Provider Content
About Pelvic Adhesions
What Are Pelvic Adhesions?
Pelvic adhesions are abnormal bands of scar tissue that may form after surgery, including C-sections, and bind tissues or organs that are usually not connected.
Most patients develop adhesions after pelvic surgery, although in some cases these adhesions do not cause symptoms or problems.
What Causes Pelvic Adhesions?
All of the abdominal and pelvic organs, except the ovaries, are at least partially wrapped in a clear membrane called the peritoneum (per-i-toe-nee-um). When the peritoneum is damaged during surgery, it becomes inflamed. Inflammation is normal and part of the healing process, but inflammation also encourages fibrous bands of scar tissue to develop.
Usually, this scar tissue dissolves, and the area continues to heal. In some cases, however, the scar tissue may develop into adhesions that grow and connect pelvic organs or tissues that normally are separate.
How Common Are Pelvic Adhesions?
Adhesions are very common after pelvic or abdominal surgery. The chances that adhesions will form after surgery and what problems may result depend on many things: the type of surgery you’re having, the number of previous surgeries you've had, and the surgical technique used.
Most patients develop adhesions after pelvic surgery. In fact, studies have shown in 55-100% of patients who had reproductive pelvic surgery will form adhesions.
What Problems Are Caused By Pelvic Adhesions?
Pelvic adhesions may result in the following symptoms or complications:
* Chronic pelvic pain – adhesions are the primary cause of chronic pelvic pain in 16% to 36% of female
* Pain during sexual intercourse
* Increased potential for bladder injury during subsequent surgery
* Infertility – 40% of infertility in women is caused by adhesions
* Bowel obstruction – adhesions are the most common cause of postoperative small bowel obstruction
An Ounce of Prevention
46% of women develop adhesions after their first C-section; that figure rises to 75% by their third C-section.
Susan Jones,* a working mother of three, describes the impact adhesions had on her life and the importance of prevention:
“My first C-section took about 10 minutes […but] my second C-section took nearly 45 minutes and the my final C-section took nearly an hour and a half. My doctor had such a hard time maneuvering around the scar tissue to get to my baby.”
“If I had known about adhesions, I would have talked to my doctor about what can be done to reduce my risk for getting them.”+
*Patient name has been changed for confidentiality purposes.
+Patient testimonial has been provided by National Women’s Health Resource Center.
Reducing your risks during C-sections and pelvic surgeries
Reducing the Risk of Adhesions
Adhesion prevention should be a key topic to discuss with your doctor before surgery.
Your doctor can help you to reduce the risk of adhesions by using careful surgical technique.
In addition, adhesion barriers are effective at reducing adhesion formation after surgery. An adhesion barrier is a physical barrier that is used to separate injured tissues from other tissues and organs during the healing process. Different types of adhesion barrier materials are available to your doctor.
If pelvic adhesions form, the only way to treat them is to cut them in a surgical procedure called adhesiolysis (ad-he-ze-o-li-sis). That's why it is important to try to minimize adhesions with good surgical technique and use of an adhesion barrier.
Addressing the Risk of Bacterial Infections
As many as 1 in 10 women develop infections at the surgical site after a C-section, a much higher rate of infection than for women delivering vaginally. By using antibacterial sutures, surgeons can address one of the risk factors associated with surgical site infection by inhibiting colonization of the suture.
Reducing Postsurgical Scarring
Naturally, you may be concerned about scarring after a C-section. Your incision can be closed using 1 of 3 methods: stapling, suturing (sewing), or via topical skin adhesive.
Topical skin adhesives can help reduce some types of visible scarring, serve as a barrier to bacteria and require no dressings to be changed as the incision heals.
Remember to talk to your doctor about reducing risks before your surgery.
Read more articles about C-Sections and Pelvic Surgery:
- About C-Sections & Pelvic Surgery
- Why Are C-sections Necessary?
- Focus On: One Method for Reducing Pelvic Adhesions
Click here to download questions to ask your doctor: http://www.pelvichealthsolutions.com/c-sections-talk-to-doctor
Click here to download questions to ask your doctor about adhesions:
http://www.pelvichealthsolutions.com/interceed-talk-to-doctor
