Pelvic Adhesive Disease

Pelvic adhesive disease is a condition that occurs when adhesions or scarring bind adjacent organs together.

All the organs in the abdominal cavity including the pelvic organs are covered with a thin layer of tissue called the peritoneum. This smooth surface produces a lubricant that allows the organs of the body to slide against each other. Damage can occur to the peritoneum that causes scarring to occur. The scarring causes the two surfaces to stick to one another. The bands of tissue between the surfaces are called adhesions. When it occurs in the pelvis between organs such as the uterus, tubes, or ovaries, it is called pelvic adhesive disease.

Adhesions are a common cause of infertility by forming around the fallopian tubes. They can cause infertility by forming around the fallopian tubes and/or ovaries. When this happens the sperm and the eggs may not be able to get together. Thus fertilization cannot occur and leads to infertility. The adhesions may also prevent an embryo from traveling down the tube into the uterus and cause an ectopic or tubal pregnancy. Below are some of the common questions concerning pelvic adhesive disease.

How Is Pelvic Adhesive Disease Diagnosed?

If one has had pelvic infections such as a ruptured appendix, pelvic inflammatory disease, chlamydia, or gonorrhea you have pelvic adhesions. The more surgeries that one has in the pelvic or abdominal cavities will increase the chances that one has pelvic adhesive disease. Also, endometriosis causes inflammation that can lead to adhesion formation and pelvic adhesive disease. Anyone with these histories can have pelvic adhesive disease. Adhesions can also form inside of the uterus from surgery, or infections.

Pelvic adhesive disease is diagnosed by looking directly at the pelvic organs with a surgery such as a laparoscopy and hysteroscopy. The hysterosalpingogram test (HSG) may show blocked or partially blocked fallopian tubes or intrauterine adhesions that suggest pelvic adhesive disease.

What Are the Symptoms?

Most of the time the only symptom is infertility. Other patients may experience pelvic or lower abdominal pain and tenderness. They may experience pain with heir periods, during intercourse, or with bowel movements.

What Treatments Are Available?

Surgery such as a laparoscopy or hysteroscopy can be used to treat adhesions in the pelvis or inside of the uterus respectively. In vitro fertilization can be used to treat the infertility associated with pelvic adhesive disease.

Can the Adhesions Grow Back?

Yes the adhesions can grow back after treatment with surgery. This is less likely to happen with laparoscopy or hysteroscopy compared to open procedures such as laparotomies.