The bands of scar tissue that are formed between tissues or organs in the body, causing them to stick together, are called adhesions. Pelvic adhesions are a condition in which tissues stick together in the pelvic region, such as the fallopian tubes, uterus, bladder, and ovaries.
Uterus adhered to the bladder is a common condition seen in women, where the outer surface of the uterus is stuck together with the bladder. Although it seems complicated, it is a treatable and manageable condition with the help of professional medical guidance using surgical and non-surgical methods.
Pelvic adhesions are caused by conditions such as endometriosis, prior surgeries like C-section and myomectomy, and pelvic inflammatory diseases.
Common Causes of Bladder Adhesions
Adhesions are thick scar tissues that make organs in the pelvic region stick together. These tissues form between the uterus and bladder, causing the two organs to stick together for several reasons, such as endometriosis, previous surgeries, or pelvic inflammatory diseases.
- Endometriosis: Tissues that normally line the inside of the uterus grow outside the uterus due to endometriosis. These are attached to places like the fallopian tubes, ovaries, and bladder. These are called implants. During the menstrual cycle, these implants respond to it even though they are outside the uterus. They cause inflammation in the uterus-bladder region. The body tries to heal the inflammation by making scar tissue during the healing process. Over time, the cycle repeats, and large clumps are formed, leading to uterus-bladder adhesion.
- Prior surgeries: Surgery is another common cause of adhesion. The body tries to maintain homeostasis(balance), leading to the sticking of organs.
- C-Section: After a C-section, the body tries to heal from surgical cuts, creating a normal internal healing response. This creates the formation of scar tissues or adhesions between the uterus and bladder. This makes it difficult to pee, as the bladder cannot relax or empty now.
- Myomectomy: This is a surgical procedure to remove uterine fibroids. Fibroid removal causes a lot of bleeding in the womb. The extra blood leads to adhesion by triggering your body.
- Pelvic inflammatory diseases: Severe inflammation due to past pelvic or uterine infection causes your uterus and bladder to stick together, causing uterine adhesion.
Symptoms of Bladder Adhesion
One of the major symptoms of pelvic adhesion is severe pain in the pelvic region. However, these are often painless and show no symptoms at all in most cases. This condition is diagnosed in many women only after they consult for any fertility-related issues.
Some of the symptoms of uterus-bladder adhesion include:
- Issues with the urinary bladder: The adhesion of the urinary bladder with the uterus makes it difficult for the bladder to stretch properly. This causes frequent urination, sudden urgency to pee, and painful urination.
- Pain during intercourse: Deep penetration pushes your uterus, making your bladder pull right along with it as they are stuck together. This causes pain during sex.
- Pelvic pain: Uterus-bladder adhesion causes pelvic pain, as whenever your bladder is filled with pee or is emptied after pee, the uterus is also pulled back and forth along with it.
The group of symptoms caused by pelvic adhesion is referred to as ARD (Adhesion Related Disorder). Some of the pelvic adhesion symptoms include:
- Inability to pass gas
- Bowel obstruction
- Painful bowel movements
- Infertility
- Depression
- Anxiety
- Pain while walking
- Pain while sitting or lying in certain positions
- Constipation or constipation that alternates with diarrhea
How Is It Diagnosed and Treated?
Since pelvic adhesion asymptomatic in most cases, they can be diagnosed with medical procedures only. It includes:
- Evaluation of your medical history, which includes menstrual cycle patterns and pain characteristics.
- Pelvic exams and ultrasound to identify any signs of infection or abnormalities in the pelvic region.
- Advanced tests like MRI scanning if other tests fail to identify the issues.
- Laparoscopy is used to make a definite diagnosis and find the locations and appearance of the adhesions.
There are surgical and non-surgical treatments for uterine adhesions.
The primary treatment of pelvic adhesions is laparoscopic surgery. The scar tissues between the uterus and bladder are removed with 3-4 small, 5- 10 mm abdominal incisions. Laparoscopic surgery requires 4K ultra-high-definition technology, which enables a gynecologist to clearly visualize the surgical area, including internal organs. The incisions help in fast recovery and less pain.
There is always a possibility of the return of scar tissues even after surgical removal. This risk can be minimized:
- Microsurgical techniques to repair pelvic tissues and reproductive organs.
- Use of anti-adhesion fluid and dissolving gels.
- Use of Gore-Tex membrane to protect uterus, tubes and ovaries from adhesion.
- Ensuring all pelvic tissues are free of blood at the end of the procedure.
Non-surgical methods of treatment for pelvic adhesions include;
- Medications: Oral medications such as NSAIDs (Non-steroidal anti-inflammatory drugs), which help to relieve abdominal pain or cramps.
- Hormonal drugs like contraceptive pills or contraceptive injections help to reduce abdominal pain.
- Pelvic floor physical therapy: This physical therapy helps to stretch tight scar tissue, stop muscle cramps, and improve organ function.
Summary
Uterus adhered to bladder is a complex condition that causes tissues between the uterus and bladder to stick together. It can cause several issues, including fertility, urinary bladder dysfunction, bowel obstruction, and other ARD. Most of the time, pelvic adhesions can be asymptomatic. Therefore, it is necessary to seek professional guidance if you have any pelvic adhesion symptoms.
Even though it is a complex condition, it can be treated and managed with both surgical and non-surgical methods. Among the treatments, laparoscopic surgery is considered the primary treatment for pelvic adhesions.
FAQs
1. What are pelvic adhesions?
Scar tissues that are formed between organs in the pelvic region, causing them to stick together.
2. Can adhesions be treated without surgery?
When adhesions cause mild pain or no symptoms at all, they can be treated with non-surgical methods like medication and therapy.
3. What are the symptoms of uterus-bladder adhesion?
Most of the time, adhesions are asymptomatic, but the symptoms include pelvic pain, issues with the urinary bladder, and pain during intercourse.
4. What is the best treatment for pelvic adhesions?
Laparoscopic surgery, which removes the scar tissues, is considered the best treatment for pelvic adhesions.
5. Do adhesions grow back after removal?
Yes. Even after removing the scar tissues using surgery, they can grow back frequently.
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