Adhesion in Gynecology Complication, Cost, and Prevention: A Review
Hanadi Baakdah, M.D.; Togas Tulandi, M.D., M.H.C.M.
The objective of this chapter is to evaluate the magnitude of the problems of adhesions in Gynecology, complications, cost for the health care, and methods to prevent adhesion formation. It contains a review of relevant literature on intra-abdominal adhesion, adhesion-reducing substances, and their related cost. Adhesions can cause infertility, abdominal pain, or bowel obstruction. The impact of adhesions to the health-care system is huge. The total cost of adhesion-related problems in the United States is more than dollar 1 billion dollars annually. Modification in surgical technique, such as the use of laparoscopy, can minimize adhesion formation. Another approach is by using adhesion-reducing substances. Many substances and materials have been used to decrease the adhesion formation; however, there remains no unequivocally effective adhesion-reducing substance. Also, its use is costly. To our knowledge, no study has been published to date that addresses the use of adhesion-reducing substances as relates to the risk of bowel obstruction or long-term costs to the health-care system.