Pelvic Adhesive Disease

Pelvic adhesive disease is a condition in which scar tissue binds adjacent organs to each other.

All of the organs in your abdominal cavity are covered with a smooth, slippery tissue called the peritoneum. The surface of this tissue is lubricated, allowing adjacent organs to glide easily against each other.
However, when the surface becomes damaged or inflamed, scar tissue forms. Scar tissue that develops between 2 organs will cause the surfaces of the organs to stick, or adhere, to each other. The bands of scar tissue are called adhesions.

Adhesions are often a cause of infertility. If they form inside or around the ends of the fallopian tubes, they may block an egg and sperm from meeting. If the tubes are partially blocked by adhesions, sperm may meet the egg, but the fertilized embryo may be trapped, resulting in an ectopic pregnancy. Adhesions that develop on the ovaries may disrupt ovulation, and those that develop inside the uterus may prevent a fertilized egg from implanting properly.

How pelvic adhesive disease is diagnosed

Your medical history and a pelvic exam may suggest the diagnosis of pelvic adhesive disease. However, only a laparoscopy or hysteroscopy can confirm this diagnosis. A laparoscopy is an outpatient surgical procedure in which your doctor will use a narrow fiber optic telescope inserted through an incision near your navel to look for and sometimes remove adhesions in your pelvic cavity. A hysteroscopy is an outpatient procedure in which your doctor will use a narrow fiber optic telescope inserted into your uterus through your cervix to look for and sometimes remove adhesions inside your uterus.

Questions & Answers

Q. What causes pelvic adhesive disease?
A. Anything that causes damage to the peritoneum—the smooth, slippery tissue covering the organs in the abdominal cavity—may result in adhesions. Surgical procedures, infections, and inflammation from endometriosis are the most common causes. It is not uncommon for adhesions to form after bowel surgery or surgery for appendicitis. Surgery on the ovaries, fallopian tubes, uterus, or cervix may also lead to adhesions. Infection and endometriosis are also capable of causing inflammation, which may damage the peritoneum and lead to adhesions.

Q. What kinds of symptoms can I expect?
A. Many women who have adhesions do not have any symptoms, except for infertility. Other women may feel abdominal or pelvic pain, menstrual cramps, tenderness, pain during intercourse, or pain during bowel movements.

Q. What treatments are available to me?
A. Surgery to remove the adhesions is the primary treatment option. It can usually be performed during a laparoscopy or hysteroscopy.

Q. Can the adhesions “grow back”?
A. Unlike tumors, adhesions do not grow back. However, new adhesions may form in the areas that were treated surgically.

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