Comparison of corticosteroid therapy in the prevention of pelvic tissue reaction and adhesion formation.

The purpose of this research was to compare the effect of glucocorticoids administered in equivalent doses with respect to inflammatory response, fibrosis and adhesion formation. The animal model used was the Sprague-Dawley rat. The surgical technique involved incision and eversion of a portion of the proximal uterine horn. The glucocorticoids administered included methylprednisolone acetate (Medrol, The Upjohn Company), 6.25 mg/kg; hydrocortisone acetate (Hydrocortisone, Merck Sharp and Dohme), 25 mg/kg; betamethasone phosphate (Celestone Phosphate Injection, Schering Corp.), 1 mg/kg; and dexamethasone sodium phosphate (Hexadrol, Organon Pharmaceuticals), 1 mg/kg. These glucocorticoids were compared with a control solution of normal sodium chloride for injection (Abbott Laboratories), 0.5 mL/rat. Four weeks after the initial surgery, the uterine horns were histologically evaluated for inflammatory response, fibrosis and adhesion formation. Betamethasone phosphate produced a significant reduction (P less than 0.05) in fibrosis when compared with all other corticosteroid or control solutions. There was no statistically significant difference in the degree of inflammation or adhesion formation.