Adhesions and Your OBGYN Practice

Dense adhesions to the uterus

Adhesions are a common consequence of pelvic surgery, forming after 46%–65% of primary C-sections^1,2,3 and after up to 95% of gynecologic laparotomies.⁴ Adhesions can lead to serious complications for patients, including infertility⁴, chronic pelvic pain⁵, and small bowel obstruction.⁶

Adhesions also complicate and prolong future surgeries by making it difficult to identify, reach, and separate tissues including the uterus, tubes, and ovaries.⁷ Adhesions can also limit and complicate future treatment options, including intraperitoneal chemotherapy⁷, radiotherapy⁸, and laparoscopy.⁷

Adhesions account for up to:

• 40% of infertility cases⁴
• 48% of chronic pelvic pain cases⁹
• 75% of small bowel obstructions¹⁰

SEPRAFILM® Adhesion Barrier is proven to help prevent postoperative adhesions.¹¹

SEPRAFILM can be applied during the following open procedures¹¹:

• C-Section (Learn more, including application techniques)
• Hysterectomy and Myomectomy (Learn more, including application techniques) 
• Pelvic floor resection
• Exploratory laparotomy
• Adhesiolyisis
• Adnexal procedures

¹²

1. Lyell DJ, Caughey AB, Hu E, Daniels K. Peritoneal closure at primary Cesarean delivery and adhesions. Obstet Gynecol. 2005;106:275-80.

 

2. Morales KJ, Gordon MC, Bates GW Jr. Postcesarean delivery adhesions associated with delayed delivery of infant. Am J Obstet Gynecol. 2007;196:461.e1-461.e6.

 

3. Fushiki H, Ikoma T, Kobayashi H, Yoshimoto H. Efficacy of SEPRAFILM as an Adhesion Barrier in Cesarean Sections. Obstetric and Gynecological Treatment [Japanese]. 2005;91(5):557-561.

 

4. DiZerega GS.  Peritoneal repair and postsurgical adhesion formation. In: Management of Common Problems in Obstetrics & Gynecology. Mishell DR, Goodwin Murphy T, Brenner PF, eds. Malden, MA: Blackwell Publishing; 2002: 267-271.

 

4. DiZerega GS.  Peritoneal repair and postsurgical adhesion formation. In: Management of Common Problems in Obstetrics & Gynecology. Mishell DR, Goodwin Murphy T, Brenner PF, eds. Malden, MA: Blackwell Publishing; 2002: 267-271.

 

4. DiZerega GS.  Peritoneal repair and postsurgical adhesion formation. In: Management of Common Problems in Obstetrics & Gynecology. Mishell DR, Goodwin Murphy T, Brenner PF, eds. Malden, MA: Blackwell Publishing; 2002: 267-271.

 

5. Keltz MD, Gera PS, Olive DL.  Prospective randomized trial of right-sided paracolic adhesiolysis for chronic pelvic pain. JSLS. 2006;10(4):443-446.

 

6. Ellis H, Moran BJ, Thompson JN, Parker MC, Wilson MS, Menzies D, et al.  Adhesion-related hospital readmissions after abdominal and pelvic surgery:  a retrospective cohort study. Lancet1999;353(9163):1476-1480.

 

7. Nichols DH, Clarke-Pearson DL, eds. Gynecologic, Obstetric, and Related Surgery. 2^nd ed. St. Louis, MO: Mosby, Inc; 1993.

 

7. Nichols DH, Clarke-Pearson DL, eds. Gynecologic, Obstetric, and Related Surgery. 2^nd ed. St. Louis, MO: Mosby, Inc; 1993.

 

7. Nichols DH, Clarke-Pearson DL, eds. Gynecologic, Obstetric, and Related Surgery. 2^nd ed. St. Louis, MO: Mosby, Inc; 1993.

 

8. Eifel PF.  Radiation therapy. In: Berek JS, Hacker NF, eds. Practical Gynecologic Oncology, 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005: 119-161.

 

9. Stovall TG, Elder RF, Ling FW. Predictors of pelvic adhesions. J Reprod Med. 1989;34:345-348.

 

10. Scovill WA. Small bowel obstruction. In: Cameron JL, ed. Current Therapy in Surgery. St Louis, MO: Mosby Yearbook Medical Publishers, Inc; 1995:100-104.

 

11. SEPRAFILM Prescribing Information. Cambridge, MA: Genzyme Biosurgery; 2007

 

11. SEPRAFILM Prescribing Information. Cambridge, MA: Genzyme Biosurgery; 2007

 

12. Makoha FW, Felimban HM, Fathuddien MA, Roomi F, Ghabra T. Multiple cesarean section morbidity. Int J Gynecol Obstet. 2004;87:227-232.