Michael L Freeman1, Ghassan M Saed, Michael P Diamond. 1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Detroit Medical Center, Wayne State University, Detroit, Michigan, USA. mfreeman@med.wayne.edu
Abstract
OBJECTIVE: To determine which ovarian sex steroid(s), when removed from an intact organism, reduce(s) postoperative adhesion development. DESIGN: Randomized, prospective, blinded study. SETTING: University vivarium. PATIENT(S): One hundred twenty sexually mature female Sprague-Dawley rats, 226-250 g. INTERVENTION(S): Day 0, sham ovariectomy or bilateral ovariectomy, accompanied by continuous-release sex steroid replacement of either no steroids (control), 17beta-E(2), natural P (P4), or combined E(2)/P4. Day 7, standardized cecal abrasion; day 14, necropsy with assessment of adhesion presence or absence. MAIN OUTCOME MEASURE(S): Adhesion formation. RESULT(S): Three rats died because of anesthesia or surgical complications, and 117 rats reached necropsy. The ovary-intact (sham) rats adhesion incidence was 60.9%; ovariectomized control rats, 20.8%; E(2), 28.6%; P4, 33.3%; and combined E(2)/P4, 24.0%. Despite differing sex steroid replacement, two-tailed chi(2) testing with correction for multiple comparisons showed no statistical difference in adhesion incidence among the four ovariectomy groups. A statistically significant lower adhesion incidence was noted between the ovary-intact sham cohort and the collective ovariectomy groups and between the sham and ovariectomized control cohorts. CONCLUSION(S): Ovarian presence or absence at the time of surgical wounding, and not the 17beta-E(2) or P milieu, modulates adhesion development. This implicates other ovarian factor(s) in postoperative adhesion development.
OBJECTIVE: To determine which ovarian sexsteroid(s), when removed from an intact organism, reduce(s) postoperative adhesion development. DESIGN: Randomized, prospective, blinded study. SETTING: University vivarium. PATIENT(S): One hundred twenty sexually mature female Sprague-Dawley rats, 226-250 g. INTERVENTION(S): Day 0, sham ovariectomy or bilateral ovariectomy, accompanied by continuous-release sex steroid replacement of either no steroids (control), 17beta-E(2), natural P (P4), or combined E(2)/P4. Day 7, standardized cecal abrasion; day 14, necropsy with assessment of adhesion presence or absence. MAIN OUTCOME MEASURE(S): Adhesion formation. RESULT(S): Three rats died because of anesthesia or surgical complications, and 117 rats reached necropsy. The ovary-intact (sham) rats adhesion incidence was 60.9%; ovariectomized control rats, 20.8%; E(2), 28.6%; P4, 33.3%; and combined E(2)/P4, 24.0%. Despite differing sex steroid replacement, two-tailed chi(2) testing with correction for multiple comparisons showed no statistical difference in adhesion incidence among the four ovariectomy groups. A statistically significant lower adhesion incidence was noted between the ovary-intact sham cohort and the collective ovariectomy groups and between the sham and ovariectomized control cohorts. CONCLUSION(S): Ovarian presence or absence at the time of surgical wounding, and not the 17beta-E(2) or P milieu, modulates adhesion development. This implicates other ovarian factor(s) in postoperative adhesion development.
Authors: Laura Detti; Ghassan M Saed; Zhong L Jiang; Michael L Kruger; Michael P Diamond Journal: J Assist Reprod Genet Date: 2008-06-13 Impact factor: 3.412