Hormone-independent ovarian influence on adhesion development.

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.