Current aspects of pathogenesis and prophylaxis of pelvic adhesions

Abstract

Introduction.Adhesive process of the pelvic organs is a pressing issue for operative gynecology that does not allow to consider results of therapeutic and preventive measures as sufficient.Aim:to analyze published data regarding contemporary aspects of etiopathogenesis of the adhesive process in pelvic organs as well as methods of its prevention.Materials and Methods.The literature sources retrieved from electronic databases PubMed, Embase, Medline, Ovid HealthSTAR, Cochrane, Google Scholar, eLibrary, CyberLeninka as well as scientific articles published in peer-reviewed open access journals over the last 30 years, including basic research in the field have been analyzed. While searching, the following keywords and their combinations in Russian and English were used: "adhesive process of the pelvic organs", "pathogenesis of the adhesive process", "prevention of the adhesive process", "gynecology", "pelvic adhesions", "pathogenesis of adhesions", "аdhesion prophylaxis", "gynecology".Results.The current aspects of the etiology and pathogenesis for adhesive process have been summarized. Existing adhesion classifications are presented. The proposed methods for preventing formation of peritoneal adhesions are described exerting most prominent effectiveness as well as describing the properties and characteristics according to the application method, the composition of contained substances and drug form. A phenotype profile of peripheral blood and peritoneal fluid lymphocytes from patients with adhesive process remains debated.Conclusion.A need to further examine formation of peritoneal adhesions at molecular and cellular levels for developing a comprehensive pathogenetically substantiated method to prevent and treat adhesions of the pelvic organs is in demand.