Causes of Infertility: Pelvic Adhesions

Pelvic adhesions may be among the causes of infertility in women. Pelvic adhesions may lead to obstruction of the tubes, pelvic pain and painful intercourse. Once detected, there are a few treatment options that can solve this problem and restore fertility.

Pelvic Adhesions and Fertility

Pelvic adhesions occur when the structures of the pelvis are linked to other tissues or structures that are found in the neighboring area. Tissues or organs may get bonded together. The pelvic adhesions may affect fertility, as the tubes may bet blocked or the uterus and the ovaries may also be affected causing irregular menstrual cycles.

Causes of Pelvic Adhesions

Pelvic adhesions may be caused by tissue irritation, which may be due to:

  • Trauma
  • Surgery such as removal of an ovarian cyst
  • Appendicitis
  • Frequent infections involving the reproductive system
  • Frequent inflammation
  • Sexually transmitted diseases such as Gonorrhea

Not all women are prone to developing pelvic adhesions following the above mentioned causes. Some women are more exposed and the reasons for this are not completely known.

Symptoms of Pelvic Adhesions

The pelvic adhesions may not show any symptoms for a long time and silently develop. When present, the symptoms of pelvic adhesions may include:

  • Pelvic pain, cramps and tenderness that is not linked to menstrual pain
  • Pain during intercourse (if an ovary gets attached to the pelvic wall)
  • Nausea
  • Bloating
  • Vomiting

Detection of Pelvic Adhesions

If pelvic adhesions are suspected, the doctor will evaluate the patient, consider her history and establish possible tests that should be performed. X-rays or ultrasounds may be performed to detect any pelvic adhesions. However, some pelvic adhesions may not show up on x-rays or ultrasounds.

A gastroenterologist should be consulted. An endoscopy should be performed to detect possible pelvic adhesions. The presence of pelvic adhesions may often be misdiagnosed for irritable bowel syndrome.

Treatment Options

The treatment options will be established depending on the severity of the pelvic adhesions. If there is an obstruction of the tubes or the bowel, these will require a decompression. A tube that will go through the stomach and the intestine may be employed.

Exploratory surgery may be required. In some serious cases, hysterectomy with removal of both tubes and ovaries will be required. This will mean that the patient will no longer be able to conceive.

In less severe cases, the pain may be managed with medication, hormonal therapy and alternative treatments such as acupuncture or herbal treatment.

Once the occlusion is fixed, the patient will be fertile again and may be able to conceive (except for the case when a hysterectomy is performed). However, the patient should be kept under supervision to monitor if new pelvic adhesions occur. Pelvic adhesions may be recurrent, especially if the treatment has involved surgery.

Prevention of Pelvic Adhesions

The formation of pelvic adhesions may be prevented by treating infections in time before causing complications and by practicing safe sex to prevent STDs.

If surgery is needed, the surgeon chosen should be extremely experienced and the procedure should be performed meticulously to avoid tissue trauma.

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