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Adhesion Information

From the GYN Diagnosis Articles List

Hysterectomy for AdhesionsMy physician believes that my pain is the result of adhesions. He says a hysterectomy could be the answer. Is this true? If so, is a total abdominal hysterectomy (TAH) my only option?

Adhesions are a type of scar tissue that has formed between two organs or tissues. These bands of scar tissue can form following a surgery, an infection, or any other trauma to an area. As the body tries to repair itself, cells may not recognize surrounding tissue and organs. Thus, as the healing organ comes in contact with another organ or tissue, the body attempts to repair both organs, causing the two areas to become connected. Over time, those adhesions can shorten and possibly cause pain, digestive issues, infertility, and painful intercourse as the affected organs are moved and distorted.

Women with unexplained chronic abdominal or pelvic pain should be evaluated for adhesions. This is especially true for women with a history of abdominal or pelvic surgeries including C-sections, appendectomies, and laparoscopies. Women with endometriosis are also more prone to have adhesion formation. Cancer and resulting treatments may also lead to adhesions.

Diagnosing adhesions without surgery can be difficult and may be the result of excluding other conditions. In their initial stage, adhesions are like filmy spider webs that are not detected on CT scans, X-rays, ultrasounds, or other tests. In later stages, the adhesions may become more dense and, thus, more visible. They can also cause a bowel obstruction which could be noted on various tests. Distorted organs or organs in an unusual location as a result of adhesions may also be noted on some tests. To help with diagnosis, women with chronic pelvic pain should keep a detailed symptom diary.

Women with suspected adhesions should look for a doctor who primarily treats women with chronic pelvic pain issues. This type of physician is not likely to practice obstetrics. Another option could be a physical therapist who practices deep tissue massage; gently breaking up the adhesions could offer symptom relief.

Painful adhesions involving the uterus may, at times, lead to a hysterectomy. However, a gynecological surgeon trained in minimally invasive surgery may be able to treat the adhesions while preserving the uterus. A skilled general surgeon may also be able to perform uterus-sparing surgery. Unfortunately, any surgery performed to treat adhesions can allow for the formation of new adhesions. In some cases, a type of adhesion barrier may be used to try to prevent new adhesions. Surgeons with adhesion experience may also use special surgical methods to try to help minimize the formation of new adhesions.

Before scheduling a hysterectomy to treat adhesions, the HysterSisters recommend seeking a second opinion. If there is an underlying cause for adhesions, that condition needs to be treated as well. Otherwise, adhesions and subsequent symptoms could continue despite the hysterectomy. If surgery is necessary, some type of laparoscopic procedure could offer the most optimal outcome, whether or not it includes removal of the uterus.

This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

06-18-2013 - 10:09 AM


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