Adhesions are abnormal bands of scar tissue that join organs or organ parts together even though they aren’t normally meant to be joined. This condition affects many women in Australia and may occur due to an infection, previous surgery, or 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 fertilised 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 a lack of menstrual periods due to adhesions. It’s also possible to experience no apparent symptoms, even when you have adhesions.

What causes adhesions?

Adhesions occur whenever the body’s natural healing process goes somewhat awry. Usually, the surfaces of the abdominal cavity, uterus, and fallopian tube are slippery, enabling the organs to move around quickly. However, the surface may become sticky if there is an injury from previous surgery, an endometrial deposit, or an infection. This will cause the organs to get stuck together. Scar tissue can also form and keep the organs in an abnormal position, creating a web-like attachment between them. 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. Regarding 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 float into the tube, an interference that reduces the chances of conceiving.

Diagnosis of adhesions

Currently, there are three main ways of diagnosing adhesions:

• Hysteroscopy
• Laparoscopy
• Hysterosalpingogram (HSG)

A hysterosalpingogram is a form of X-ray 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 inserting a clean little tube into the uterus through the cervix to help the doctor see everything inside the uterine cavity and the openings of the fallopian tubes. This technique can be used to diagnose uterine cavity problems, including Asherman’s syndrome. A laparoscopy is a procedure in which a tiny incision is made in the abdomen, and 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.

Adhesions treatment

Your healthcare provider may perform open or laparoscopic surgery, also called adhesiolysis. In this case, an electric current or scalpel will cut the adhesions.

Open adhesiolysis

Since adhesions can form after the surgical procedure, open adhesiolysis might not be suitable except when you need to remedy severe problems like bowel obstruction. In about 70% of cases, surgery to remove the initial adhesions may cause the development of more adhesions. Therefore, thoroughly discuss the benefits, risks, and alternatives to surgery with your healthcare provider before making your final decision.

Laparoscopic adhesiolysis

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 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 dealing with extensive adhesions. But it’s important to note that it can be time-consuming (it 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

Surgical adhesiolysis is crucial for relieving symptoms, but there’s a risk of new adhesions forming after surgery. Modern surgical protocols include targeted measures to prevent this. For example, surgeons apply barrier agents that temporarily separate tissues during healing, reducing scar tissue formation. Meticulous tissue handling and advanced precision instruments minimize trauma and inflammation during surgery, key factors in adhesion formation. These strategies, backed by clinical research and expert consensus, lower recurrence rates and improve recovery. Discuss these preventive techniques with your healthcare provider to understand the benefits and potential risks of your surgery.

What Does Adhesion Pain Feel Like?

Adhesion pain varies in intensity and type, depending on the scar tissue’s size, location, and extent. Many describe it as a constant, deep ache in the lower abdomen or pelvic area that worsens with certain activities. Some experience a sharp, cramping sensation during menstruation, after physical exertion, or following sexual intercourse. Others may feel sudden, stabbing pains when internal pressure changes—for example, after a large meal or during prolonged inactivity.

• Pain typically localises to the lower abdomen and pelvic region but can radiate to the lower back.
• Activities that stretch or pull the adhesions can trigger or worsen pain, as the abnormal tissue tugs on surrounding organs.
• Pain intensity can range from a mild, nagging discomfort to severe, debilitating cramps, making it difficult to recognise without discussing symptoms with your healthcare provider.

Experts, including those at the Cleveland Clinic, stress that recognising these pain patterns is essential for accurate diagnosis and effective management. If you experience persistent or severe pain, consult a healthcare professional who can evaluate your symptoms in the context of your overall health and medical history.

Fertility treatment for adhesions

In case there is scar tissue within your fallopian tubes, it may be possible to have a surgical repair done. However, IVF treatment will be more successful and affordable. If 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 minimise pain and improve the odds of conceiving successfully. But depending on your situation, you may need fertility treatment or IVF after surgery. Talk to your doctor about your options and discuss what to expect before and after surgery .

Frequently Asked Questions:

What are adhesions and how do they form?

Adhesions are abnormal bands of fibrous scar tissue that form during the body’s natural healing after injury, surgery, or infection. They develop when repair processes mistakenly link tissues or organs that are normally separate.

What symptoms might suggest the presence of adhesions?

Symptoms of adhesions vary. Some people experience constant or intermittent abdominal or pelvic pain, irregular menstrual cycles, or discomfort during daily activities. Others may have no noticeable symptoms.

How can adhesions affect reproductive health?

How can adhesions be prevented?

Adhesions form naturally during the healing process, making their prevention challenging. Current clinical practices use careful surgical planning combined with post-operative strategies to minimise their development. Many surgeons now choose less invasive techniques that reduce tissue damage and inflammation. Additionally, specialized agents serve as temporary barriers during healing, preventing scar tissue from connecting adjacent tissues.

A structured recovery programme is equally crucial. Early movement, targeted physiotherapy, and strict adherence to personalized wound care protocols create an optimal healing environment and reduce abnormal scar formation. Clinical studies and expert reviews show that this combined approach not only speeds up recovery but also lowers the risk of adhesion recurrence. Patients should discuss these evidence-based prevention methods with their healthcare provider to understand the benefits, potential risks, and the best plan for their individual situation.

What treatment options are available?

Treatment for adhesions includes conservative methods, such as medications to relieve pain and reduce inflammation, and surgical interventions when necessary. Each option has benefits and risks, so consult a healthcare provider to choose the best approach for your situation.

Aftercare and Long-Term Management

After adhesions treatment, a structured aftercare plan is crucial for lasting health and effective recovery. Work closely with your healthcare provider to create a personalised follow-up strategy that tracks progress and addresses any new issues.

Regular check-ups with your specialist help detect early signs of recurrence and adapt your care plan as needed. A multidisciplinary approach—bringing together gynecologists, fertility specialists, and pelvic physiotherapists—is strongly recommended by experts like the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Incorporate these practical strategies into your long-term management plan:

• Regular follow-ups : Schedule consultations to monitor recovery and address symptom changes promptly.
• Tailored physiotherapy : Engage in a physiotherapy program to maintain pelvic mobility and support tissue healing.
• Balanced diet : Follow an anti-inflammatory diet rich in nutrients for repair and overall wellbeing.
• Gradual physical activity : Slowly resume exercise under professional guidance to build strength safely.
• Local support : Utilize local health resources and support networks to stay informed about best practices and additional care options.

This comprehensive aftercare approach supports healing and ensures sustained quality of life and better long-term outcomes after adhesion treatment.

Can adhesions recur after treatment?

Yes, adhesions can recur after treatment. Healthcare professionals recommend regular monitoring and tailored management strategies to minimise the risk of recurrence and support overall reproductive and general health.

Adhesions and Pregnancy Risks

Adhesions in pregnancy can alter the uterus and placental development. Experts advise women with a history of adhesions to consider the following risks:

• Ectopic Pregnancy: Scar tissue can shift the implantation site, raising the chance of the fertilised egg implanting outside the uterus.
• Abnormal Placental Attachment: A disrupted uterine lining may lead to conditions like placenta accreta or placenta previa.
• Impaired Uterine Flexibility: Adhesions might limit the uterus’s ability to expand properly, potentially complicating labour.
• Reduced Blood Flow: Changes in tissue structure can affect placental blood supply, possibly impacting fetal growth.

Regular prenatal check-ups and early intervention are crucial for managing these risks. Women in Australia and worldwide should discuss personalised care plans with their healthcare providers, following guidelines from leading obstetric authorities.

Local Healthcare and Support in Australia

Australia’s healthcare system provides evidence-based care for women with adhesions. National and state services collaborate to deliver personalised treatment plans grounded in the latest research and clinical guidelines.

Specialist clinics and hospitals in major cities like Sydney, Melbourne, and Brisbane offer advanced diagnostic services and minimally invasive treatments. Multidisciplinary teams—including gynaecologists, fertility specialists, pelvic physiotherapists, and mental health professionals—work together to provide personalised care and continuous support.

Beyond clinical care, resources such as the Better Health Channel and Healthdirect Australia provide current information on adhesion management and treatment guidelines from authorities like the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. These resources give women clear guidance on treatment options and potential risks, helping them make informed choices.

Community support networks and online platforms also play a vital role by offering peer support and access to counselling services. Engaging with these groups allows patients to share experiences and gain emotional support during their treatment.

Australian health experts stress that early intervention and coordinated, personalised care are essential for effectively managing adhesions and improving overall well-being.

Evan kurzyp

Evan Kurzyp

Evan is the founder of Fertility2Family and is passionate about fertility education & providing affordable products to help people in their fertility journey. Evan is a qualified Registered Nurse and has expertise in guiding & managing patients through their fertility journeys.