Surgeons can also reduce the risk of adhesions by:. Minimizing risks for adhesions is the best course since the only way to treat adhesions is to surgically remove them during a procedure called adhesiolysis. Ironically, since the procedure itself damages the peritoneum, it can cause even more adhesions. Plus, adhesions often reform after adhesiolysis.
You may be taking opioids unnecessarily. A conversation with your doctors on your pain management options can help. Your Health. Your Wellness. Your Care. Real Women, Real Stories. Home pelvic health Surgical Adhesions from Gynecologic Surgery. Surgical Adhesions from Gynecologic Surgery. Learn about this common complication from pelvic and abdominal surgeries.
Medically Reviewed. Although many women develop adhesions after surgery and never know it, in some women adhesions can cause serious complications, including: Pelvic pain: One study found that 82 percent of patients suffering from chronic abdominal pain had adhesions and no other disease.
Other studies find that adhesions are the most common reason for chronic pelvic pain in women. This pain occurs because adhesions bind together normally separate organs and tissues. As you move throughout the day, these tissues stretch, affecting nearby nerves and causing pain. Pain during intercourse: Adhesions can also cause pain during intercourse a condition called dyspareunia. Infertility: Adhesions that form as a result of certain types of gynecologic surgery, especially tubal surgeries and surgeries to remove fibroids myomectomies , are a common cause of infertility.
Adhesions between the ovaries, fallopian tubes or pelvic walls can prevent an egg from the ovaries from getting into and through the fallopian tubes.
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Adhesion prevention agents for gynaecological surgery: an overview of Cochrane reviews. Global Surgery evidence and solutions for achieving health, welfare, and economic development. Download references. The authors wish to acknowledge Gabriel Nuamah, obstetricians, residents, house officers and nurses at KBTH for their technical assistance.
We are grateful for the advice of Prof. Tulandi about the adhesion score and Dr. John the Baptist Wilson for his feedback on the draft manuscript.
We would like to express our appreciation to Dr. Peter Zuithoff for his statistical advice. We thank the pregnant women for their participation. Last but not the least, the authors wish to acknowledge the significant contribution of Dr. Samuel Amenyi Obed, the immediate former head of department of Obstetrics and Gynecology, whose sudden demise prevented him from participating in the project to the end. The hard copies and electronic data set are available from the corresponding author on reasonable request.
Box GP , Accra, Ghana. Joyce L. Browne, Alexander V. You can also search for this author in PubMed Google Scholar. MAN was responsible for correspondences and supervised data collection, co-designed the study and study procedures. ND proposed the study and coordinated it. KK-G supported proposal and manuscript writing. MJR participated in questionnaire and standing operating procedure design, and data analysis. All authors participated in manuscript writing, read and approved of final manuscript.
Correspondence to Mercy A. All participants provided written informed consent. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Reprints and Permissions. Nuamah, M. Prevalence of adhesions and associated postoperative complications after cesarean section in Ghana: a prospective cohort study.
Reprod Health 14, Download citation. Received : 21 June Accepted : 25 September Published : 02 November Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article.
Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Research Open Access Published: 02 November Prevalence of adhesions and associated postoperative complications after cesarean section in Ghana: a prospective cohort study Mercy A. Nuamah 1 , Joyce L. Browne 2 , Alexander V. Abstract Background The global increase in Cesarean section rate is associated with short- and long-term complications, including adhesions with potential serious maternal and fetal consequences.
Methods In this prospective cohort study, women scheduled for cesarean section at Korle-Bu Teaching Hospital in Accra, Ghana were included from June to December Conclusion With cesarean section rates rising globally, intra-abdominal adhesions occur more frequently. Plain English summary Cesarean sections CS are potentially life saving for mother and child. Background Cesarean section CS is the most frequently performed operation worldwide and the rates of CS delivery have been rising rapidly over the past few decades [ 1 , 2 , 3 ].
Methods Aims This study aimed to investigate the prevalence of adhesions in women with and without previous CS, and the association between adhesions and maternal and neonatal outcomes 3 days and 6 weeks postpartum.
Variables Trained research assistants collected data using standardized questionnaires. Results Between June and December , participants were included in the study, Flow diagram of participant inclusion. Full size image. Presence and severity of adhesions by number of previous cesarean section.
Table 2 Baseline characteristics of participating women Full size table. Table 3 Maternal and neonatal outcomes in women, by adhesion status Full size table. Table 4 Association between adhesions and maternal and neonatal outcomes Full size table.
Discussion This study observed that the majority of women with a history of CS or abdominal surgery had adhesions, and this affected operation time, infant delivery time, and perioperative blood loss for severe adhesions , but not other outcomes. Strengths and limitations Strengths of this study include the prospective design in which women were recruited before CS. Implication for clinical practice Unfortunately, there is no gold standard to avoid adhesions or detect adhesions prior to surgery [ 16 ].
Conclusion The majority of women with a history of CS or abdominal surgery had adhesions and this affected operation time, infant delivery time, and perioperative blood loss for severe adhesions , but not other outcomes. References 1. Article PubMed Google Scholar 3. Adhesion-related disorder ARD is a group of symptoms that may occur as a result of adhesions.
A person with ARD will usually experience chronic abdominal pain. Typical adhesions form within the first few days after surgery, but symptoms can last for months or even years. Symptoms may be mostly in one area of the abdomen, but are often generalised, vague, 'crampy' and difficult to define.
This means ARD can be difficult to diagnose. Symptoms of ARD may include:. Other intestinal problems may include constipation, obstruction, or alternating constipation with diarrhoea from partial obstruction.
Women may experience gynaecological problems, which can add to the anxiety and self-esteem problems that may already be experienced by women who suffer with this disorder. Symptoms of ARD can be mistaken as a sign of another condition. These can include a whole host of other possible diagnoses such as chronic fatigue syndrome, endometriosis, irritable bowel syndrome, fibromyalgia, depression and anxiety.
It is very difficult to diagnose the chronic pain of adhesions correctly. Diagnostic tests such as blood tests, x-ray procedures, CT scans, MRIs and ultrasound will not diagnose adhesions.
Hysterosalpingography an x-ray that views the inside of the uterus and fallopian tubes may help diagnose adhesions inside the uterus or fallopian tubes. According to your symptoms, your doctor will order the appropriate diagnostic tests to rule out other medical conditions that may have similar symptoms. If the results of these tests are normal or negative for abnormal pathology, a diagnostic laparoscopy may be appropriate.
This is the only test that can confirm the presence of adhesions. If adhesions are found, you doctor can usually release them during the same surgery. Adhesions can be treated either with open or laparoscopic keyhole surgery, known as adhesiolysis.
The adhesions are cut by scalpel or electrical current. As adhesions are likely to form after certain surgical procedures, open adhesiolysis may not be worthwhile, except to remedy serious problems such as bowel obstruction.
In around 70 per cent of cases, the operation to remove the original adhesions will cause more adhesions to develop. Discuss the risks, benefits and alternatives to surgery thoroughly with your doctor before you make a decision.
People with symptoms of adhesions may consider laparoscopic surgery. The advantage of this procedure is that only a small incision cut is required, which is why it is also known as 'keyhole surgery'. Laparoscopy is the preferred method for performing infertility surgery as there is a decreased risk of new adhesions forming.
Laparoscopic adhesiolysis can significantly improve quality of life among women with chronic pelvic pain due to adhesions. This procedure shows similar results to more invasive forms of surgery when it comes to managing extensive adhesions. However, it can be time-consuming the procedure may take two to four hours , technically difficult and involves some risk. Adhesion barriers commercially made that are placed at the time of surgery may reduce adhesion formations.
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