Adhesions in the pelvis - what is it and how to treat?

Adhesions in the pelvis are formed of connective tissue, and may be localized between the walls of the uterus and its appendages, bladder, and loops and ligaments of the rectum.

They lead to the development of pain, as well as cause other unpleasant symptoms. The intensity and characteristics of their manifestation depend on the stage of the pathological process. If untreated, it can lead to secondary infertility.

If a woman has the first signs of this pathology, it is impossible to delay in visiting a doctor and passing a diagnosis. In some cases, treatment can be carried out exclusively by surgery. But for the prevention of adhesions in the pelvis, you can use the recipes of alternative medicine.

What it is?

The abdominal cavity is lined with a closed serous membrane. It is formed by 2 sheets, which smoothly pass one into another. The parietal layer lines the entire surface of the abdominal cavity and small pelvis, and the visceral layer - the internal organs.

The main objectives of the peritoneum is to ensure the free mobility of the organs and reduce their friction among themselves. It protects the internal organs from infection and preserves the fatty tissue of the abdominal cavity. Under the influence of adverse factors, hypoxia develops in the area affected by the pathological process. Further, the situation can develop in 2 directions:

  • independent (physiological) restoration of damaged peritoneal tissues;
  • the development of adhesions.

When adhesions are formed, the adhesion process (accretion) of different parts of the visceral peritoneum, or the tissues of the latter with the parietal leaf, occurs.

This is not a lightning process: the formation of adhesions occurs in several stages:

  1. Reactive phase. This stage lasts for 12 hours after the violation of the integrity of the peritoneal tissue.
  2. Exudative stage (1-3 days). It is characterized by an increase in the permeability of blood vessels. Under the influence of this process, unchanged and inflammatory cells, as well as the liquid fraction of blood containing fibrinogen, penetrate into the cavity of the pelvis.
  3. Stage of adhesion. On day 3, fibrinogen is transformed into fibrin, located on the surface of the peritoneum in the form of filaments. Constant cells form fibroblasts that synthesize collagen, which is the main component of connective tissue.
  4. Phase of young adhesions, with a duration of 1-2 weeks. Such formations have a loose structure, since the amount of collagen in them is still quite small. In the thickness of adhesions begins the active formation and growth of blood vessels and nerve fibers. Soon smooth muscle cells migrate to them.
  5. The latter phase is accompanied by the formation of mature fibrous adhesions consisting of connective tissue. This phase can last from 14 to 30 days. Increasing the density of collagen leads to their thickening, and the capillaries develop into larger vessels.

Causes of adhesions in the pelvis

Lead to enhanced formation of connective tissue can:

  1. Inflammatory processes in the area of ​​the pelvic organs: colpitis, endometritis, adnexitis, parametritis, etc. In this case, it can be both an acute and a chronic phase of the pathological process.
  2. Transferred operations. The risk of adhesions in the pelvis increases if the patient has previously undergone surgical laparotomic surgery: appendectomy, cesarean section, removal of uterine appendages, hysterectomy, etc.
  3. Hemorrhage into the pelvic cavity during ovarian apoplexy, rupture of the fallopian tube during ectopic pregnancy, etc.
  4. Endometriosis. Stage 3 and 4 of this dangerous gynecological disease are characterized by the formation and distribution of adhesions to the abdominal organs.
  5. Injuries of the pelvic organs - open and closed.

According to studies, in most cases, adhesions in the pelvis are formed with a combination of 2 or more causes. The development of the pathological process can occur after surgical interventions, when a woman conducts promiscuous sex life, as well as if she doesn’t receive timely medical care.

Symptoms

The more adhesions are located in the abdominal cavity, the more brightly and intensively the symptoms of the pathological process will appear. It is usually divided into 3 forms: acute, intermittent and chronic.

Acute form

For this form of adhesions is characterized by the occurrence of acute and pronounced pain. Women suffer from a constant increase in their intensity, the presence of nausea and vomiting. Body temperature and heart rate rise.

One of the accompanying symptoms of adhesions in the pelvis is intestinal obstruction, accompanied by a decrease in blood pressure, drowsiness, weakness, decreased daily diuresis, constipation. This condition requires urgent medical attention. Often in such situations resort to emergency surgery.

Intermittent form

In this case, the pathology may not manifest itself. Pain syndrome is weak and not very pronounced, and the majority of patients complain, mainly, of digestive disorders.

Chronic form

In this case, the symptoms will be either too mild or will not appear at all. From time to time a woman will have lower abdominal pain and constipation. It is a chronic form of pathology that is considered the most common.

A similar deviation is observed in endometriosis, as well as in the latent course of genital infections. In this case, women cannot become pregnant and, having addressed this complaint to their gynecologist, for the first time they will know their diagnosis.

Complications

Lack of treatment of adhesions in the pelvis can cause serious and serious complications. Thus, the disease can lead to:

  • bend of the uterus;
  • rupture of the ovary or fallopian tube;
  • internal bleeding;
  • sepsis.

Adhesions in the pelvis result in a woman having an ectopic pregnancy instead of a normal conception, with all the consequences that follow from it.

Complications of the pathology are difficult to treat, so if you experience suspicious symptoms, you should seek medical help as soon as possible.

Diagnostics

Adhesions in the pelvis are difficult to diagnose. As a rule, it is not possible to identify them at the first examination, but, nevertheless, the doctor may suspect them.

In order not to be mistaken with the diagnosis, it is important to conduct a number of diagnostic procedures. Thus, the diagnosis scheme necessarily includes:

  • taking a cervical smear on the microflora and cytology;
  • PCR test;
  • Ultrasound;
  • MRI of the pelvic organs.

Ultrasound diagnosis and MRI are performed in all cases, since it is these procedures that give the maximum amount of information necessary for making a diagnosis. Sometimes a uterus x-ray is performed to evaluate the tubal patency. If their obstruction is detected, the presence of adhesions in the pelvis will be almost 100% confirmed.

No less common is diagnostic laparoscopy, during which you can also determine the stage of the pathological process. At the first stage of pathology, the capture of the egg is still possible, at the second it becomes difficult, and at the third it becomes completely impossible.

How to treat adhesions in the pelvis?

The treatment of a pathology depends on the stage of its development, the severity of the manifestation and associated complications. At the first stage, a complex conservative therapy can be carried out, including:

  1. The use of antibiotics. They are necessary if the adhesion process is the result of exposure to pathogenic microflora. The preparations are selected in accordance with the sensitivity of the identified bacteria to one or another type of antimicrobial substances.
  2. Use of NSAIDs. Non-steroidal anti-inflammatory drugs are used in cases of pronounced pain syndrome and edema. In parallel, they contribute to the resorption of adhesions in the initial stages of their formation.
  3. Hormone therapy. Hormones are used if adhesions in the small pelvis result from adenomyosis or extragenital endometriosis.
  4. The use of fibrinolytics. This group of drugs contains enzymes, the main action of which is the splitting of connective tissue strands. As a result, adhesions gradually resolve - in whole or in part.
  5. Conducting vitamin and immunotherapy. These drugs are prescribed as an adjunct to the main treatment regimen. They are aimed at improving the overall well-being of the patient and the correction of the immune system.

To supplement the treatment regimen, patients are prescribed physiotherapy and balneotherapy sessions.

Surgical intervention

With the ineffectiveness or inappropriateness of conservative treatment, doctors may resort to surgery. Often it is combined with diagnostic laparoscopy. Surgical intervention is necessary for acutely flowing, intermittent and chronic course of the pathological process (only in the acute phase).

During the operation, the dissection of adhesions and their removal. Perform this manipulation laparoscopic method.

There is another operational method for treating adhesions in the pelvis - the use of a laser. It is advisable to use it if:

  • adhesions capture not too wide area of ​​the abdominal cavity;
  • There is an opportunity to clearly see the place of splicing fabrics

If the pathological process has affected too large an area, an open surgical method of excision of pathological intergrowths is used. In this case, resort to the use of trocar - a special tool that provides access to the pelvic cavity.

For excision of adhesions can be applied:

  1. Electrosurgical method, involving the use of a special electrocautery for dissection and removal of adhesions.
  2. Aquadissection method. During such a procedure, a special fluid is used, under the influence of which the tissues of adhesions are destroyed.

Folk remedies

Treatment of adhesions in the pelvis is possible, and it can be of very high efficiency, but it is better to carry it out along with the medications and procedures prescribed by the doctor. In this case, infusions prepared on the basis of the flowers and seeds of plantain, dill, fresh parsley help well. But it is necessary to talk about the possibility of such therapy with the doctor, because at best, these tools simply will not help, and at worst, they will lead to a deterioration of the patient’s health.

Prevention

Prevent the development of adhesive processes is possible only if timely treatment of inflammatory and infectious diseases of the pelvic organs. You should also:

  • avoid hypodynamia;
  • regularly undergo gynecological examinations by a gynecologist;
  • do sport;
  • avoid hypothermia;
  • monitor body weight;
  • practice safe sex, especially when sex is promiscuous;
  • abandon operations if they are not carried out according to strict indications;
  • timely and completely cure infectious diseases of the genital tract and STDs.

To avoid the development of adhesions after surgery or inflammatory diseases of the pelvic organs, it is necessary:

  • follow a diet to avoid constipation and bloating;
  • complete a course of physiotherapy;
  • follow exactly the mode of physical activity prescribed by the doctor;
  • plan pregnancy;
  • avoid excessive physical exertion for six months after the operation;
  • See your doctor if you have any suspicious symptoms.

Forecast

Timely and properly prescribed treatment gives favorable prognosis for recovery. Surgical intervention can reduce the intensity of pain and restore the functioning of the reproductive system of a woman by almost 60% in patients who have been diagnosed with adhesive disease at stage 1-2 of development.

The use of a special gel barrier against adhesions will help to avoid the recurrence of the disease in the future.

Watch the video: ABDOMINAL ADHESIONS Symptoms, Causes & Treatments (November 2019).

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