What Problems Can Pelvic Adhesions Cause?

Pelvic Adhesions are a common occurrence after pelvic or abdominal surgery. Adhesions are also common in women who suffer from pelvic inflammatory disease (PID), endometriosis (en-do-me-tree-o-sis), or sexually transmitted diseases. Pelvic adhesions observed in gynecologic patients are a major contributing factor to infertility, pelvic pain and/or intestinal obstruction. Such adhesions may be the sequelae to inflammatory processes, endometriosis, and prior surgical intervention. 

The likelihood that pelvic adhesions will form after surgery and what problems may result will vary based on many things - for instance, the type of surgery you are having, the number of previous surgeries you've had, the surgical technique used during the procedure, and your own individual predisposition to adhesion formation.

However, studies have consistently shown that a majority of women who have gynecologic surgery will experience some degree of adhesion formation. For example, in one review of six studies involving patients who had pelvic reconstructive surgery, between 55% and 100% of these patients developed adhesions within six months of surgery - and often adhesions were evident within just a few weeks.

While most adhesions do not cause trouble, adhesions can lead to a variety of potentially serious complications including:

Pelvic pain: Adhesions are a common cause of pelvic pain - an estimated 38 percent of women suffering from pelvic pain have adhesions. Adhesions cause pelvic pain because they bind normally separate organs and tissues together, essentially "tying them down" so that the stretching and pulling of everyday movements can irritate nearby nerves.

Pain during intercourse: Adhesions can also cause pain during intercourse.

Infertility: Adhesions that form as a result of certain types of gynecologic surgery, especially tubal surgeries and surgeries to remove fibroids (myomectomies), are a common cause of infertility. Adhesions between the ovaries, fallopian tubes or pelvic walls can block the passage of the ovum (egg) from the ovaries into and through the fallopian tubes. Adhesions around the fallopian tubes can also make it difficult or impossible for sperm to reach the ovum.

Bowel obstruction: Adhesion formation involving the bowel is particularly common following a hysterectomy. While these adhesions don't normally result in any problems, there is one serious problem that can develop. This problem is called intestinal or bowel obstruction (blockage of the intestine that limits or stops passage of its contents) and it can occur a few days or many years after surgery. Symptoms of bowel obstruction may include pain, nausea, and vomiting.

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