SURGICAL AND MEDICAL MANAGEMENT OF SEVER PID WITH PERITUBAL ADHESOLYSIS AND UTERINE LAPAROSCOPIC MYOMECTOMY AS SUCCESSFUL MANAGEMENT OF SECONDARY INFERTILITY

Adhesions are abnormal peritoneal fibrotic bands with varying degrees of stiffness that connect two surfaces that are normally separated in the peritoneal cavity. They are responsible for locating the inflammatory reaction when there is an infection or foreign body carrying oxygen to ischemic tissue [1]. Many serious complications may be associated to adhesions such as chronic pelvic pain and small bowel obstruction and are associated to dyspareunia and secondary infertility [2]. Adhesion formation occurs in 90% of abdominal and pelvic surgeries, with a lower incidence when the surgery is performed laparoscopically Laparoscopic myomectomy offers a real benefit to infertile patients with uterine fibroids and peritoneal adhesions. The procedure requires a skilled surgeon and laparoscopy technique to minimize adhesion formation and other proven benefits.