China 
Africa 
Explore chapters and articles related to this topic
How Long Does it Take Uterine Scar(s) to Heal?
Published in John C. Petrozza, Uterine Fibroids, 2020
Intrauterine adhesions, also known as Asherman's syndrome, are defined as the presence of adhesions inside the uterine cavity and/or endocervix. Clinical manifestations include amenorrhea, hypomenorrhea, recurrent pregnancy loss, infertility and abnormal placentation. Conforti et al. reviewed the risk factors associated with Asherman's syndrome and identified curettage after miscarriage to have the highest incidence of Asherman's syndrome [25]. Extrauterine adhesions following abdominal myomectomies may similarly cause problems with fertility as well as pain. There are many anti-adhesion adjuvants but there is no one accepted standard of care, and careful surgical technique is highly recommended.
Principles of Pathophysiology of Infertility Assessment and Treatment*
Published in Asim Kurjak, Ultrasound and Infertility, 2020
Joseph G. Schenker, Aby Lewin, Menashe Ben-David
Various methods are used for the prevention of adhesion formation after surgery. Barrier substances like 10% of 32% dextran are left in the pelvis at the end of surgery. Medical treatment with dexamethasone and progesterone instillated in the pelvis at the end of surgery and administered parenterally during the postoperative period. Early postoperative laparoscopy for the dissection of newly formed adhesions is practiced by some surgeons.
Principles of treatment
Published in Caroline Overton, Colin Davis, Lindsay McMillan, Robert W Shaw, Charles Koh, An Atlas of ENDOMETRIOSIS, 2020
Caroline Overton, Colin Davis, Lindsay McMillan, Robert W Shaw, Charles Koh
The aim of surgical treatment is to destroy or excise endometriotic nodules and divide peritubal or periovarian adhesions, restoring normal anatomy where possible (Figure 7.1). Cystectomy of ovarian endometriomas improves spontaneous pregnancy rates and reduces pain. In addition it may improve the response to in vitro fertilisation (IVF). Drawbacks of surgery include postoperative adhesion formation and incomplete removal of the disease.
The potential association between metabolic syndrome and risk of post-surgical adhesion
Published in Archives of Physiology and Biochemistry, 2023
Gordon A Ferns, Milad Shahini Shams Abadi, Mohammad-Hassan Arjmand
Adhesion formation is a part of the wound healing process in tissues after trauma and surgeries. Both inflammation and fibrin clot deposition are the main mechanisms during the early phase of the normal or pathological healing process. Briefly, a rapid immune response begins with local and circulating immune cells, secretion of pro-inflammatory cytokines, and the formation of a fibrin matrix are an important mechanism in normal healing (diZerega & Campeau 2001). The balance between fibrin matrix deposition and degradation, or fibrinolytic activity, is important. The coagulation cascade is activated in response to injury to blood vessels and inflammation in the traumatised area with increases the permeability of vessels to increase exudate fluid and flow more inflammatory cells to the site. Fibrin matrix gel is lysed within a few days by the fibrinolytic system (Buckman et al. 1976). Plasmin is responsible for a physiological fibrinolytic sequence that result from plasminogen activation by tissue plasminogen activator (tPA) (Holmdahl et al. 1996). After surgery, a decrease of tPA activity is associated with an increased susceptibility to adhesions (Sulaiman et al. 2002).
Hyperglycaemia and the risk of post-surgical adhesion
Published in Archives of Physiology and Biochemistry, 2022
Gordon A. Ferns, Seyed Mahdi Hassanian, Mohammad-Hassan Arjmand
Post-operative abdominal adhesions present a challenge for patients undergoing abdominal or pelvic surgery and their surgeons. Adhesion formation is characterised by the development of fibrotic bands and pathological junctions between different organs or intra-abdominal organs to the abdominal wall. These fibrotic bands can lead to adhesions between organs and may lead to the disruption in the function of organs (Diamond and Freeman 2001, Arung et al.2011). Postoperative adhesion occurs in majority of cases following abdominal and pelvic surgeries (Menzies and Ellis 1990, Coccolini et al.2013). Serious problems are created by adhesion bands for patients such as intestinal obstruction (Menzies 1992), infertility (Ward and Panitch 2011), pelvic pain (Sulaiman et al.2000), repeated surgeries (Coleman et al.2000), and economic costs (the Surgical and Clinical Adhesions Research (SCAR) Group-2005, Parker et al. 2005). There are many studies of the pathogenesis of fibrotic bands post-operatively, but there is much unknown about the mechanisms involved in this disorder, for example why the intensity of adhesions is different in individuals with similar surgical procedures.
Endostatin in fibrosis and as a potential candidate of anti-fibrotic therapy
Published in Drug Delivery, 2021
Zequn Zhang, Xi Liu, Zhaolong Shen, Jun Quan, Changwei Lin, Xiaorong Li, Gui Hu
Postoperative adhesion (POA) is a manifestation of assorted aberrant histologic proliferation, characterized by hyperplastic fibrous tissue adherence to adjacent tissues and organs (Figure 6). Fibrotic adhesion bands may have various appearances, ranging from thin-layer slices to thick bands with neovascularization. More than 90% of patients undergoing abdominal surgery develop varying degrees of abdominal adhesions, which lead to complications like chronic abdominal pain, intestinal obstruction, and female infertility (Arung et al. 2011; Hellebrekers & Kooistra 2011). Besides, adhesion formation secondary to ligament and tendon healing may restrict joint movement. Moreover, POA secondary to open-heart surgery may make the pericardium fibrotic and thickened, resulting in constrictive pericarditis, which critically influences cardiac function. Furthermore, adhesions that occur after plastic surgery may seriously diminish therapeutic efficacy and fail to achieve desired outcomes. These complications frequently require multiple hospital admissions, increasing the burden on the patient and the healthcare system (ten Broek et al. 2013). These facts suggest that POA is an important clinical problem with potentially serious outcomes. Existing anti-adhesion strategies include reducing intraoperative damage, physical barriers, and anti-adhesion drugs (Moris et al. 2017; Kou et al. 2020; Li et al. 2020). However, currently, there are few effective anti-adhesion drugs.