All you need to know about Pelvic Adhesions

by Dr. Manika Khanna Gaudium IVF Centre

Millions of women across the globe are struggling with infertility today, because of reasons that are diverse. Amongst the commonest issues that lead to female infertility is pelvic adhesion, which can deter you from getting pregnant as well as cause pelvic pain, tenderness and bowel obstruction. Detection of pelvic adhesions is what makes them the trickiest to deal with as these may remain dormant for an extended period of time or become symptomatic a long time after the causative event.

Treatment and management of pelvic factor infertility is not a big deal, provided that the patient is able to read the symptoms and the specialist makes timely diagnosis to begin with the requisite infertility treatment. In fact, infertility caused by pelvic adhesions can be resolved easily. All you need to do is to know all about the mystery to be equipped to resolve it and get moving with the journey of parenthood.

What exactly are pelvic adhesions and what causes them?

Pelvic adhesions are the bands of scar tissues which are formed between the organs of the abdominal region (including reproductive organs such as fallopian tubes, uterus, and ovaries), thus leading to infertility problems such as inability to conceive and painful intercourse. In healthy pelvic cavity, the organs themselves as well as the space between them are lined with a slippery tissue called peritoneum. The tissue ensures that the organ do not get adhered to each other and slip off when they come in contact.

When tissue irritation occurs due to an inflammatory event, an adhesive process takes place during the healing; as a result, the organs in the pelvic cavity becoming stuck to each other unintentionally. The reason is that the human body cannot differentiate between organs and scar tissue and may end up connecting them to each other.

Inflammatory events can be anything ranging from pelvic inflammatory disease to infection/blockage in the fallopian tubes, sexually transmitted diseases, endometriosis and post surgical trauma that follows a pelvic surgery (surgery of fallopian tubes and ovaries are primarily responsible for adhesion-related infertility). Inflammation of colon and gall bladder as well as appendicitis makes other possible causes of formation of pelvic adhesions and consequent infertility.

What are the implications of pelvic adhesions?

Pelvic adhesions which are formed on the fallopian tubes or ovaries can be responsible for infertility as well as related complications. Women who have adhesions in and around the fallopian tubes are at high risk of, during which pregnancy develops outside the uterus, in the fallopian tubes.

Those with adhesions in the uterus, a condition medically termed as Asherman’s Syndrome, can come across complications such as recurrent miscarriages. In some cases, the ovaries become adhered to the pelvic walls after an ovarian cystectomy (surgical removal of ovarian cyst); as a implication, the patient may suffer from painful intercourse and persistent pelvic pain.

Another instance of pelvic adhesions is that of the ones in small intestine, which can result in partial or complete obstruction of bowel. Women who suffer from adhesions experience pain as a common symptom, particularly if organs get displaced from their normal position. In many cases, these adhesions may go undetected for years, as symptoms do not manifest in at all in some women.

Diagnosis and Management of Pelvic Adhesions

When pelvic adhesions are suspected as the cause of female infertility, proper diagnosis has to be conducted to establish their presence before beginning with the infertility treatment. The diagnostic procedure in this case involves minimally invasive laparoscopic surgery, during which the pelvic organs are inspected visually with the aid of a slender telescope. The procedure is carried out under general anesthesia.

When it comes to management of pelvic adhesions, the patient may be recommended medication as an effective pain management therapy. On the other hand, more aggressive approach such as laparoscopic surgery is advised if these are causing serious female infertility issues for the patient. If the reproductive organs like ovaries and fallopian tubes are tied down due to extensive adhesions, they need to be cut off to restore the normal function of these organs.

Minimally invasive surgical techniques are only suggested here as this result in fast healing and also minimize the formation of scar tissue. Patients who no longer need to reproduce can even have the ovaries and tubes removed with hysteroscopy in case the problem is acute. In addition to knowing all about the treatment of pelvic adhesions, women should also be aware of the practices that can reduce the chances of their formation in the first place.

As a preventive measure, opting for meticulous and minimally invasive surgical techniques instead of large, open surgeries can inhibit adhesion formation. Use of adhesion barrier surgical products has been regarded appropriate in this regard. Additionally, it is vital to prevent infection as well as have it treated at an early stage so that infectious process is nipped in the bud. Also, women should indulge in safe sex so that the risk of sexually transmitted diseases is reduced to the minimum.

Gaudium IVF is a renowned infertility clinic in India, where a tailor-made approach is followed for each of its patient. The top IVF clinic in Delhi offers effective solutions for a variety of infertility related issues such as pelvic adhesions. For free second opinion by Dr Manika Khanna, the best infertility specialist in India, visit Gaudium IVF.