Adhesions??

I've been told the following from someone on another board. Has anyone dealt with the adhesions? How common are they?


The risks for developing adhesions are quite high no matter what sort of surgery you have because no matter what you have to remove the uterus using incisions. And every cut surface will sprout scar tissue. Adhesions are internal scar tissue that forms in fibrous bands. They attach your internal organs together.

If you are among the lucky 95%, you will never have any symptoms or problems from them at all. If you are one of the unlucky elite(!) your problems can be things like severe, constant agonizing pain, and/or partial bowel obstructions, and/or full bowel obstructions.

The first piece of advice that I would give you is to find out if your surgeon believes that adhesions can cause pain. If she/he doesn't, find another surgeon. There are a list of surgical techniques that the surgeon can use to minimize adhesion formation. Ask the surgeon what s/he will do to minimize adhesion formation. What you want to hear is something like:

1) use surgical gloves with no talc or other foreign bodies
2) keep tissues well hydrated throughout the surgery
3) never use dry sponges
4) handle tissues very gently
5) make sure that every single bleeder is tied off or cauterized before closing
6) make sure that all blood is out of the pelvic cavity before closing. (typically this means multiple rinses with saline.)

DON'T tell the surgeon this list and ask him/her if he/she is going to do these things. Because then he/she will just tell you what you want to hear and you won't know whether it is true or not. Ask the surgeon for the surgeon's list.

Good luck, and you should really do your homework on this one. You may find something that will be an effective alternative to the hysterectomy. If you don't, then you will be going in with the confidence of knowing that there aren't any other viable alternatives, and that you have taken the best actions to ensure that you have minimized the risks of complications.

If you're wondering how one fares during surgery with adhesions, I'm your poster child. The doc who did my lap assisted tubal ligation 12 years ago said she'd never seen anyone with so many adhesions who had no pain. Adhesions and endo on my bowel didn't cause digestive tract problems, but it did cause terrible back pain. One ovary was stuck to my abdomial wall, and I don't know what else was where, but I was given the impression everything was glued to something else.

Had TAH/BSO, and a 90 min operation took 2 1/2 hours due to all the scar tissue, endo, and adhesions. Doc had to cut the stuck ovary out of my abdominal wall. I came through it just fine and am bouncing back faster than doc thought I would, for my age (48) and the extent of my surgery.