Adhesion Related Information

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Adhesions are bands of scar-like, fibrous tissue that can form when there is any kind of tissue injury. According to Van Den Beukel et al. (2017), adhesions can cause pelvic pain. They also reports that “reformation of adhesions has been linked to relapse of pain after adhesiolysis” (Van Den Beukal et al., 2017). Hermann and Wilde (2016) note that adhesion formation is “highly prevalent in patients with a history of operations or inflammatory peritoneal processes”. (Endometriosis is an inflammatory disorder.)

Links:

Studies:

  • Hao, M., Zhao, W. H., & Wang, Y. H. (2009). Correlation between pelvic adhesions and pain symptoms of endometriosis. Zhonghua fu chan ke za zhi44(5), 333. Retrieved from https://pubmed.ncbi.nlm.nih.gov/19573306/ 

Conclusion:Pelvic adhesions are characteristic lesions of endometriosis, the site and degree pelvic adhesions are closely correlated with pain symptoms.”

  • Abd El-Kader, A. I., Gonied, A. S., Mohamed, M. L., & Mohamed, S. L. (2019). Impact of endometriosis-related adhesions on quality of life among infertile women. International Journal of Fertility & Sterility13(1), 72. Retrieved from https://europepmc.org/article/med/30644248

“The prevalence of adhesions resulted from endometriosis was 37.6%. Demographic characteristics of the women with endometriosis-related adhesions were not significantly different from those of women without endometriosis- related adhesions. The most common location for endometriotic adhesions was adnexal adhesion (51.2%) followed by adhesion of anterior abdominal wall (24.4%). Quality of life was significantly impacted by endometriosis related adhesions (P=0.002).”

“Preoperative blood Serum and CA 125 results were obtained and pelvic adhesion scores were calculated. The patient group with adhesion scores less than 28 points was defined as the mild adhesion group, and those with a score of 28 or more were members of the severe adhesion group. The CA 125 level was significantly higher in the severe adhesion group than in the mild adhesion group. The CA 125 level, size of the largest cyst, and WBC count were associated with the level of pelvic adhesion. Adhesion scores were significantly higher in the CA 125 ≥ 35 U/mL group than in the CA 125 < 35 U/mL group. Patients with a preoperative CA 125 level higher than 35 U/mL are at high risk for pelvic adhesion.”

“The negative impact on the tubo-ovarian unit can be directly by distorting the anatomy, indirectly by invoking inflammation or by oxidative damage with poorer-quality oocytes. Endometriosis even seems to have a negative effect on pregnancy outcome after in vitro fertilization.”

References

Herrmann, A., & De Wilde, R. L. (2016). Adhesions are the major cause of complications in operative gynecology. Best Practice & Research Clinical Obstetrics & Gynaecology35, 71-83. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1521693415001935

Van Den Beukel, B. A., de Ree, R., van Leuven, S., Bakkum, E. A., Strik, C., van Goor, H., & ten Broek, R. P. (2017). Surgical treatment of adhesion-related chronic abdominal and pelvic pain after gynaecological and general surgery: a systematic review and meta-analysis. Human Reproduction Update23(3), 276-288. Retrieved from https://academic.oup.com/humupd/article/23/3/276/3058801