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External Uterine Adhesions
Photograph of a laparoscopic view of the uterus with several regions of adhesions and vesicles (fluid filled blisters) on the outside (serosal) uterine surface. These findings are most consistent with chronic irritation possibly due to a persistent infection or pelvic endometriosis. The reproductive significance of these findings is not clearly known, but any process that results in chronic irritation or inflammation of the reproductive organs is theoretically able to cause subfertility. Therefore, I use the char free power settings on an ultrapulse CO2 laser to completely vaporize these lesions (and possibly underlying endometriosis) and also administer antibiotics. Cautery (or other destructive surgical instruments) may result in local burn injury and postoperative adhesion formation so I prefer the ultrapulse laser with these sorts of lesions.
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