GnRHa for adhesion formation after uterine serosal injury in an euestrogenic milieu

OBJECTIVE: To assess whether the adhesion-preventing effect of gonadotropin -releasing hormone agonist (GnRHa) is through hypoestrogenism. STUDY DESIGN: Four groups of previously ovariectomized mts received various combinations of depot leuprolide acetate injection (3.75 mg/kg/mo) subcuta neosly, conjugated equine estrogens (50 mu g/kg/d) orally and phosphate-buf fered saline injection subcutaneosly, yielding group 1, saline only; group 2, saline and conjugated equine estrogens; group 3, depot leuprolide acetat e only; and group 4, depot leuprolide acetate and conjugated equine estroge ns. Surgical adhesions were induced by monopolar cautery on the right uteri ne horn through laparotomy and were then scored on day 21 after surgery. RESULTS: Adhesion scores for mts that received conjugated equine estrogens and saline were significantly higher than scores of those given conjugated equine estrogens and depot leuprolide acetate, depot leuprolide acetate onl y and saline only (P=.019, .026 and.027, respectively). However, there was no significant difference in the adhesion scores for these three groups. CONCLUSION: Hypoestrogenism results in the development of fewer peritoneal adhesions postoperatively. Our findings also indicated that other mechanism s, in addition to those inducing hypoestrogenism, are at work in the adhesi on-preventing effects of GnRHa therapy.