Category: Causes
What are the causes of adhesions in gynecology?
Adhesions may form as the result of the following common gynaecologic procedures: Ovarian Surgery: The ovary is the most common site for adhesions to form, usually resulting from surgery to remove ovarian cysts. Surgical Treatment of Endometriosis: Endometriosis is a disease in which patches of endometrial tissue – the mucous membrane that lines the inside of the uterus – become implanted outside the uterus. Endometriosis often occurs in the pelvis and abdomen and can be associated with severe inflammation and dense adhesions. The abnormal tissue is removed through surgery. Myomectomy Myomectomy is the removal of fibroids from the uterus. Adhesion formation at the incision line on the uterus is a common complication of the procedure. Adhesiolysis Adhesiolysis is the removal or surgical separation of adhesions. Ironically, the removal of adhesions can aggravate the healing process, thereby leading to the formation of new adhesions. Reconstructive Tubal Surgery: The repair of blocked fallopian tubes is a delicate procedure that often includes the removal of existing adhesions. Unfortunately, the surgery itself can lead to the formation of new adhesions. Adhesions also are a common occurrence in women who suffer from pelvic inflammatory disease (PID) and sexually transmitted diseases
Which factors contribute to the cause of adhesions?
Factors that contribute to the cause of adhesions include the following: Trauma: The healing process from surgery is a major contributor to adhesion formation. Ischemia: During surgery, blood flow is often disrupted as a result of tissue cutting, blood clotting or tying of stitches. This may result in ischemia, or reduction of blood flow to the tissues, therefore contributing to adhesion formation. Foreign Bodies: Foreign bodies include stitches, lint from sponges or talc from surgical gloves. Foreign bodies can cause an inflammatory reaction in the body and can trigger adhesion formation. Inflammation: Endometriosis and PID can cause inflammation, which can result in adhesion formation. Adhesions following abdominal surgery Abdominal surgeries that could lead to adhesions include
What are different types of adhesions?
The tissue develops when the body’s repair mechanisms respond to any tissue disturbance, such as surgery, infection, trauma, or radiation. Although adhesions can occur anywhere, the most common locations are within the abdomen, the pelvis, and the heart. Pelvic adhesions:
Pelvic adhesions may involve any organ within the pelvis, such as the uterus, ovaries, fallopian tubes, or bladder, and usually occur after surgery.
Adhesions between anterior uterine wall
Adhesions between uterus ,adnexa and bowel posteriorly
Pelvic inflammatory disease (PID) results from an infection (usually a sexually transmitted disease) that frequently leads to adhesions within the fallopian tubes.
A woman’s eggs pass through her fallopian tubes into her uterus for reproduction.
Tubal adhesions can lead to infertility and increased incidence of ectopic pregnancy in which a fetus develops in the tube.
Adhesions reform after surgery!
Surgery without any effects…
and which could be very dangerous, especially in adhesions surgery cases!
The next some images show why a surgery without adequate adhesion barriers doesn’t work and therefore is absolute
unnecessary, without any effect and can be dangerous.
This patient has adhesions between sigma / left pelvic wall / uterus / ovar
