Are You At Risk?

Patients who have had, or are going to have, abdominal or pelvic surgery should be aware of the potential complications associated with adhesion formation.

You may never know if you have adhesions - many do not cause problems and are not diagnosed. However, some adhesions significantly restrict the movement of internal organs and can cause complications by twisting or pulling them from their normal positions. Complications may appear quickly after surgery or may take years to become troublesome. Sometimes follow-up surgery is necessary to remove adhesions, either to alleviate the pain or limit further complications.

Adhesions can make further abdominal surgeries longer and more challenging for surgeons to perform. They may make it impractical for doctors to be able to perform laparoscopic procedures. This narrows the range of intervention options available to you if you need further surgery. If adhesions are significant, usually the only option is open abdominal incision, which typically is associated with a greater risk of complications, pain and longer recovery time.

Some further complications adhesions can cause include:

• infertility1
  
• chronic pelvic pain2
• small bowel obstruction3

Adhesions and infertility

Adhesions affecting the ovaries and fallopian tubes are a major cause of infertility. They either block the passage of the egg down the fallopian tubes to the womb or stop the sperm travelling up to meet the egg. 20-40% of all infertility cases are thought to be is adhesion-related.4,5

Adhesion sites commonly associated with infertility

Adhesions and chronic pelvic pain

Pelvic adhesions are the most common cause of chronic pelvic pain.5 They ‘tie down’ organs, restricting their mobility. As a result, everyday movements cause stretching and irritation of nerves which is felt as pain.

Adhesions and small bowel obstruction

The most severe consequence of pelvic adhesions is obstruction of the bowel (intestines). This is a serious condition where the contents of the bowel get stuck in the digestive system. It can cause cramp-like pains in the stomach, nausea and vomiting. If it worsens to a point of complete obstruction, it is considered a medical emergency and failure to treat the problem can lead to serious and permanent damage.