title: Vaginal adhesions after transvaginal pelvic reconstructive surgeries: prevalence and clinical implications.
abstract: OBJECTIVE
  Our aim was to assess the prevalence of vaginal adhesions after transvaginal pelvic reconstructive surgeries and evaluate relevant risk factors and impact on surgical outcome and sexual function.
  
  
  METHODS
  This was a retrospective study examining medical records of all patients undergoing transvaginal pelvic reconstructive surgeries for pelvic organ prolapse (POP) at our institution between January 2006 and December 2007.
  
  
  RESULTS
  One hundred and ninety -nine women were included in the study, of whom 165 had a comprehensive pre- and postoperative follow-up assessment and were available for final analysis. Vaginal adhesions were reported in 18 (10.9%) women during the first follow-up visit 36 ± 34 days postoperatively. Adhesions were reported to be successfully separated manually in all cases during pelvic examination. Patients with or without vaginal adhesions showed no statistically significant differences in demographic, obstetric, or clinical characteristics or in severity of prolapse. No statistically significant correlation was found between any specific surgical procedure and the risk of developing vaginal adhesions. Rates of prolapse recurrence, postoperative vaginal narrowing and dyspareunia were not significantly different between groups.
  
  
  CONCLUSIONS
  Vaginal adhesion formation is a relatively common complication after transvaginal pelvic reconstructive surgeries unrelated to preoperative degree of prolapse or to the type of surgery. If adhesions are separated manually at an early stage, surgical outcome and sexual function do not seem to be adversely affected.
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology , Carmel Medical Center, Rappaport Faculty of Medicine,Technion University, 7 Michal St., Haifa, Israel, 34362. graceyounes@gmail.com.
authors.forename: Grace
authors.initials: G
authors.lastname: Younes
authors.affiliation: Department of Obstetrics and Gynecology, Bnei Zion Medical Center, Haifa, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Goldschmidt
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology , Carmel Medical Center, Rappaport Faculty of Medicine,Technion University, 7 Michal St., Haifa, Israel, 34362.
authors.forename: Ariel
authors.initials: A
authors.lastname: Zilberlicht
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology , Carmel Medical Center, Rappaport Faculty of Medicine,Technion University, 7 Michal St., Haifa, Israel, 34362.
authors.forename: Ron
authors.initials: R
authors.lastname: Auslender
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology , Carmel Medical Center, Rappaport Faculty of Medicine,Technion University, 7 Michal St., Haifa, Israel, 34362.
authors.forename: Nir
authors.initials: N
authors.lastname: Haya
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology , Carmel Medical Center, Rappaport Faculty of Medicine,Technion University, 7 Michal St., Haifa, Israel, 34362.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Abramov
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D015995:Prevalence; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000453:epidemiology; D014621:Vagina; D014623:Vaginal Diseases / Q000453:epidemiology*
keywords: Dyspareunia; Pelvic organ prolapse; Reconstructive pelvic surgery; Vaginal adhesions; Vaginal dimensions