Ikechebelu JI, Eleje GU, Umeobika JC, Eke NO, Eke AC, Mbachu II
Black women are predisposed to the formation of adhesions, which may be a contributing factor in female infertility. Laparoscopic approach in contrast to open abdominal operations militates against intra-abdominal adhesion formation and may be beneficial to African women where available. To determine the prevalence and pattern of intra-abdominal adhesions in women with prior histories of open appendicectomy being investigated for infertility using laparoscopy and dye test in Nnewi between 1st January 2007 and 31st December, 2008.This was a prospective survey at a private specialist hospital in Nnewi, South-east Nigeria over a two-year period. Data was collected with a pre-designed proforma which included the socio-demographic characteristics and laparoscopic findings in various abdomino-pelvic organs among infertile women that underwent laparoscopy and dye test. A total of 212 patients met the inclusion criteria. The data was analyzed using SPSS package. During the study period, a total of 517 patients had laparoscopy and dye tests, of which 212 (41.0%) patients had prior histories of open appendicectomy. Out of the 212 patients, 86 had adhesions at the previous appendicectomy site. This gave a prevalence rate of 40.6%. The mean age was 35.8± 5.7 years and all the patients were Nigerians (black). Of the 86 patients, 11 (12.8%) had adhesions involving their reproductive organs: right fallopian tube (8/11) and right ovary (3/11). Seventy five (87.2%) patients had adhesions affecting other organs excluding the reproductive organs. Intra-abdominal adhesions were common among infertile women with prior history of open appendicectomy and reproductive organs were affected. There is need to recommend laparoscopy in the treatment of appendicitis in young women in particular to minimize the risks of adhesion and its sequalae. Efforts should be made to make laparoscopy available and affordable in our surgical practice.
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