Guest Author - Maria Hester, M.D.

Adhesions are a very common side effect of surgery. Basically, adhesion is just a fancy name for scar tissue. Whenever a doctor performs surgery, there is the chance that an adhesion will form. However, in addition to surgery, ahesions can form in response to any type of injury, such as pelvic inflammatory disease, in which the fallopian tubes are inflammed as a result of infection. Endometriosis is another common cause of adhesion formation.

An adhesion is a type of scar that creates an abnormal connection in the body. For instance, the adhesion can form an external connection between organs, such as the colon [large intestine] and the urinary bladder. Adhesions can also form around organs and cause blockage. As a matter of fact, one of the most dreaded complications of abdominal surgery is a small bowel obstruction, or SBO. While many SBOs do not result in complete obstruction of the bowels, others do, causing a potentially life-threatening situation.

If the bowels are completely obstructed, without surgery to lyse the adhesions, the bowel wall will eventually burst open, showering the abdominal cavity with untold numbers of bacteria, which in turn, cause potentially fatal infection of the abdominal cavity [peritonitis]. A ruptured bowel can also lead to life-threatening septic shock.

On the other hand, if adhesions form in the pelvic cavity, they can cause a variety of gynecologic-related symptoms, such as dyspareunia (pain during sexual intercourse), chronic pelvic pain, or infertility.

Chronic pelvic pain is pain in the pelvic region. In this condition, adhesions are believed to cause traction on organs and nerves resulting in chronic pain. Nerves can even become entrapped in this scar tissue. Unfortunately, even after the initial insult, such as an infection endometriosis, is brought under control, the adhesions remain. Adhesions do not dissolve. They remain until there is some surgical intervention to remove them. As a result, it is not uncommon to experience daily, unremitting pelvic pain long after improvement of the precipitating event. This condition is a potentially debilitating one which often causes significant physical and psychological pain.

Those who suffer from chronic pelvic pain may require large doses of pain medications just to function on a daily basis. The emotional toll this pain causes can be almost as debilitating as the physical pain. A feeling of helplessness and loss often develops and many require treatment for depression to help them cope with their pain.

Unfortunately, even after undergoing surgery to lyse adhesions, there is a small chance they will return, possibly necessitating even more surgical procedures. Nevertheless, there is always hope for chronic pelvic pain and other complications of adhesions. While all potential treatments, both medications and procedures, carry some risk, in many, many cases, the risk to benefit ratio is far on the side of proceeding.
Be determined to work with your physician to find the best solution to your situation and do not be discouraged if the first attempt does not completely fix the problem.