing adhesion formation after gynecological surgery: a rat uterine horn model.
abstract: OBJECTIVE
  To investigate the effect of misoprostol in the reduction of adhesion formation after gynecological surgery.
  
  
  METHODS
  A double blind, randomized controlled experimental study was designed. Twenty-one female Wistar Hannover rats were divided into three groups as control, misoprostol and Hyalobarrier(®) groups. A uterine horn adhesion model was created. After anesthesia induction, 1.5-2cm injuries were made to the each uterine horn by cautery. The control group received no special medications except for the standard surgical procedure. The misoprostol group received 10μcg/kg misoprostol in addition to the standard surgical procedure, and the Hyalobarrier(®) group received 1cm(3) ready-for-use Hyalobarrier(®) gel intraperitoneally in addition to the standard surgical procedure. After 14 days from the first surgical procedure, adhesion scores were evaluated.
  
  
  RESULTS
  The extent (p<0.001), severity (p<0.001), degree (p<0.001) and total adhesion score (p<0.001) values of the control group were statistically higher than the values of misoprostol and Hyalobarrier(®) groups. The inflammation score value of misoprostol group was statistically lower than control and Hyalobarrier(®) groups (p<0.001).
  
  
  CONCLUSIONS
  In this study, we have found a new therapeutic potential of misoprostol that may be useful in preventing pelvic adhesion and reducing inflammation scores.
authors.affiliation: Van Özalp State Hospital, Clinic of Obstetrics and Gynecology, Turkey. Electronic address: drcihankaya@gmail.com.
authors.forename: Cihan
authors.initials: C
authors.lastname: Kaya
authors.affiliation: Bakirkoy Dr Sadi Konuk Training and Research Hospital, Department of Pathology, Turkey.
authors.forename: Nurten
authors.initials: N
authors.lastname: Sever
authors.affiliation: Bakirkoy Dr Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Cengiz
authors.affiliation: Bakirkoy Dr Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, Turkey.
authors.forename: Şükrü
authors.initials: Ş
authors.lastname: Yıldız
authors.affiliation: Bakirkoy Dr Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ekin
authors.affiliation: Bakirkoy Dr Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Yaşar
mesh_terms: D000818:Animals; D004311:Double-Blind Method; D004353:Drug Evaluation, Preclinical; D005260:Female; D005782:Gels; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D016595:Misoprostol / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D011897:Random Allocation; D017208:Rats, Wistar; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control*; D014599:Uterus / Q000601:surgery*
chemical_list: D005782:Gels; D016595:Misoprostol; D006820:Hyaluronic Acid
keywords: Hyaluronic acid; Misoprostol; PGE1; Surgical adhesions; TGF β1