The effects of ozone therapy on postoperative adhesions and ovarian functions: An experimental study



Rats, Ozone, Adhesion


Aim: Numerous methods are used to prevent the development of postoperative adhesion formation. There are few studies on the effects of ozone therapy on postoperative intraabdominal adhesions and ovarian functions. This study aimed to investigate the effects of ozone treatment on postoperative intraabdominal adhesions and ovarian roles in rats.Methods: Twenty female Wistar albino rats were randomly allocated into two groups as laparotomy (Group 1, n: 10) and laparotomy + intraperitoneal ozone (Group 2, n: 10). After laparotomy, parietal peritoneum, uterus and adnexal surfaces were scraped in both groups. Follicle-stimulating hormone (FSH), Estradiol (E2), Lactate Dehydrogenase (LDH), Urea, and Creatinine levels were measured, and histopathological evaluation was performed. Both groups were compared concerning histopathological and biochemical findings.Results: In the ozone-treated group, antioxidant levels (P=0.012) were significantly higher, and E2 levels (P=0.005) were substantially lower than the control group. There was no statistically significant difference between the two groups regarding FSH, Urea, Creatinine, and LDH (P=0.12, P=0.72, P=0.45, and P=0.79, respectively). Histopathologically, postoperative intraabdominal adhesion rates between the two groups were statistically similar.Conclusion: Although there was no statistically significant difference, ozone therapy had a decreasing effect on severe fibrosis and congestion rates. Although there was no difference in FSH, low levels of E2 in Group 2 suggest that ozone treatment may have a protective effect on the ovaries. However, further studies are needed concerning adhesion formation and the impact on ovarian functions.


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Arung W, Meurisse M, Detry O. Pathophysiology and prevention of postoperative peritoneal adhesions. World J Gastroenterol. 2011;17:545-53.

Ellis H. The clinical significance of adhesions: focus on intestinal obstruction. Eur J Surg Suppl. 1997;577:5-9.

Okabayashi K, Ashrafian H, Zacharakis E, Hasegawa H, Kitagawa Y, Athanasiou T, et al. Adhesions after abdominal surgery: a systematic review of the incidence, distribution and severity. Surg Today. 2014;44:405-20.

Diamond MP, Freeman ML. Clinical implications of postsurgical adhesions. Hum Reprod Update. 2001;7:567-76.

Diamond MP. Reduction of postoperative adhesion development. Fertil Steril. 2016;106:994-7.

Diamond MP, Wexner SD, diZereg GS, Korell M, Zmora O, Van Goor H, et al. Adhesion prevention and reduction: current status and future recommendations of a multinational interdisciplinary consensus conference. Surg Innov. 2010;17:183-88.

Gupta J. Chronic pelvic pain. In: Edmonds DK, Lees C, Bourne TH, Eds: Dewhurst's Textbook of Obstetrics & Gynaecology. Wiley: Blackwell; 2018. pp. 744-52.

Gomez-Gil V, Garcia-Honduvilla N, Pascual G, Rodriguez M, Bujan J, Bellon JM. Peritoneal adhesion formation and reformation tracked by sequential laparoscopy: optimizing the time point for adhesiolysis. Surgery. 2010;147:378-91.

Wilson MS, Ellis H, Menzies D, Moran BJ, Parker MC, Thompson JN. A review of the management of small bowel obstruction. Members of the Surgical and Clinical Adhesions Research Study (SCAR). Ann R Coll Surg Engl. 1999;81:320-8.

Schnuriger B, Barmparas G, Branco BC, Lustenberger T, Inaba K, Demetriades D. Prevention of postoperative peritoneal adhesions: a review of the literature. Am J Surg. 2010;201:111-21.

Ural DA, Saruhan H, Saygın İ, Aykan DA, Ural A, İmamoğlu M. Long-term outcomes of pure olive oil to prevent postoperative peritoneal adhesions in rats. J Surg Med. 2019;3:218-22.

diZerega GS. Contemporary adhesion prevention. Fertil Steril. 1994;61:219-35.

Smith NL, Wilson AL, Gandhi J, Vatsia S, Khan SA. Ozone therapy: an overview of pharmacodynamics, current research, and clinical utility. Med Gas Res. 2017;7:212-9.

Uysal B, Demirbag S, Poyrazoglu Y, Cayci T, Yesildaglar N, Guven A, et al. Medical ozone therapy decreases postoperative uterine adhesion formation in rats. Arch Gynecol Obstet. 2012;286:1201-7.

Sayar I, Bicer S, Gursul C, Gurbuzel M, Peker K, Isik A. Protective effects of ellagic acid and ozone on rat ovaries with an ischemia/reperfusion injury. J Obstet Gynaecol Res. 2016;42:52-8.

Merhi Z, Garg B, Moseley-LaRue R, Moseley AR, Smith AH, Zhang J. Ozone therapy: a potential therapeutic adjunct for improving female reproductive health. Med Gas Res. 2019;9: 101-5.

Smith AJ, Clutton RE, Lilley E, Hansen KEA, Brattelid T. PREPARE: guidelines for planning animal research and testing. Lab Anim. 2018;52:135-41.

Ogut E, Yildirim FB, Sarikcioglu L, Aydin MA, Demir N. Neuroprotective Effects of Ozone Therapy After Sciatic Nerve Cut Injury. Kurume Med J. 2020;65:137-44.

Guevara-Guzman R, Arriaga V, Kendrick KM, Bernal C, Vega X, Mercado-Gomez OF, et al. Estradiol prevents ozone-induced increases in brain lipid peroxidation and impaired social recognition memory in female rats. Neuroscience. 2009;159:940-50.

Di Filippo C, Capuano A, Rinaldi B, Luongo M, Lettieri B, Rossi F, et al. Intraperitoneal oxygen/ozone treatment decreases the formation of experimental postsurgical peritoneal adhesions and the levels/activity of the local ubiquitin-proteasome system. Mediators Inflamm. 2011;606718.

Lalountas MA, Ballas KD, Skouras C, Asteriou C, Kontoulis T, Pissas D, et al. Preventing intraperitoneal adhesions with atorvastatin and sodium hyaluronate/carboxymethylcellulose: a comparative study in rats. Am J Surg. 2010;200:118-23.

Bocci VA. Scientific and medical aspects of ozone therapy. State of the art. Arch Med Res. 2006;37:425-35.

Bocci V. Ozone as Janus: this controversial gas can be either toxic or medically useful. Mediators Inflamm. 2004;13:3-11.

Demirbag S, Uysal B, Guven A, Cayci T, Ozler M, Ozcan A, et al. Effects of medical ozone therapy on acetaminophen-induced nephrotoxicity in rats. Ren Fail. 2010;32:493-97.

Souza YM, Fontes B, Martins JO, Sannomiya P, Brito GS, Younes RN, et al. Evaluation of the effects of ozone therapy in the treatment of intra-abdominal infection in rats. Clinics. 2010;65:195-202.

Guven A, Gundogdu G, Sadir S, Topal T, Erdogan E, Korkmaz A, et al. The efficacy of ozone therapy in experimental caustic esophageal burn. J Pediatr Surg. 2008;43:1679-84.

Kesik V, Uysal B, Kurt B, Kismet E, Koseoglu V. Ozone ameliorates methotrexate-induced intestinal injury in rats. Cancer Biol Ther. 2009;8:1623-28.

Radwanska E, Headley SK, Dmowski P. Evaluation of ovarian function after tubal sterilization. J Reprod Med. 1982;27:376-84.






Research Article

How to Cite

Deniz R, Baykuş Y, Uzuner MB, Adalı Y. The effects of ozone therapy on postoperative adhesions and ovarian functions: An experimental study. J Surg Med [Internet]. 2020 Jan. 2 [cited 2022 Nov. 28];4(1):66-70. Available from: