What’s an Adhesion?

The word adhesion refers to internal scarring whereby organs that are not normally attached become welded together with bands of tissue. Adhesions in the pelvis are caused by previous gynecologic surgery, trauma, inflammation, endometriosis, or tumors.  When tissues are traumatized or inflamed, the healing systems of the body are activated.  Just like a cut on your skin heals with a scab and eventually a scar, the same thing occurs inside your body.

The effects of adhesions depend on where they occur. For example, adhesions involving the intestines can lead to pain with bowel movements, cramping, or even bowel blockages. Adhesions around the pelvic structures can lead to pain with urination, generalized pain, or pain with intercourse. Adhesions around the ovaries can lead to pain with ovulation.

Adhesions can also make surgery more complicated.  When organs are attached to each other, they must be separated before the operation can proceed.  See my video, “Complex Hysterectomy Made Easy” on my YouTube Channel, DoctorKTV, to see how adhesions are separated during an operation.

Once adhesions form, they can’t be removed.  They must be separated during gynecologic surgery to make an operation possible, but they generally reform during the healing process.

Here is a picture of an adhesion between the uterus and the bladder. This patient had a cesarean section in the past.

This is a picture of adhesions between internal fat and the patient’s abdominal wall.

Here is a picture of the process of separating adhesions in order to proceed with surgery. At the start of an operation, these adhesions interfere with seeing the surgical area. Once I have cut through them with the scissors, the view will be clear to continue the surgery.