The risk of developing adhesions after female reproductive organ surgery

Aim. To identify risk factors for the development of pelvic adhesions in women of reproductive age. Material and methods. The study retrospectively analyzed 500 clinical records of randomly selected patients who underwent gynecologic pelvic surgery for various indications. Of them, 290patients diagnosed with pelvic adhesions according to the R-AFS classification system were included in the main retrospective group. A retrospective comparison group was made up of 210 patients without pelvic adhesions. Continuous data were presented as median and the quartiles with differences between unpaired groups assessed by the Mann-Whitney U test. Qualitative variables were summarized as counts and percentages. The odds ratio (OR) and 95% confidence intervals (95% CI) to determine the risk factors for developing adhesions were calculated. Results. The study identified risk factors for developing postoperative pelvic adhesions. It showed that already known risk factors predisposing to the formation of pelvic adhesions should be added with such factors as non-gynecologic comorbidities (diseases of the cardiovascular and endocrine system), endocrine disorders (estrogen deficiency and hypersecretion of thyroxine), intraoperative blood loss > 1000 ml, and the time from the last surgery > 12 months. Conclusion. The study results showed that non-gynecologic comorbidities (diseases of the cardiovascular and endocrine system), endocrine disorders (estrogen deficiency and hypersecretion of thyroxine), intraoperative blood loss more than 1000 ml, and the time from the last surgery more than 12 months may be considered as risk factors for the formation of adhesions. These findings must be taken into account when developing preventive and therapeutic measures.

postoperative pelvic adhesions, risk factors