Pelvic Adhesions

From the website of the International Adhesions Society:

Chronic pelvic pain and/or associated intestinal disturbance are a major cause of misery for thousands of patients. Often in constant pain, the patient experiences loneliness, hopelessness, frustration and desperation with thoughts of suicide. Although ADHESIONS are often (but not always) the cause of this pain, treatment for adhesions is not performed either because the surgeon does not believe that adhesions can cause the problem, or because lysis of adhesions is considered too difficult or futile.

What are Adhesions?

An ADHESION   is a type of scar that forms an abnormal connection between two parts of the body.  Adhesions can cause   severe clinical problems.  For example, adhesions   involving the female reproductive organs (ovaries, Fallopian   tubes) can and do cause infertility,   dyspareunia   (painful intercourse) and debilitating   pelvic pain.  Adhesions involving the bowel   can cause bowel   obstruction or blockage.  Adhesions may form   elsewhere such as around the heart,   spine   and in the hand   where they lead to other problems.

Adhesions occur in response   to injury of various kinds.  For example, non-surgical insults such as endometriosis,   infection, chemotherapy, radiation and cancer may damage   tissue and initiate ADHESIONS.  By far the most   common kind of ADHESION is the one that forms after   surgery.  ADHESIONS typically occur at the site   of a surgical procedure although they may also occur elsewhere.

Adhesions and Chronic Pelvic Pain (CPP)

ADHESIONS are believed to cause pelvic pain by tethering down organs and tissues, causing traction (pulling) of nerves. Nerve endings may become entrapped within a developing adhesion. If the bowel becomes obstructed, distention will cause pain.

Some patients in whom chronic pelvic pain has lasted more than six months may develop “Chronic Pelvic Pain Syndrome.”

Adhesions and Surgery

Adhesions are an almost inevitable outcome of surgery, and the problems that they cause are widespread and sometimes severe. It has been said by some that adhesions are the single most common and costly problem related to surgery, and yet most people have not even heard the term.

Menzies and Ellis (1990) found that 93% of patients who had undergone at least one previous abdominal operation had adhesions, compared with only 10.4% of patients  who had never had a previous abdominal operation.

Furthermore, 1% of all laparotomies developed obstruction  due to adhesions within one year of surgery with 3% leading to obstruction at some time after surgery.

Lastly, following surgical treatment of adhesions causing intestinal obstruction, obstruction due to   adhesion reformation occurred in 11 to 21% of cases   (Menzies, 1993).

The problem with adhesiolysis is that ADHESIONS almost   always reform, and so the procedure is sometimes self-defeating.

In addition, the presence of adhesions makes surgery more hazardous, because of the risk   of injury to the bowel, bladder, blood vessels and ureters.

Thank you, http://joynpain2.wordpress.com, for pointing out this frequently misdiagnosed chronic pain problem.

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