Predictors of pelvic adhesions

The presence of pelvic adhesions is implicated as a significant cause of pelvic pain, bowel obstruction and infertility in women. Laparoscopy has become an invaluable method for the evaluation and treatment of such adhesions. A prospective study was designed to correlate specific findings in the preoperative history and physical examination with the presence of adhesions seen at laparoscopy. Two hundred seventy-three consecutive patients undergoing laparoscopy were analyzed; pelvic adhesions were found in 99 (36.3%). At the time of laparoscopy the only historical predictor found to be associated with adhesive disease was previous pelvic surgery. Physical examination predictors associated with the presence of adhesions were uterine immobility, a right adnexal mass and right adnexal tenderness.