Adhesions

Adhesions are fibrous bands of scar tissue that form between tissues and organs that are not normally connected, causing them to stick together. For example, the bladder or bowel may adhere to the uterus.

Either accidentally or during a surgical procedure, wounds and incisions are the primary reason scar tissue develops. Every surgery produces a wound. Scar tissue forms when a fibrous protein called fibrin, involved in the clotting of blood, is deposited onto a wound site as part of the healing process. The fibrin forms a mesh or clot, helping it heal.

Some adhesions do not cause problems, but others can prevent tissues and organs from moving freely. Adhesions may cause severe pain when turning, bending, lifting, or any motion that pulls on the scar tissue that is stuck to other organs.

Adhesions may develop after any type of pelvic surgery, such as hysterectomy, exploratory laparoscopy, laparotomy, and C-section. They may also develop from severe or chronic pelvic infections and IUDs.

Adhesions can be removed by a procedure called lysis of adhesions, which involves cutting away the scar tissue that is sticking to other tissue or organs. But every time there is cutting or scraping in the pelvis, more scar tissue develops. Adhesion barriers are often used to inhibit the production of scar tissue. They can help reduce the amount of scar tissue that will grow, but it does not eliminate it. After two or three surgeries to remove adhesions, surgery often culminates in a hysterectomy and removal of the ovaries.

Hysterectomy is often recommended to cure pain caused by adhesions. But the adhesions must be cut before the uterus can be removed. Adhesions can be surgically removed without removing the female organs, and an adhesion barrier can be applied to limit the production of additional adhesions. Adhesions also form after a hysterectomy, so there is no benefit to removing the uterus or ovaries when removing adhesions.

An effective, less invasive way of breaking up adhesions and relieving pelvic pain is with gentle massage or yoga exercises. See the exercises by Geeta Iyengar in the back of B.K.S. Iyengar’s Light on Yoga. If there is pelvic infection or inflammation, massage should be avoided, because it may increase the pain and worsen the inflammation.

The uterus and ovaries have many important lifelong functions. The most consistent problems women report after hysterectomy (surgical removal of the uterus), whether the ovaries are retained or not, include a 25–pound average weight gain in the first year following the surgery, a loss of sexual feeling, a loss of vitality, joint pain, back pain, profound fatigue, and personality change. For more information, watch the short video “Female Anatomy: the Functions of the Female Organs.”