THE USE OF ADHESION BARRIERS IN INFERTILE PATIENTS WITH ADHESIVE PROCESS ASSOCIATED WITH SEVERE FORMS OF ENDOMETRIOSIS

The study was dedicated to efficacy analysis of the use of adhesion barriers in adhesive process associated with external genital endometriosis, stage III–IV during endosurgical treatment.

Group I consisted of 60 infertile patients with external genital endometriosis, stage III–IV who during surgery were applied hemostatic material “Gynecare interceеd” of sufficient surface to cover a traumatized zone, in 70 patients of group ІІ during surgery antiadhesive gel “Ethicon Intercoat” was applied with the help of applicator. Group III consisted of 70 patients who received a standard surgical treatment.

Analysis of obtained results showed that interleukins IL-6, IL-10 level in examined patients are a marker for adhesive process prior to operation. Intraoperational use of adhesion barriers leads to decrease in inflammatory activity markers as verified by proinflammatory cytokines Il-6 and IL-10. Intensiveness of pain syndrome positively lessens as compared to preoperative values: in group І (5.38±0.25; 3.33±0.25; р<0.001) and in group ІІ (5.49±0.25; 2.83±0.25; р<0.05). Group ІІІ also showed tendency to lessening — (5.17±0.25; 4.23±0.25).

Figures for reproductive function recovery did not significantly vary in groups with the use of different adhesion barriers and corresponded to in group І — 28 (46.6%), in group ІІ — 32 (45.7%), in group ІІІ — 19 (27.1%) (c2=6.89; df=2; р=0.03).

Therefore it is rational to recommend introduction of adhesion barriers into surgical treatment of infertile patients with adhesive process associated with external genital endometriosis stage III–IV.