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. 2020 Mar 22;2020(3):CD000475. doi: 10.1002/14651858.CD000475.pub4

Wallweiner 1998.

Methods Unit of randomisation: participant
 Method of randomisation: not stated
 Time of randomisation: at completion of surgery
 Blinding: yes
Participants Women (N = 40) undergoing initial treatment for endometriosis by laparoscopy‐vaporisation of peritoneal deposits, excision of endometrioma, reconstructive surgery, and adhesiolysis
 No dropouts
Mean age, years: 27
 Pre‐existing adhesions: yes
 Cause of adhesions: endometriosis
 Microsurgery: no
 Location: Germany
 Timing: not stated
7 dropouts: 4 were pregnant, 2 withdrew, and 1 had such dense adhesions at laparoscopy of both ovaries that no assessment could be made
Pre‐existing adhesions: nil
 Mean age, years: 28
 No other cause of infertility found
 Timing: 1994 to 1995
Country: UK (1 centre)
Interventions Oxidised regenerated cellulose applied to all injured visceral peritoneal surfaces of ovary,tubes and uterus vs no treatment
Other adjuvants used: none
Second‐look laparoscopy
  1. Timing: 3 to 6 months after initial surgery

  2. Surgeon unaware: yes

  3. Adhesiolysis: nil

Outcomes Adhesions at second‐look laparoscopy: 3 to 6 months later
  1. Incidence (per participant)

  2. Severity according to scoring system

  3. Surface area

  4. Extent: area, area differential, % improvement

  5. Incidence in participants with endometriomas

  6. Severity in participants with endometriomas


Adverse outcomes: unknown
Pregnancy: not stated
Notes Power calculations: nil
 Sponsorship: not stated
 Documentation: video
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Method of randomisation not clearly stated
Allocation concealment (selection bias) Unclear risk Not clearly stated in text
Blinding of participants and personnel (performance bias) 
 All outcomes Unclear risk Not stated whether initial surgeon was blinded; however as control was no treatment, this appears unlikely. Not clearly stated whether participants were blinded
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk States that evaluator performing second‐look laparoscopy was not familiar with the initial operative site, but does not clearly state that evaluator was blinded to treatment allocation
Incomplete outcome data (attrition bias) 
 All outcomes Unclear risk No mention of whether withdrawals or dropouts occurred during the study
Selective reporting (reporting bias) Unclear risk Data reported as numbers in a dichotomous score. P values stated. No conversion or subsets of data. No pre‐publication protocol for reference purposes
Other bias Low risk No other bias identified

AFS: American Fertility Society.

BBT: basal body temperature.

CI: confidence interval.

GnRH: gonadotrophin‐releasing hormone.

HSG: hysterosalpingogram.

mAFS: modified American Fertility Society.

PID: pelvic inflammatory disease.

PTFE: polytetrafluoroethylene.

SD: standard deviation.

SEM: standard error of the mean.

SLL: second‐look laparoscopy.