What are endometriosis adhesions?

Endometriosis occurs when the cells that your uterus sheds every month during your period begin to grow outside of your uterus.

When these cells swell and your uterus tries to shed them, the area around them becomes inflamed. One affected area can become stuck to another affected area as both areas try to heal. This creates a band of scar tissue known as an adhesion.

Adhesions are most often found throughout your pelvic area, around your ovaries, uterus, and bladder. Endometriosis is one of the most common reasons why women develop adhesions unrelated to a prior surgery.

There no known way to prevent adhesions from forming, but options for pain relief and medical procedures are available that can help you manage them. Keep reading to learn more.

Tips for identification

Although adhesions can affect endometriosis symptoms, it’s important to understand that an adhesion comes with its own set of separate symptoms. That’s why when you develop endometriosis adhesions, your symptoms might change.

Adhesions may cause:

You also may feel a different kind of pain prior to and during your period. Women with adhesions describe the pain as being more of an internal stabbing rather than the dull and persistent throbbing that comes with endometriosis.

Your daily movements and digestion can trigger adhesion symptoms. This can cause a sensation that feels like something is being tugged on inside you.

How to manage your symptoms

When you have an endometriosis adhesion, finding a way to manage your symptoms can be a process. Different things work for different people. Over-the-counter pain medications, such as ibuprofen (Advil) and acetaminophen (Tylenol), can help minimize the pain, but they sometimes aren’t enough.

Sitting in a warm bath or reclining with a hot water bottle when your pain flares up can help relax your muscles and soothe the pain from the adhesion. Your doctor may also recommend massage techniques and physical therapy to try to break up the scar tissue and lessen the pain.

This condition can impact your sex life, your social life, and your mental health. Speaking to a licensed mental health professional about these side effects can help you deal with any feelings of depression or anxiety that you may be experiencing.

What treatment options are available for adhesions?

Adhesion removal carries a risk of the adhesion coming back, or causing more adhesions. It’s important to be mindful of this risk when you consider having an endometriosis adhesion removed.

Adhesions are removed through a type of surgery called adhesiolysis. The location of your adhesion will determine what kind of surgical treatment is best for you.

For example, laparoscopic surgery is less invasive and can break up and remove an adhesion that blocks your bowels. Laparoscopic surgery is also less likely to create more adhesions during the healing process.

Some adhesiolysis procedures need to be performed with traditional surgical equipment instead of a laser. Surgery to remove an adhesion happens while you’re under general anesthesia and in a hospital setting because of the risk of infection. Recovery times can vary according to how big your incision is.

More research about the outcomes of adhesion removal is needed. The success rate appears connected to area of your body where the adhesion is. Surgeries for adhesions to the bowel and abdominal wall tend to have a lower rate of adhesions returning after surgery.

Is removal necessary?

Q:

Who should get an adhesion removed?

A:

Endometriosis can affect up to 15 percent of premenopausal women, and yet women can go undiagnosed for years. Endometriosis can interfere with day-to-day quality of living, having a ripple effect on your life, relationships, occupation, fertility, and psychological functioning. It’s a poorly understood disease, with no blood test for diagnosis or clear path for effective treatment.

Making a decision about treatment needs to be discussed thoroughly and with your future planned pregnancies in mind. If you want children, the plan may be different than if you’re done having children.

Talk to your doctor about treatment. Hormonal treatment may provide some help managing the symptoms for several years.

Surgical procedures are usually offered when hormonal or other treatments no longer provide relief. There is significant risk that adhesions can return after any abdominal surgery and the adhesions can become worse. But for those living with endometriosis with a daily impact on work, family, and functioning, surgery is an option.

Ask questions about the use of surgical procedures such as films or spray during surgery to reduce the development of later adhesions. Having the surgery done laparoscopically (through a little incision and a camera) will reduce the chance of adhesions developing. Do your research and become an informed consumer of your healthcare.

Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHTAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Can endometriosis treatment cause adhesions?

Procedures to removal endometrial tissue from your pelvis and other areas carry a high risk of adhesions. Any abdominal surgery can lead to more adhesions.

During healing from any surgery, your organs and the surrounding tissue become swollen as they heal. It’s a lot like when you have a cut on your skin: Before a scab forms, your skin sticks together as your blood clots as part of your body’s healing process.

When you have an adhesion, the new tissue growth and natural healing process of your body can create scar tissue that blocks your organs or impairs their function. The organs of your digestive and reproductive systems are very close together in your abdomen and pelvis. The close quarters of your bladder, uterus, fallopian tubes, and bowels mean adhesions can happen after any surgery involving that area.

There’s no way to prevent adhesions after an abdominal surgery. Certain sprays, liquid solutions, medications, and surgical methods are being researched to find a way to make adhesions less common after surgery.

What’s the outlook?

Endometriosis adhesions can make an already uncomfortable condition more complicated. Being aware of strategies to treat and manage adhesion pain can help.

If you’ve been diagnosed with endometriosis and feel like your pain is different than usual, see your doctor. You should also see your doctor if you’re experiencing new symptoms, such as stabbing pain, constipation, or loose stools.