All organs in the abdominal cavity and pelvis of a woman (fallopian tubes, uterus, ovaries, rectum, bladder) are covered with a special thin membrane - the peritoneum. In its structure, it is smooth and has no nodes. In the same case, if the inflammatory process begins in the pelvis (inflammation of the ovaries, uterus, fallopian tubes), which is accompanied by peritonitis, a plaque appears on the surface of the peritoneum, which contains fibrin. This substance is able to glue the surfaces of internal organs with each other, provoking an adhesion process. Due to this, a mechanical natural obstacle appears to spread inflammation in the pelvis. But the fact is that after the cessation of inflammation, adhesions remain.
Adhesive process, which performed its protective function in case of peritonitis disease, further leads to disruption in the functioning of the internal organs of the small pelvis. Its function is to protect the body from the spread of inflammation throughout the abdominal cavity. Therefore, it turns out that after the treatment of peritonitis it is urgent to begin treatment of adhesive disease. Only in this case, the probability of the formation of a large area of adhesions decreases significantly. But if the inflammatory process has become chronic, most likely, an adhesive disease of the abdominal cavity will begin to develop without visible symptoms and external signs. In this case, pain occasionally occurs in the lower abdomen during cooling, and constipation is also sometimes possible.
The main treatment for adhesions is laparoscopy. Only this operation allows you to accurately carry out very delicate manipulations. Using a laparoscope, the surgeon separates the adhesions, after which they are carefully removed.
The main methods for separating adhesions are:
- laser therapy, i.e. dissection of adhesions with a laser,
- aquadissection (this procedure is performed using water),
- electrosurgery is a method in which the adhesion process is dissected by an electric knife.
After the operation, the patient must undergo preventive treatment. In order to prevent the emergence of new mergers, a number of methods are used.
Firstly, various barrier fluids are introduced into the pelvic cavity.
Secondly, the fallopian tubes and ovaries are enveloped with polymer absorbable films.
Very often, after the first operation, a control diagnostic laparoscopy is prescribed, which must be applied after a couple of months. This is done in order to complete the formation of new adhesions.
In addition, the surgeon usually recommends special treatment, which is aimed at suppressing inflammation and deposition of fibrin on the surface of the peritoneum. Additionally, funds are prescribed that activate the process of its dissolution.
Traditionally, the adhesion process after surgery is treated this way.
The doctor prescribes the following drugs:
- Fibrinolytic agents that dissolve fibrin.
- Anticoagulants that interfere with the process of blood clotting.
- Antibiotics and anti-inflammatory drugs.
But medical practice shows that the treatment regimen will be selected individually in all specific cases.
Quite often, even laparoscopy does not guarantee that all problems that are associated with the therapy of this pathology will be resolved.
The fact is that with the help of a similar operation and the above treatment, the fallopian tubes and ovaries are released from adhesions. But the process of restoring their internal structure and functioning is impossible. Therefore, after the laparoscopy procedure, women have to resort to in vitro fertilization (IVF) to conceive a child.