Pelvic Adhesive Disease

When inflammation develops in pelvic organs they are getting swollen and their surface is getting covered with overlay containing fibrin. This fibrin adhere surfaces of adjacent organs to each other as a mechanic barrier to inflammation to extend. In the areas of bond of organs, whitish films form.

Inflammation does not always result in adhesions. When a disease is diagnosed and treated early, adhesions do not form. They start forming when acute process turns into chronic and healing delays.

Adhesions my hinder organs from normal functioning. It may affect intestine from normal functioning which can cause bowel obstruction. If adhesions affect fallopian tubes, ovaries, uterus they may hinder egg from meeting ovule. Thus, adhesions can lead to infertility.

Reasons for Pelvic Adhesive Disease

  • Appendicitis
  • Pelvic organ inflammation (the most common)
  • Mechanical defect of peritoneum and organs within it together with pelvic organs (as a result of injuries)
  • Peritoneal hemorrhage (specifically in blood is infected, bleeding may occur during ectopic pregnancy)
  • Chemical exposure (antibiotics, spirit, talk, iodine, sulphanilamides)
  • Surgery for peritoneal and pelvic organs (foreign bodies left inside the body – medical tampons or drainages - result in adhesions)
  • Endometriosis

Preventing Pelvic Adhesive Disease

  • Have operations for internal parts of the body in time when acute conditions
  • Have cleansing of abdominal cavity
  • Having antibiotic therapy during and after surgery
  • Using anticoagulants

Diagnosing Pelvic Adhesive Disease 

  • Medical history
  • Blood test
  • X-ray (depending on location different methods are used, e.g. sensor probe using barium or irrigoscopy)
  • Gynecological exam (may raise suspicion of adhesion)
  • Ultrasound (not reliable)
  • Magnatic resonance imaging
  • Laparoscopy

Treating Pelvic Adhesive Disease

There are two main options conservative and surgery. Surgery may be used in acute case of bowel obstruction (urgent measure) or planned surgery may be performed in recurred condition.

In Gynecology, main method is laparoscopy. Adhesion resection and removal.

Different methods of treatment include:

  • Laser treatment – adhesion resection with laser
  • Electric surgery – adhesion resection with electric surgical knives
  • Aqua dissection – adhesion resection with water under pressure