Everything You Should Know About Adhesions Symptoms and Treatment
Adhesions are anomalous bands of scar tissue that join organs or organ parts together even though they aren’t normally meant to be joined. This condition affects a significant number of women in Australia and may occur due to an infection, previous surgery, or some disease.
Adhesions may lead to infertility by interfering with the ovulation process, preventing the sperm and egg from meeting, and making it difficult for the uterus to accommodate the fertilized embryo. Adhesions are also a possible cause of clogged fallopian tubes. Pelvic inflammatory disease (PID) and endometriosis may cause adhesions that affect one’s ability to conceive.
In other cases, adhesions may cause severe pain, including pain while having sex and menstrual cramps. Some women in Australia also experience abnormal menstrual bleeding, light periods, or lack of menstrual periods due to adhesions. It’s also possible to experience no apparent symptoms even when you have adhesions.
What are the causes of adhesions?
Adhesions occur whenever the natural healing process of the body goes somewhat awry. Usually, the abdominal cavity, uterus, and fallopian tube surfaces are slippery, which enables the organs to move around quickly.
But if there is an injury from previous surgery, an endometrial deposit, or an infection, the surface may become sticky. This will cause the organs to get stuck together. Scar tissue can also form and keep the organs attached in an abnormal position, and this creates a web-like attachment between organs. The adhesions can be strong and thick, forcing the organs to pull on each other unnaturally. This causes pain, particularly during menstruation or sexual intercourse.
When it comes to Asherman’s syndrome, adhesions will occur within the uterus. While the cases may be rare, the condition causes uterine walls to stick together almost entirely.
Intrauterine adhesions usually prevent healthy endometrium from forming. This can prevent the healthy implantation of the embryo. If the implantation occurs by chance, the risk of getting a miscarriage will be higher.
In the case of pelvic inflammatory disease, or other forms of infection that affect the reproductive system, the fallopian tubes may become inflamed. The inflamed surface may even develop adhesions or scar tissue within the tubes.
The adhesions will prevent sperm or egg from coming together. Endometriosis also causes adhesion in the pelvic cavity, especially near the ovaries or fallopian tubes, which leads to ovulation interference.
Endometrial adhesions can also prevent the fallopian tube from moving naturally. Since the ovary isn’t attached to the fallopian tubes, the ovulated egg must find a way to get to the fallopian tube. If adhesions affect the natural movement of the tubes, it will be difficult for the egg to get to float into the tube, an interference that reduces the chances of conceiving.
Diagnosis of adhesions
Currently, there are three main ways of diagnosing adhesions:
- Hysterosalpingogram (HSG)
A hysterosalpingogram is a form of x-ray that is used to determine the uterus’s shape and check if the tubes are clear. If the fallopian tubes are blocked, you may be diagnosed with HSG.
A hysteroscopy involves using a clean little tube known as a hysteroscopy that’s inserted into the uterus through the cervix to help the doctor see everything inside the uterine cavity and the openings of the fallopian tubes. You can rely on this technique to diagnose uterine cavity problems, including Asherman’s syndrome.
A laparoscopy is a process where a tiny incision is made in your abdomen, and then a lighted tube with a camera device is inserted along with the instruments. This method is the only way to diagnose endometriosis.
It’s possible to get ordinary results on hysteroscopy and HSG and still have mild or severe endometriosis.
Your healthcare provider may opt to use open or laparoscopic surgery, also called adhesiolysis. In this case, the adhesions will be cut by an electric current or scalpel.
Since adhesions can form after the surgical procedure, open adhesiolysis might not be suitable except in situations where you need to remedy severe problems like bowel obstruction.
In about 70% of the cases, the surgery for removing the initial adhesions may cause the development of more adhesions. Therefore, make sure you discuss the benefits, risks, and alternatives to surgery thoroughly with your healthcare provider before making your final decision.
Women who experience adhesion symptoms can consider laparoscopic surgery. One of the primary benefits of this procedure is that it requires a small incision or cut, which is why it is also called keyhole surgery. Laparoscopy is an upstanding method for performing infertility surgery because it reduces the risks of new adhesion growth.
Laparoscopic adhesiolysis may improve the quality of life among women who have chronic pelvic pain caused by adhesions. The surgery shows similar results to other invasive forms of surgery when it comes to dealing with extensive adhesions. But it’s important to note that it can be time-consuming (takes about two to four hours) due to the difficulties involved in the procedure.
Many women who undergo laparoscopic adhesiolysis:
- Experience minimal complications
- Are discharged the same day after the procedure
- Will not need to have major abdominal incisions
- Resume full activity in a week after the surgery
If you do not want to undergo surgery, your healthcare provider may recommend non-surgical treatments. This may include:
- Taking medication (this is the first treatment option for acute pain)
- Soft tissue mobilization
- Physical therapy
- Lifestyle changes
Make sure you consult with the healthcare provider to determine if you should go for the surgical or non-surgical treatment options depending on your situation.
Remember that the same surgery used to diagnose endometriosis or adhesions is used to treat and eliminate adhesions. This way, you will not have to go through surgery two times.
Fertility treatment for adhesions
In case the scar tissue within your fallopian tubes, it may be possible to have a surgical repair done. But IVF treatment will be more successful and affordable.
If the Asherman’s syndrome is the primary cause of your infertility, you may need to remove the adhesions during operative hysteroscopy. The chances of conceiving naturally afterwards will increase, or your provider may recommend fertility treatment after surgery.
In the case of endometriosis or pelvic adhesions, scar tissue removal may minimize pain and improve the odds of conceiving successfully. But depending on your situation, you may need fertility treatment or IVF after surgery. Make sure you talk to your physician about your options and discuss what to expect before and after surgery.