It would seem that adhesions are a natural reaction of the body to the inflammatory process. However, the consequences that may arise as a result of the lack of appropriate therapy are not so harmless. What you need to know about this ailment, how to respond, identify the causes and treat? About this in the article below.
What are spikes
The word adhesions is usually understood as connective tissue (cords) in the form of a thin film that, as it were, fuses adjacent organs. From a physiological point of view, this is a normal protective reaction of the body. But if the localization of the adhesive process in the small pelvis is established, then this can lead to problems in the reproductive system. Since the external organs are covered by the serous membrane, which is also called the visceral peritoneum, free movement of the internal organs is due to the peritoneal fluid. This can be observed, for example, during pregnancy, when the growing uterus slightly changes the location of the intestinal loops or bladder.
The process of the appearance of adhesions occurs due to the inflammatory process, in which the tissues swell and fibrinous plaque forms on the visceral peritoneum. In its structure, fibrin is very sticky and therefore it is easy to connect adjacent tissues. The body reacts in such a way so that the inflammation does not affect other organs and does not go any further. Unpleasant symptoms disregarded, the lack of adequate treatment lead to tissue fusion.
Forms and symptoms of the disease
It is customary to distinguish between three stages of the development of adhesions in the small pelvis. Symptoms that cannot be overlooked are usually expressed in acute, intermittent and chronic form.
A gradual deterioration is characteristic of the acute stage of the adhesive process. A woman may complain of pain in the lower abdomen, vomiting, nausea, heart palpitations and fever. At the doctor’s appointment, the abdomen is palpated and the woman feels soreness. These symptoms may indicate bowel obstruction. If untreated, renal failure can develop, and the woman's condition deteriorates sharply.
In the intermediate stage of the adhesion process in the pelvis, signs of the disease can either occur or disappear. The woman notes that for periods she is disturbed by disorders in the intestines.
The third stage, chronic, is marked by a temporary manifestation of unpleasant symptoms that occur after sexual intercourse, with a sharp change in body position, physical activity, during examination on a gynecological chair. Most often, the adhesion process in the pelvis is diagnosed when a woman cannot become pregnant for a long time. During diagnosis, obstruction of the fallopian tubes, endometriosis is determined.
Reason for occurrence
Several factors can affect the development of the adhesion process in the small pelvis:
- inflammation in the fallopian tubes, ovaries, adnexitis, endometritis, salpingitis;
- endometriosis, manifested in the proliferation of cells similar in structure to the inner surface of the uterus; it is noted that wherever endometriosis is located, it will inevitably lead to the development of adhesions, since in itself it is a consequence of the development of the inflammatory process;
- surgical intervention - abortion, cesarean section, curettage;
- tuberculosis of the female reproductive system;
- installation of an intrauterine device;
- ovarian apoplexy, ectopic pregnancy, as well as other heavy bleeding that occur in the pelvis and peritoneum, as the protein contained in the blood acts as a catalyst for the formation of adhesions.
Normally, the pelvic organs from the abdominal cavity are separated by the muscular abdominal wall, a kind of layer that consists of a thin film called the peritoneum. Due to the fact that its surface is smooth, the movement and fertilization of the egg occurs without any obstacles. Also in the natural form is the growth of the fetus. If an adhesion process is formed in the small pelvis, then it can interfere with the internal movement of fluids, the movement of the egg through the fallopian tubes.
Surgery as one of the reasons
The most common cause of adhesions in the pelvis is surgery. For example, some women have a pathology after cesarean section. Other surgical interventions in the abdominal cavity and pelvic organs should not be ruled out. The hemorrhage that occurs during surgery, provokes the development of aseptic inflammation and adhesions. Moreover, indirect signs of an adhesive process in the pelvis can be perceived by a woman as a result of the development of completely different diseases.
Doctors try to use less traumatic methods of surgical intervention to reduce the risk of complications. The longer the surgery takes, the higher the risk of adhesions.
Methods for identifying a disease
During the examination, the doctor can diagnose only indirectly adhesions in the pelvis. During ultrasound diagnostics or MRI, it is possible to get almost 100% answer to the question about the presence of adhesions. Hysterosalpingography can tell about patency of the fallopian tube. If there are problems, then the reason for the spikes is almost unique.
The presence of the inflammatory process is confirmed by analyzes of a smear for microflora, which is taken from the vagina, and PCR analysis for the presence of a latent infection. Visually determine the development of the adhesive process as a result of laparoscopy. Simultaneously with the inspection, dissection of adhesions is also carried out.
If this study is carried out only for the purpose of diagnosis, then the degree of the course of the disease is determined as a result:
- Adhesions do not interfere with the capture of the egg, located around the ovary or oviduct.
- When difficulties arise in capturing an egg, the cords are located between the ovary and the oviduct, or between them and neighboring organs.
- There is no possibility of egg capture due to blockage and twisting of the fallopian tubes.
What complications may arise
If a woman does not treat the adhesive process in the pelvis, an inflammatory disease and infections penetrate the appendages, fallopian tubes, the body begins to produce inflammatory exudate. It can be purulent or serous, spreading throughout the oviduct. The danger lies in the fact that an inflammatory secretion can enter the abdominal cavity, which then provokes the loss of fibrin. It is able to close the abdominal opening of the fallopian tube, and eventually lead to its complete blockage. In this case, the doctor can observe that the fallopian tube has become closed.
In the case when the opening of the fallopian tube remains open, but purulent discharge takes place, there is a risk of them entering the uterine cavity, and then into the vagina. There is another point - the defeat of the ovaries through the circulatory system, into which the infection penetrates.
Left untreated, inflammation leads to a change in the size and shape of the tube and ovaries. They become larger, and the latter resembles a ball in shape. The development of the adhesive process in the pelvis, namely in the oviduct, occurs as a result of desquamation or exfoliation of the epithelium. Opposite surfaces are glued together to form partitions. During the diagnosis, the doctor can visualize a saccular mass, which consists of several chambers.
As a result, the diagnosis is made based on what kind of discharge. Purulent talk about pyosalpinx, serous - about sactosalpinx or hydrosalpinx. If treatment has not been carried out at this stage, then a purulent tubo-ovarian formation occurs. These diseases are characterized by the need for treatment of the adhesive process in the pelvis. In this case, the attachment point of adhesions can affect the ovaries, oviduct, uterus, pelvic walls along with the intestines, omentum.
Treatment methods
After identifying the cause and diagnosing the disease, the question arises of how to treat the adhesive process in the pelvis? There are two options: conservative method and surgical intervention. The first is that a woman immediately after surgery recommends a special diet, moderate physical activity. In practice, it was noted that if you get up early from bed, normalize the intestines, then in the hospital you can start the process that prevents the development of adhesions. Food should consist of small portions, 5-6 times a day. Excessive loads are also excluded at the moment when the adhesion process did not develop as a result of the operation, but because of an inflammatory disease.
In the postoperative period, doctors prescribe antiplatelet agents and anticoagulants that improve blood circulation. Physiotherapeutic treatment has proven itself positively, for example, a course of electrophoresis with Lidaza solution.
When diagnosing sexually transmitted infections, a course of antibacterial and anti-inflammatory drugs is prescribed. Hormone therapy is indicated for the establishment of genital endometriosis.
Surgical intervention
In the event that indirect treatment has not yielded results, it remains to resort to surgical intervention. The main indicator for the operation is an acute form of the disease. Depending on how complex the degree of adhesions in the small pelvis, the appropriate scheme of operation is selected. It is customary to distinguish three types:
- electrosurgery, when the dissection of adhesions is carried out by an electric knife;
- aquadissection - the process takes place under strong water pressure;
- laser therapy with a special laser.
How to perform a dissection is decided by the doctor during surgery.
Treatment of chronic adhesive process
It also cannot do without physiotherapy with fibrinolytics, hirudotherapy, massage, exercise therapy. A positive result was noted when using tampons with Vishnevsky ointment in the vagina. Reducing painful spasms is possible with the help of drugs "Papaverine", "No-shp".
In the absence of contraindications, it is recommended to do yoga, and breathing exercises will improve blood circulation. During the exercise, pelvic organs are massaged, which helps the resorption of adhesions. This treatment is considered one of the available, takes a little time and can be spent at home.
Spike complications
The most difficult form of the disease is acute, in which a sharp deterioration in health is possible. A woman may feel severe headache caused by lowering blood pressure, dizziness, weakness, lethargy. In this case, it is recommended to urgently contact a medical institution or call a doctor.
Since with the development of the adhesive process, twisting and necrosis of the ovarian tissues, the development of an ectopic pregnancy and other complications are possible, then you can not hesitate. In some cases, urgent surgery is required.
ethnoscience
If the adhesive process of the pelvis is diagnosed, treatment with folk remedies should be carried out in combination with the main one. It is strictly forbidden to prescribe and select methods of therapy for yourself. Only after consulting a doctor can you try to resort to folk recipes. For example, take honey and aloe juice in a 1: 1 ratio. This mixture is applied to the swab and inserted into the vagina for 6 hours, but not more than 8. The duration of therapy should be monitored by a doctor.
If the commissures are single, then you can use infusions of herbs to relieve the inflammatory effect, for example, this one: crushed incense root (60 gr.) Pour 1.5 tbsp. hot water. It is advisable to leave overnight or for 8 hours. Douching is carried out with a filtered solution (for 1 liter of water 2 tbsp. Of solution). The course is 10 days.
Pregnancy and adhesions - is it possible?
Pregnancy with spikes is possible. Since they do not always have a neglected form or are numerous. In the event that commissures cause inconvenience, doctors recommend monitoring diet and bowel function. So you can avoid constipation, dull pain, heartburn.
It is worth monitoring your health, fearing the development of inflammatory diseases. They can worsen well-being and adversely affect the development of the fetus. Moderate physical activity will stimulate normal blood circulation. The attending physician will separately monitor the condition of the pregnant woman and advise the necessary therapy.
Preventative measures
In order to prevent the re-development of the adhesive process, it is recommended:
- undergo an annual examination by a gynecologist;
- treat inflammatory diseases in the pelvic organs in time;
- engage in moderate physical activity.
If the disease has not yet passed into a neglected form, then treatment gives quite tangible relief and recovery. And subsequent preventive measures will avoid their reappearance.