Home Physicians Definitions Discussions About Us Contact Us Sitemap
Womens Surgery Group
Endometriosis
Menopause
Osteoporosis
Gynecologic Cancer
Incontinence
Ovarian Cysts
Abnormal Pap Smears
Congenital Anomalies
Ectopic Pregnancy
Breast Cancer
Pelvic Pain
Infertility
Fibroids
Adhesions
Links
Hysterectomy

 

 

 

 

 

 

 

 

 

 

Treatments

What causes adhesions to form?
The pelvic and abdominal organs, such as the ovaries and uterus, are wrapped in a clear membrane known as the peritoneum (membrane that wraps the pelvic and abdominal organs). Whenever there is any injury, trauma or infection, or when surgery is performed in this area, adhesions can form. Removing these bands of scar tissue aggravates the healing cycle, and can therefore cause the formation of new adhesions.

Adhesions form as the result of the following common gynecologic procedures:
Ovarian Surgery: The ovary is the most common site for adhesions to form, usually resulting from surgery to remove ovarian cysts.

Surgical Treatment of Endometriosis: Endometriosis is a disease in which patches of endometrial tissue - the mucous membrane that lines the inside of the uterus - become implanted outside the uterus. Endometriosis often occurs in the pelvis and abdomen and can be associated with severe inflammation and dense adhesions. The abnormal tissue is removed through surgery.

Myomectomy is the removal of fibroids from the uterus. Adhesion formation at the incision line on the uterus is a common complication of the procedure.

Adhesiolysis is the removal or surgical separation of adhesions. Ironically, the removal of adhesions can aggravate the healing process, thereby leading to the formation of new adhesions.

Reconstructive Tubal Surgery: The repair of blocked fallopian tubes is a delicate procedure that often includes the removal of existing adhesions. Unfortunately, the surgery itself can lead to the formation of new adhesions.

Adhesions also are a common occurrence in women who suffer from pelvic inflammatory disease (PID) and sexually transmitted diseases.

Factors that contribute to the cause of adhesions include the following:
Trauma: The healing process from surgery is a major contributor to adhesion formation.

Ischemia: During surgery, blood flow is often disrupted as a result of tissue cutting, blood clotting or tying of stitches. This may result in ischemia, or reduction of blood flow to the tissues, therefore contributing to adhesion formation.

Foreign Bodies: Foreign bodies include stitches, lint from sponges or talc from surgical gloves. Foreign bodies can cause an inflammatory reaction in the body and can trigger adhesion formation.

Inflammation: Endometriosis and PID can cause inflammation, which can result in adhesion formation.

How are adhesions diagnosed?
Adhesions are diagnosed using laparoscopy - inspecting the abdominal cavity and pelvic structures with a narrow lighted tube, or laparoscope. The laparoscope is inserted through a small incision in the abdominal area. Laparoscopy has become a standard way to diagnose various gynecologic disorders.

How are adhesions treated?
The only way to treat adhesions is to remove or separate them through surgery. This procedure is called adhesiolysis. Unfortunately, adhesions often reoccur in more than 70 percent of women as a result of this treatment: The formation of new adhesions is an ongoing problem because removal of the adhesions aggravates the healing cycle. Because of the cyclical nature of adhesions, many women are forced to endure chronic pain. Therefore, adhesion prevention is vital.