More physicians' comments about adhesions...from OB/GYN.net Women's Health Forum

From: Helen Dynda (olddad66@runestone.net)
Sat Oct 14 13:11:28 2000


1.) "Re: adhesions"...responded to by: J. Glenn Bradley, MD: "Adhesions begin to form within hours of surgery. We know that generally speaking, the more tissue injury in the abdomen, the greater the tendency for adhesion formation. Thus, again generally speaking, laparoscopic surgery is associated with a lesser tendency for adhesion formation, as opposed to a large laparotomy incision. Unfortunately some individuals have a greater tendency for adhesion formation than others, despite the extent of the surgical procedure. I have re-laparoscoped patients with this proclivity for adhesions within 7 days, as the adhesions if present are wispy, not dense, not vascular, and easily swept aside. I am also careful to consider a nerve interruption procedure ( if appropriate and indicated ) in an effort to provide long-term pain relief. I always recommend that any procedure be videotaped, as a ( moving ) picture is worth a thousand words if a second opinion is needed. Your consultant is literally there, and able to offer his / her best opinion based on the actual pelvic situation, as opposed to relying on a written description of what was found."

http://forums.obgyn.net/forums/womens-health/WHF.9805/0560.html

2.) "Re: Are adhesions guaranteed after a myomectomy operation?"...responded to by: Joseph Pastorek, MD: "Adhesions are scar tissue that form after tissue damage, either from surgery or infection or trauma, etc. Adhesions don't " expose " nerves...they cause pain usually by pulling on things that they're stuck to. In any case, myomectomy MAY cause adhesions, but that is highly dependent on the patient, the location of the myomas, and the amount of damage from surgery. However, most of our experience with myomectomy is that it does NOT cause terrible adhesions and pain...the whole reason you do the myomectomy is to help with pain, menstrual disturbances, etc."

http://forums.obgyn.net/forums/womens-health/WHF.9806/0084.html

3.) "Re: Pelvic Pain"...responded to by: J. Glenn Bradley, MD: "IMHO, consideration needs to be given for laparoscopy, as the multiple surgeries make you an obvious candidate for pelvic adhesions which may not show up on a CT scan or MRI. This Dx. is particularly suggestive if you are tender on pelvic exam, and suffer from dyspareunia. The laparoscopy is probably safest if the " open " technique is used, and hopefully your surgeon is skilled at laparoscopic lysis of adhesions ( do ask!!! ). Elavil can sometimes work wonders for pain relief that is not obtainable any other way. If no pelvic pathology is found to explain the pain, also consider medical hypnosis as a means of blocking the pain. Finally, if laparoscopy is undertaken, strongly advise video of the procedure as it will be very helpful if you wish another opinion. Still photographs are a very poor substitute, IMHO"

http://forums.obgyn.net/forums/womens-health/WHF.9806/0110.html

4.) "Re: cramping"...responded to by: Joseph Pastorek, MD: "It depends where the adhesions are and what they are attached to. They can cause cramping, " just " pain, cold sweats and fainting, all sorts of wonderful things, simply depending on what organs they are attached to."

http://forums.obgyn.net/forums/womens-health/WHF.9806/0218.html

5.) "Re: Discomfort after a Laparoscopy"...responded to by: J. Glenn Bradley, MD: "The most likely diagnosis is adhesions. Removing a " cyst " from the ovary usually means that the ovary is ' opened ' somewhat like opening an orange, and the cyst is stripped out. Unfortunately the ovarian tissue has a propensity for becoming stuck to adjacent structures such as the tube or pelvic sidewall. I would suspect that you will require repeat laparoscopy; and if the other ovary is normal, depending on the condition of the involved ovary, consider removing it. If not, the adhesions should be cut and an adhesion barrier applied around the ovary to minimize the development of recurrent adhesions. Despite the term, ' barrier ', the adhesions may form anyway."

http://forums.obgyn.net/forums/womens-health/WHF.9806/0632.html

6.) "Re: Is surgery to remove adhesions justifiable surgery?"...responded to by: J.Glenn Bradley, MD: "Do see another GYN with experience in treating adhesive disease. PLEASE read my current post on obgyn.net re: adhesions ( Banter with Dr. B )."

http://forums.obgyn.net/forums/womens-health/WHF.9806/1062.html

7.) "Re: Abdominal Pain"...responded to by: J. Glenn Bradley, MD: "A GI consult certainly sounds reasonable. If the problem is not identified and solved, I would bet you have adhesions secondary to your surgery and are experiencing intermittent partial small bowel obstruction. If this is the case, the GI studies will be negative ( this is almost always the case in my experience ). Operative laparoscopy with lysis of adhesions should be considered. Do discuss carefully what this really means...as laparoscopic lysis of adhesions many times is not for the novice."

http://forums.obgyn.net/forums/womens-health/WHF.9807/0236.html

8.) "Re: Adhesions"...responded to by: Harvey S. Marchbein, MD: "I feel for you. What you've gone through is very draining both physically and emotionally. You've gone through all well described reasonable methods of treatment and the problem continues. From your description, Gore-Tex may not be what you're looking for but only your physician can know for sure.

"I'd suggest looking into alternative therapy. Acupuncture has been helpful to many of my patients with chronic or recurrent conditions."

http://forums.obgyn.net/forums/womens-health/WHF.9808/0193.html

9.) "Re: Symptoms of Adhesions"...responded to by: D. Ashley Hill, MD: "Adhesions, another word for scar tissue in the abdomen, can cause a variety of symptoms. Most often, they seem to cause a " tearing "- " pulling "- or " sharp " sensation, usually in the lower abdomen area. Some patients report that this pain is all the time, while others say it comes and goes. I imagine that it depends on what the adhesions are pulling on, and what the person is doing at that time. For example, if the adhesions, which are kind of like thin strands of rubber bands, are between the uterus and intestines, they may cause pain during intercourse, bouncing motions, or with bowel movements. If they are around the ovaries, ovulation or certain exercises may make the pain worse. Some conditions cause adhesions between the liver and the diaphragm; those folks can feel sharp pain even when taking a deep breath!"

http://forums.obgyn.net/forums/womens-health/WHF.9808/0333.html


Enter keywords:
Returns per screen: Require all keywords: