Surgical management of periadnexal adhesions.

The importance of the lysis of periadnexal adhesions with regard to pregnancy rate was evaluated in 101 infertile patients. All patients had at least one patent tube and normal fimbria. The periadnexal adhesions were classified into four grades according to their nature and extent. A significant inverse relationship was noted between the grade of adhesions and the pregnancy rate. The overall pregnancy rate was 45.5%. The pregnancy rate in grade 1 adhesion group was 64.7%, compared with 25.0% in grade IV (P less than 0.05). Postoperative early hydrotubations with hydrocortisone yielded a significantly higher pregnancy rate (52%), compared with patients not treated (25%, P less than 0.02). In order to improve the results, more effort should be directed to the prevention of adhesion formation.