[Adjuvant treatment of tubal surgery. Randomized prospective study of systemically administered corticoids and...

The effectiveness of systemic corticosteroids in the prevention of adhesion formation and reformation has been recently questioned, on the grounds of non randomized studies. Noxythiolin has been tried in animal experiments, but never in the human. In this paper, a randomized study of the effect of dexamethasone and/or noxythiolin versus no treatment has been conducted by the Group d'Etude des Adhérences Pelviennes. 126 patients have been operated upon by microsurgery (salpingectomy and/or salpingolysis). Adhesions have been assessed by a score derived from the American Fertility Society endometriosis classification, before operation and by laparoscopy 3 to 6 months later. The mean improvement on adhesion score was 23.2 in the corticosteroid treated group, 19.3 in the noxythiolin group, 15.7 in the noxythiolin and corticosteroid group, 10.2 in the control group. 40% of patients (13 out of 32) in the corticosteroid group, versus 26% (5 out of 29) in the noxythiolin and corticosteroid group and 19% (6 out of 31) in the control group (p less than 0.02) became pregnant. No adverse effect has been noted. These results support the use of corticosteroids in infertility surgery.