Pelvic adhesions (scar tissue) are usually caused by multiple pelvic/abdominal surgeries, infection, or endometriosis. Scar tissue can be completely asymptomatic and not cause any problems. When scar tissue causes infertility, pain or gastrointestinal problems, such as bloating and constipation, surgical resection needs to be considered
Pelvic adhesions are a type of scar tissue that may be formed if the pelvis has been disrupted in a particular way. Your body will naturally produce scar tissue as a normal part of the healing process, so if you have had surgery, have endometriosis, or have had inflammation or an infection in that area, it may be the case that adhesions will form as well.
Adhesions can form after any type of pelvic surgery that you have had, including hysterectomies and surgeries for ectopic pregnancy. They are also more commonly formed after open surgeries, rather than laparoscopic (keyhole) surgeries.
Physically, pelvic adhesions are bands of scar tissue. They will normally form between different organs or tissues in the body, causing them to stick together. For some patients, this may not be a problem and they will be able to go through their everyday life without any ill effects. For others, however, pelvic adhesions may have an impact on areas of their life, especially their fertility. This is because pelvic adhesions will often affect the fallopian tubes.
In most cases, pelvic adhesions will not present any symptoms. The two most common that a person can have are problems with their fertility and ongoing chronic pain in the pelvic area. It is also possible that these symptoms are not being caused by pelvic adhesions, though, so it is always recommended that you speak to your doctor or healthcare provider if you are having pain that does not seem to be getting any better.
When diagnosing adhesions, your doctor may start by asking you questions about your symptoms and your medical history, including prior surgeries. From this, they may then carry out an examination using both their hands and a stethoscope. They may also take your temperature, pulse rate, and blood pressure, ask you for a urine sample, or suggest that blood tests are carried out.
It is also possible that you will need some imaging tests, such as those carried out via ultrasound, to determine whether or not you have pelvic adhesions.
If you have specifically been having issues related to your fertility, your GP may then refer you to a fertility specialist or a gynaecologist. These professionals will be able to suggest tests that can help to identify whether or not your fertility problems are being caused by adhesions. From this, they may then either recommend surgical or non-surgical options for treatment or managing your symptoms.