Pelvic Adhesion

…bands of scar tissue that form between organs and tissues in the pelvic cavity. .

Pelvic adhesions can result from previous surgeries, infections, endometriosis, or other pelvic inflammatory conditions.

Adhesions can produce a wide range of symptoms, which can vary depending on their location, extent, and the organs involved and in woman they can cause a variety of gynecologic symptoms due to their impact on the reproductive organs and structures in the pelvic region.

Some gynecologic symptoms associated with pelvic adhesions include:

Chronic pelvic pain:

By restricting the movement and function of organs within the pelvis, adhesions can lead to chronic and often debilitating pelvic pain.
The adhesions can cause organs and tissues to stick together, leading to tension, inflammation, and irritation in the pelvic cavity.
Pain may be constant or intermittent.

Infertility:

Adhesions can restrict the natural sweeping function of the fallopian tube in capturing the egg at the time of ovulation, preventing the egg from reaching the uterus.
Pelvic adhesions can affect fertility by causing obstruction and distortion of the fallopian tubes, which can prevent the egg from meeting the sperm or hinder the movement of the fertilized egg into the uterus increasing the risk of an ectopic pregnancy.

Dyspareunia (painful sexual intercourse):

Adhesions in the pelvic area can cause pain and discomfort during sexual activity by immobilizing or tilting the uterus.

Ovarian dysfunction and Cysts:

Adhesions can affect the ovaries, potentially leading to ovulation problems or irregularities in the menstrual cycle and abnormal menstrual bleeding.
Adhesions may cause the ovaries to become fixed in an abnormal position, potentially leading to the development of ovarian cysts.
Adhesions can lead to pain or discomfort during ovulation, known as mittelschmerz.

Digestive issues:

Adhesions involving the digestive organs can lead to symptoms like abdominal pain, nausea, or vomiting.
If the adhesions involve the intestines, they can lead to symptoms such as bloating, constipation, or pain during bowel movements.

Pelvic inflammatory disease (PID)

Pelvic inflammatory disease (PID) is the result of an infection of the female reproductive organs.

It most often occurs when sexually transmitted bacteria (chlamydia or gonorrhea) spread from your vagina to your uterus, fallopian tubes or ovaries.

Recurrent pelvic infections: Pelvic adhesions can create pockets or spaces that trap bacteria, increasing the risk of recurrent pelvic infections.

The signs and symptoms of pelvic inflammatory disease might be mild and difficult to recognize. Some women don’t have any signs or symptoms.

When signs and symptoms of PID are present, they most often include:

Pain — ranging from mild to severe — in your lower abdomen and pelvis
Unusual or heavy vaginal discharge that may have an unpleasant odor
Unusual bleeding from the vagina, especially during or after sex, or between periods
Pain during sex
Fever, sometimes with chills
Painful, frequent or difficult urination
HYDROSAPINX
Infertility

The Fallopian Tube

The fallopian tubes extend from your uterus to your ovaries. Healthy fallopian tubes provide an open passageway for an egg and a sperm to unite (fertilization).

Fimbriae are finger-like extensions that sweep an egg from your ovaries into your fallopian tubes.

Fertilization of the egg occurs in the fallopian tube and the fertilized egg, or embryo, is swept back to the uterus by microscopic fingers called villi. From there, an embryo can implant in your uterine wall and develop into a fetus.

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Hydrosalpinx is a condition in which a fallopian tube becomes blocked.

A blocked fallopian tube may prevent sperm from reaching your egg. If fertilization does occur, the blockage in your fallopian tube can prevent the embryo from reaching your uterus.

What causes hydrosalpinx?

An untreated infection is the most common cause of hydrosalpinx.

Harmful bacteria can damage the fallopian tubes and cause them to become inflamed. This inflammation often happens at the part of the fallopian tube near your ovaries, or the fimbriae. As part of the healing process, your fimbriae may fuse together, sealing your fallopian tubes. Then normal secretions get trapped inside the fallopian tube, causing them to swell.

Certain illnesses or injuries can affect the ends of the fallopian tube:

Sexually transmitted infections (STIs), like chlamydia and gonorrhea.
Pelvic inflammatory disease (PID), oftentimes resulting from untreated STIs.
Scar tissue left over from pelvic surgery, especially surgery on your fallopian tubes.
Tissue build-up from endometriosis.
Some tumors.

Symptoms

Hydrosalpinx rarely causes symptoms. When symptoms are present, they include:

Pelvic pain that may worsen during or immediately following your period.
Vaginal discharge that’s discolored and/or sticky.
Infertility

Infertility

20% to 30% of infertility cases involve problems related to the fallopian tubes (tubal factor infertility). Hydrosalpinx is present in 10% to 20% of these cases.

This can decrease your chances of becoming pregnant through in vitro fertilization (IVF)
Research suggests that the fluid from a hydrosalpinx can flow backwards into your uterus, creating an unhealthy environment for a developing embryo.
An untreated hydrosalpinx can make it difficult to become pregnant, and it can increase your risk of miscarriage and pregnancy complications.

Treating a hydrosalpinx can improve your chances of becoming pregnant. Your treatment will depend on factors like the severity of your blockage and your age.

If you are experiencing gynecologic symptoms such as chronic pelvic pain, fertility concerns, or abnormal menstrual bleeding, it’s essential to seek evaluation and diagnosis from a gynecologist or a healthcare provider experienced in treating pelvic disorders.

Proper evaluation, including imaging studies and laparoscopy, if necessary, can help identify the presence and extent of pelvic adhesions and guide appropriate treatment options to alleviate symptoms and improve overall health.

Call the office of County Obstetrics & Gynecology to schedule a consultation.

County Obstetrics & Gynecology