Adhesions in the uterus: symptoms and treatment in women
Many women are subjected to various operations, but not all know what effects surgery can have a large impact on women’s health. This applies to the adhesions that form on the female organs, and can become a serious impediment to maternity. Adhesions in the uterus are due to infectious diseases, operations on the pelvic organs, abortion and inflammatory diseases.
What are spikes (synechia)?
What are adhesions in gynecology is nothing more than a cord consisting of connective tissue. Their appearance in the fallopian tubes and the ovaries entails infertility.
Adhesions can form between any organs, but is most commonly found in the abdominal cavity.
Inflammation may be mild swelling of the tissues, and thus on the surface of an organ begins to form a film of the protein fibrin. This film holds the bodies together. Welded on is immobilized, and this leads to various consequences. Thus the body is fighting the spread of inflammation. In the uterus synechia can splice the front wall from the rear, with the sprouting to form “pockets” and bruise the cervix and fallopian tubes.
But not every inflammation may go the process of formation of adhesions. If a woman is the time to go for medical assistance, the appearance of adhesions can be prevented.
Particularly noteworthy are the fallopian sinehii, or asherman’s syndrome. In this case, sinehii are in the lower part of the uterus and in the cervical canal that can interfere with the rejection of menstrual blood. While there may be severe pain. In severe cases there is fusion of 75% or more of the uterine cavity with the distribution of adhesions on the fallopian tubes. Such a condition threatens to infertility.
There are several stages of the development of adhesive processes in the uterus:
- Education thin the adhesions, which take no more than 1⁄4 of uterine cavity. While adhesions in the tubes have not yet formed.
- The process gradually spreads, sinehii occupy more than 50% of the uterine cavity. The fallopian tube is involved, there is partial obstruction.
- Sinehii almost filled the internal uterine surface (75%). Observed obstruction of the fallopian tubes.
The reasons for the formation spiek in the uterus:
- Inflammation of the pelvic organs.
- Various infections and diseases transmitted through sexual contact.
- Childbirth, resulting in serious complications (including delayed parts of the placenta).
- The termination of pregnancy.
- The long delay of the ovum in the uterus when regressing pregnancy.
- Uncontrolled use of the Navy.
- Surgery affecting a woman’s reproductive organs, such as the removal of fibroids, ovarian cysts or my Appendix.
All of these factors can lead to the formation of adhesions, and further to infertility.
Those women who are planning pregnancy it is necessary undergo ultrasonography — the ultrasound specialist would certainly have the women adhesions or other pathology.
Adhesions in the fallopian tubes
After the termination of pregnancy or other operations in the fallopian tubes can get inflammation due to infections caught there. In consequence of inflammation, adhesions may be formed film, which cover the cavity of the fallopian tube partially or completely. If a woman fails go to the doctor, the process becomes irreversible. Because of the adhesions the fallopian tubes are unable to operate normally, increasing the risk of ectopic pregnancy. Very often, all this leads to the removal of the fallopian tubes.
Basically, the formation of adhesions takes place without visible symptoms, and very often their presence is revealed only when it is impossible to get pregnant. That is, the woman could not establish whether it had the adhesions. The formation of adhesions in the fallopian tubes does not violate the menstrual cycle, did not result in a discharge or anything unusual, so a diagnosis can only ask the specialist after the ultrasound or laparoscopy.
Diagnosis of uterine adhesions
Currently, there are only two methods of diagnosis of adhesions in the uterus — sonosalpingography and salpingography. When salpingography in the fallopian tube is injected with a special solution, and then Shine x-rays. While clearly visible to all growths and other lesions in the fallopian tubes. The procedure is usually performed just before ovulation. If sonosalpingography solution is also injected into the fallopian tubes, and then conducted an ultrasound, the results of which prescribe follow-up treatment.
After the woman was set the final diagnosis, the physician needs to find out at what stage is the development of the disease. Experts identify three stages of development of adhesive disease:
- Tumors located only on the walls of the fallopian tubes, and between them there is enough distance to promote the fertilized egg. At this stage it is not possible to resort to surgical intervention.
- The second stage of development of the disease is characterized by the fact that the tumors are situated between the ovary and fallopian tube, and do not allow the egg to move. In this case, is usually carried out laparoscopically.
- The third stage of development of the disease is a complete obstruction of the fallopian tubes due to extensive growths of tumors. The promotion of the egg impossible. An effective method is surgery.
All this proves the need for an ultrasound before planning pregnancy or during routine examination of the patient.
How to treat sinehii?
Currently, this problem is faced very large number of women. But do not despair, since medicine can offer a truly effective methods for the treatment of adhesions.
Laparoscopy is one of the types of surgery, which is used not only for treatment but also for diagnosis. The patient receives General anesthesia, then the abdomen is made of microscopic holes, through which introduce the laparoscope. It can be used very accurately to ascertain the condition of the female reproductive organs. At this time, through the cervical canal specialist injects a special liquid, which is brightly painted, and for its promotion can be seen to make the conclusion — whether there is a spike and what they view — with full or partial obstruction. After the diagnosis of doctors is another task — to remove from the fallopian tube these formations.
Laparoscopy allows to completely clear fallopian tube from the growths, and thus minimizes the likelihood of their recurrence. Unfortunately, this method is not effective with complete obstruction of the pipes, as after the operation ciliated epithelium inside the tube can not recover.
Commissural formation in the ovaries
The occurrence of adhesions on the ovaries means that they are connected with the nearest authorities. Usually the ovaries are spliced with the uterus. Because adhesions can form in the blood circulation in the ovaries and infertility.
The reasons can begin adhesions:
- the presence of genital infections;
- transferred abortion;
- a caesarean section or other surgery in the pelvic cavity;
- ectopic pregnancy.
Symptoms of adhesions in the ovaries:
- pain during sex or physical activity;
- frequently recurring pain in the lower abdomen or in the sacrum;
- irregular menstrual cycle.
Diagnosis is carried out using the same laparoscopy and magnetic resonance imaging. But the basic method still is laparoscopy, in which specialists use laser, water streams or electrodes. In this case, in addition to surgical intervention, you will need antibiotic treatment, means that prevent the formation of blood clots and vitamins. In addition, the patient just need to move a lot, because the movement does not form spikes.
What is the danger of adhesions?
Adhesions not only makes the bodies stationary, but can easily hit a nearby organ, and it is impossible to predict the direction of illness. For example, episiotomy — necessary incision of vagina during childbirth, may cause adhesions, which will affect the bowel and cause prolapse of the bladder and the uterus itself. After a simple operation — removal of appendicitis, in women and girls can occur adhesions in the ovaries and the fallopian tubes, which will eventually lead to infertility.
Adhesions during pregnancy
Such an unpleasant thing as the appearance of adhesions in pregnancy, can cause abdominal pain women. Appears this disease is usually a disorder of the bowels strong constipation or diarrhea, frequent fever, vomiting and pain. In chronic course of the disease may only experience recurring abdominal pain. It happens that the disease does not manifest itself.
If adhesions during pregnancy found, then the woman should abandon such procedures as imaging and laparoscopy, as they can cause various complications in the development of the child. All that is permitted during pregnancy — to make a diagnosis using ultrasound.
Sometimes the presence of adhesions in women detected only during pregnancy and on the one hand it is good — it means adhesions have not affected fertility. On the other hand, this is bad, as it is during pregnancy ways to treat adhesions is very limited. Sinehii in late pregnancy can cause dangerous disease — caused by the adherence of the placenta to the uterine wall.
Adhesions after hysterectomy
After such a major surgery like hysterectomy, there may be adhesions in the abdominal cavity. Adhesions violate the bowels, causing discomfort and pain. To avoid the appearance of adhesions after hysterectomy, women need to receive physiotherapy treatment — these treatments help dissolve the scars and make them more elastic and soft.
Do not forget about physical activity after the removal of the uterus, a woman needs mobility, to form new adhesions. If in a few weeks after hysterectomy there are such signs as fever, swelling of the surgical scar, bleeding, the woman is an urgent need to see a doctor.
If the patient ignores the treatment, the disease can cause obstruction of the intestine, and this would entail another surgery. Sometimes adhesive disease practically makes itself known — intermittent pain, a little upset or bloating, which passes quickly. The lack of symptoms does not mean that it is not. Asymptomatic too bad for a woman’s body. Moreover, patients mistakenly believe that recovered and do not seek help from your doctor.
Prevention of adhesive disease
Those methods of prevention that exist at this time, are not very effective, so experts are constantly looking for new solutions.
After various operations have not begun to form adhesions, the woman must restore the correct operation of the intestine. This requires special stimulating drugs. Without them, the intestines will return to normal in about 4 days, but during that time, adhesions can be formed.
Before planning pregnancy, expectant mother should undergo a complete examination from your gynecologist, who will establish precisely whether women’s sinehii or not. If the patient showed adhesions of the fallopian tubes with partial cross, it would help laparoscopy — a small operation to restore patency. If the fallopian tubes are completely closed, and then the woman may become a mother using IVF — in vitro fertilization.