What are adhesions and how to treat them? What causes adhesions after surgery? Spikes how to treat them.

Adhesions in gynecology is when connective tissue begins to form between organs, due to which they can grow together in the future. These connections are called spikes. If you do not get rid of pathological changes in a timely manner, they will cause severe complications.

What are adhesions in gynecology

The adhesive process in gynecology is the formation of connective tissue strands in the pelvic area. With the disease, adhesions appear in the uterus and organs located in the abdominal cavity. A number of signs testify to the development of the process, but the pathology can form asymptomatically. The phenomenon can lead to infertility if you do not contact a specialist in time.

Causes of the adhesive process

Connecting strands are formed due to the influence of a number of factors, which include:

1. Conducting intrauterine surgery: abortion, curettage, caesarean section or hysteroscopy.
2. The presence of a sexual infection in a latent form.
3. Inflammation in the pelvic organs.
4. Injury.
5. Weakened immune defense.

In addition, adhesions in the uterus can form due to:

• non-compliance with the rules of personal hygiene;
• frequent change of sexual partners;
• malnutrition;
• regular hypothermia of the body;
• untimely medical measures.

In order for the adhesive process not to cause health problems, it must be diagnosed and treated in a timely manner.

Types of adhesions and their symptoms

A woman should know what pelvic adhesions are, symptoms and treatment. It should be borne in mind that the disease can proceed in a latent form. The following stages of pathology are distinguished:

1. A common type is chronic, in which there is no pronounced clinical picture. The patient may experience pulling pain in the lower abdomen and suffer from constipation. Some women experience disruptions in the menstrual cycle, accompanied by pain. When there is no therapy, relapses and infertility occur. For this reason, it is necessary to regularly undergo examination and carry out adequate treatment.
2. In an acute and extremely serious condition, the adhesive process leads to the appearance of a pronounced pain syndrome, which accompanies tachycardia, fever and indigestion. On palpation, there are signs of intestinal obstruction. The patient feels intense thirst, her skin and mucous membranes become pale or bluish. An overgrowth in an acute form requires immediate hospitalization and treatment.
3. The periodic type of pathology is characterized by pain in the lower abdomen, frequent urge to urinate, the appearance of constipation or diarrhea, as well as a slight increase in body temperature. For this stage of the disease, conservative methods of therapy are used.

In order not to worsen the state of health, you need to regularly visit a gynecologist, especially when there are symptoms of the disease.

Diagnosis and treatment of adhesions in the pelvis

The adhesive process in the small pelvis, the treatment of which is determined after the collection of anamnesis and examination of the patient, can be determined in several ways. The gynecologist conducts an examination to identify limited uterine mobility, shortening of the vaginal vaults, pain in the appendages and the presence of strands. The doctor may prescribe the following procedures:

1. Pelvic MRI may show white anechoic compounds, if present.
2. Laparoscopy allows you to determine the presence of pathological changes. The method can be transferred from diagnostic to therapeutic, in which the dissection of the fusion is performed.
3. With metrosalpingography, the patency of the fallopian tubes is established.
4. In most cases, adhesions can be identified by ultrasound of the pelvic organs, where they appear as inhomogeneous echoes connecting the organs and the pelvic walls.

To identify the harmful microorganism that caused the development of inflammation, a smear is taken on the vaginal flora, bacterial inoculation of the contents of the organ, and sensitivity to antibiotics in these bacteria is determined. Treatment of adhesions in gynecology is carried out with the help of conservative therapy and surgical intervention.

At the initial stage of the disease, antibiotics are used to eliminate the infection that caused the inflammation. Taking non-steroidal anti-inflammatory drugs, which include Diclofenac and Indometcin, allows you to relieve swelling, relieve pain and remove loose compounds by resorption at an early stage.

If the patient has endometriosis, then hormonal drugs are prescribed. Due to fibrinolytic enzymes, compounds are dissolved. Enzymes can be used as suppositories, administered intravenously, or used in physical therapy.

In addition, the woman attends physiotherapy, gynecological massage and exercise therapy. Taking vitamins and immunomodulators helps to improve the general condition, normalize blood circulation, stimulate immunity and metabolism in tissues.

When conservative methods have not had the desired effect, an operation is prescribed. The indication for emergency surgery is the development of severe complications, which include intestinal obstruction and ectopic pregnancy.

The dissection of the strands is carried out using laparoscopy. With laser therapy, adhesions are cut with a laser beam. Aquadissection is performed to remove adhesions with high pressure water. In electrosurgery, an electric knife is used to separate joints.

Recipes of traditional medicine will help get rid of unpleasant symptoms, but do not eliminate strands. Before including these methods in treatment, you should consult a doctor. Often, patients use chamomile, from which they prepare a solution for douching.

For 1 glass of water you need 2 tbsp. l. plants. The mixture is placed on fire and brought to a boil. After it is allowed to brew for 30 minutes. In the future, the liquid is filtered with gauze, divided into 2 equal parts and the procedure is carried out in the morning and evening. The course of treatment is 2 months.

Effective is honey with propolis. The ingredients are mixed in an amount of 1 tsp, smeared on a tampon and inserted into the vagina at night. Treatment will take 14 days. The procedure is carried out 1 time in 2 days. For a tampon, mono use gauze, which is folded into several layers. If the honey is candied, then it is first melted in a water bath.

Forecast and prevention

Treatment of adhesions should be carried out in a timely manner. In this case, the forecast will be positive. If therapy is absent, complications arise. In order not to become a victim of pathology, it is necessary:

• follow a diet that excludes the use of foods that cause bloating;
• visit a gynecologist 2 times a year;
• perform physiotherapy procedures;
• engage in light physical education;
• take antispasmodics for severe pain;
• consult a specialist if you have regular pain and other unpleasant symptoms.

Adhesions in the uterus will not form if you monitor your health and treat inflammatory processes in a timely manner.

Despite a long period of study of adhesive processes in the abdominal cavity, in particular, in the small pelvis, no common views on the mechanism of their occurrence and prevention have been developed so far. Mortality from intestinal obstruction caused by adhesions, according to US researchers, is about 2000 people in 1 year. In women, the adhesive process in the pelvis occurs 2.6 times more often than in men, and adhesive obstruction of the intestine - 1.6 times. At the same time, the mortality rate as a result of this pathology among women is lower by 10-15%.

What is the adhesive process in the pelvis

The abdominal cavity is lined with peritoneum, which is a closed serous membrane. It consists of 2 sheets, passing one into the other. One of them, parietal, lines the inner surface of the entire abdominal cavity and the cavity of the small pelvis, the second, visceral, covers the internal organs.

The main functions of the peritoneum are to ensure the free mobility of organs, reduce friction between them, protect against infection and localize the latter when it penetrates into the abdominal cavity, and preserve the adipose tissue of the abdominal cavity. As a result of exposure to damaging factors, there is a violation of the oxygen supply to the damaged zone (hypoxia). In the future, there are 2 options for development:

• physiological restoration of the peritoneum;
• adhesion development.

In the second case, adhesion (“sticking”) occurs between different parts of the visceral peritoneum or the latter with the parietal sheet, the formation of strands (fusions, adhesions). This process occurs in phases:

1. Reactive, occurring within the first 12 hours after inflammatory or mechanical damage to the peritoneum.
2. Exudative - for 1-3 days, vascular permeability increases, which leads to the release of undifferentiated cells, inflammatory cells and a liquid blood fraction containing fibrinogen protein into the pelvic cavity.
3. Adhesive - on the third day, fibrinogen is transformed into fibrin, which falls on the surface of the peritoneum in the form of threads. Undifferentiated cells develop into fibroblasts. The latter synthesize collagen, which is the main substance of connective tissue.
4. The phase of young adhesions, lasting from 1 to 2 weeks. They are loose due to insufficient amounts of collagen. In adhesions, new vessels and nerve endings grow, smooth muscle cells migrate into them.
5. The formation of dense fibrous connective tissue mature adhesions lasts from two weeks to 1 month. They are compacted by increasing the density of collagen and the transformation of capillaries into vessels of a larger caliber.

Causes and risk factors

The entire multi-phase adhesive process of the pelvic organs is universal for any damage - inflammatory or mechanical in nature (due to trauma, inflammation, operations). It is an adaptive mechanism that is aimed at separating the site of inflammation from healthy sections. In itself, the formation of adhesions is a protective reaction of the body in response to tissue damage and a decrease in their oxygen supply. However, the tendency to adhesive process, the degree of its severity and prevalence in all people are different, which depends on the genotypic and phenotypic (associated with the genotype) signs and characteristics.

Thus, the main cause of the adhesive process is currently considered to be genetically determined excessive reactivity of the connective tissue, reduced immunological protection and predisposition of the peritoneum to the corresponding type of reaction. In this regard, the risk factors for the occurrence of adhesive disease are divided into:

• endogenous, or internal, which are genetically determined features of the body that reduce its adaptive ability to the occurrence of hypoxia;
• exogenous, or external - these are those that are outside the body and, in terms of their area and strength of influence, exceed the degree of its adaptive capabilities;
• a combination of endogenous and exogenous factors, which greatly increases the likelihood of formation and prevalence of adhesions.

The adhesive process of the small pelvis in its severity is interconnected with the severity of the adhesive process of the entire abdominal cavity. Clinically, the most common causes are:

1. Surgical interventions. The severity and frequency of adhesions are affected by the urgency of surgical treatment (in 73%), the type of access, the volume of the operation, the introduction of drains into the small pelvis for the outflow of blood and inflammatory fluid (in 82%). So, for example, laparoscopic access is less traumatic than laparotomy (with an incision in the anterior abdominal wall); removal of the fallopian tube, ovary, fibroids, supravaginal amputation of the uterus without appendages or its extirpation, etc. also differ in the degree of damage to the peritoneum. The frequency of adhesive disease significantly increases after repeated operations on various parts of the abdominal cavity: after the first operation, it averages 16%, and after the third - 96%.
2. Processes of the inflammatory nature of the uterus and appendages, bacterial vaginosis (colpitis). Most often, the adhesive process is provoked by inflammation caused by chlamydia, gonococci, as well as a combination of sexually transmitted infectious agents.
3. Complications of the course of pregnancy and childbirth, diagnostic curettage of the uterine cavity, artificial termination of pregnancy, especially repeated instrumental abortions, contraception using an intrauterine device. All this contributes to the development of an ascending infection.
4. External endometriosis of the pelvic organs (proliferation of cells of the inner lining of the uterus beyond its limits). Endometriosis damage in many cases stimulates immune mechanisms leading to the formation of fibrinous connective strands between adjacent structures.
5. Systemic immune diseases of the connective tissue (scleroderma, dermatomyositis, rheumatism, systemic lupus erythematosus, etc.).

In ongoing studies, one reason for the formation of adhesions was found only in 48%, in other cases it was a combination of two or more factors.

Clinical course of adhesive disease and its diagnosis

Adhesions become a clinical problem only if they lead to specific complications, on which the symptoms of the adhesive process of the pelvic organs also depend. The main complications include:

1. Intestinal obstruction
2. Violation of gestation, infertility

Signs of intestinal obstruction

Intestinal obstruction can occur in acute and chronic forms. Acute intestinal obstruction occurs as a result of a decrease in the lumen of the intestine due to its compression by adhesions, infringement of the wall of the intestine or entry of the intestinal loop in the form of a double-barrel into the “window” formed by adhesions, etc. As a result of the infringement of the intestine, the passage of fecal masses and discharge gas through the intestines, which leads to overstretching of its upper sections. In addition, irritation of the nerve receptors of the intestinal wall causes spasm of the terminal branches of the mesenteric arteries, disruption of microcirculation in them, deterioration of the outflow of venous blood and lymph, and effusion of the liquid part of the blood into the intestinal lumen.

This simplified mechanism of acute intestinal obstruction explains:

• the appearance in the abdomen of pains of a cramping, and then a permanent character;
• dry mouth;
• bloating;
• nausea and vomiting;
• lack of act of defecation and discharge of gases.

With the provision of timely surgical care, the prognosis is favorable. Otherwise, necrosis (necrosis) of the wall or a certain section of the intestine occurs, which requires not only the dissection of adhesions and the release of the intestine, but its resection (partial removal). With a longer course of the disease, dehydration of the body, electrolyte disturbances, hypovolemic shock, vascular, cardiac and respiratory failure, etc. occur, followed by a likely adverse outcome.

Chronic intestinal obstruction can sometimes last for years and not lead to more severe consequences. It is manifested by intermittent short-term cramping pains of varying intensity, constipation, sometimes diarrhea, moderate bloating of a transient nature, nausea, and rarely vomiting. Such symptoms can sometimes be triggered by physical activity, the use of foods that promote gas formation (garlic, legumes, foods rich in fiber).

Chronic pelvic pain syndrome

Pain is associated with the tension of adhesions when the pelvic organs are displaced. In this case, irritation of pain receptors and short-term ischemia (impaired blood supply) occur as a result of both the mechanical action of the strands themselves and reflex vasospasm.

Chronic pelvic pain is characterized by:

1. Prolonged, almost constant, with a periodic increase in the intensity of pain in the lower abdomen, inguinal and lumbar regions. These pains can be sharp, aching, or dull. Often their tendency to increase is associated with psycho-emotional and physical stress, hypothermia, a certain position of the body for a long time.
2. Painful menstruation and periods of ovulation.
3. Pain during excessively active sexual intercourse, heavy lifting or physical education, during the act of defecation, bladder overflow or emptying.

The presence of at least one of this group of symptoms supports the diagnosis of chronic pelvic pain syndrome.

Violation of gestation and infertility

The adhesive process of the small pelvis during pregnancy can to some extent limit the mobility of the uterus and its increase. Stretching of fibrous adhesions in this case can be accompanied by frequent and sometimes almost constant pain in the lower abdomen, urge to urinate frequently, constipation, discomfort during defecation, bloating, and forced restrictions on a woman’s good nutrition. Symptoms depend on the location and severity of the adhesive process.

The danger lies in the fact that the strands can lead to impaired innervation and blood circulation in various parts of the uterus and its associated hyperactivity. The latter can cause spontaneous abortion or premature birth.

But the adhesive process has an even greater influence on the possibility of fertilization. Deformation of the fallopian tubes, a change in position in relation to other organs, a decrease in their lumen, occlusion (closure) of the fimbrial or ampullar sections with the development of hydrosalpinx (accumulation of fluid in the fallopian tube), impaired mobility of the fimbriae - all this can cause a deterioration in transport through these sections of the egg or / and spermatozoa, the absence of fertilization or the occurrence of the latter, but with the subsequent development of an ectopic pregnancy. In addition, the presence of adhesions inhibits the growth of follicles, which is associated with a decrease in the adequacy of the blood supply to the ovaries.

Adhesions are the cause of obstruction of the fallopian tubes and, as a result, infertility

Diagnosis of the disease

Based on:

• symptoms and clarification of anamnesis data (survey): the presence in the past of inflammatory processes in the small pelvis, abortions, surgical interventions, endometriosis, intrauterine device;
• data from a vaginal examination by a gynecologist, during which the location of the uterus and its mobility, the presence of pain, size, degree of mobility and displacement of the appendages and other organs are determined;
• data, hysterosalpingography or ultrasonic hysterosalpingoscopy, allowing to assess the patency of the fallopian tubes, and, if necessary, laproscopic examination.

Principles of treatment

Treatment of the adhesive process in the pelvis is carried out by such conservative methods as diet therapy, the use of ultrasound, high-frequency currents, iontophoresis with enzyme preparations, magnetic therapy, mud therapy and others. However, any conservative therapy in order to eliminate adhesions is ineffective. To some extent, it helps in eliminating the symptoms of adhesions in chronic intestinal obstruction, chronic pelvic pain syndrome, and even less in infertility.

In the event of acute obstruction, only surgical dissection of adhesions and restoration of bowel function are indicated, if necessary, its resection.

For the treatment of infertility, attempts are possible to restore the location of the fallopian tubes by dissecting adhesions using the laparoscopic method and their subsequent hydrotubation (washing the tubes with solutions), which is also ineffective.

Most often, with infertility, it is necessary to use modern assisted reproductive technologies (ART), including ovarian stimulation in order to obtain single mature follicles (ovulation induction), methods of artificial introduction of selected and processed sperm into the uterine cavity (artificial insemination) and in vitro fertilization (IVF) .

The internal organs of a person are covered with a serous membrane, which allows them to be separated from each other, to change their position during body movements. With the development of a pathological process in one of the organs, the formation of connective tissue often occurs, which glues the serous membranes together, preventing them from moving and functioning properly.

In medicine, this condition is called adhesive disease or adhesions, which in 94% of cases develop after surgery. Outwardly, adhesions are similar to a thin plastic film or thick fibrous strips, it all depends on the degree of adhesive disease, as well as the organ in which the pathological process has developed. Adhesions after surgery can appear between almost any internal organs, but most often they develop in the intestines, lungs, between the fallopian tubes, ovaries or heart. What are adhesions, how dangerous are they, and how to treat adhesions after surgery.

What are adhesions after surgery

Normally, after the operation, the internal organ that was submitted to outside intervention should heal, a scar appears on it, and its healing is called an adhesive process, which is a normal physiological process and passes over time without disturbing the work of other organs. The adhesive process has nothing to do with adhesive disease, in which pathological growth and thickening of the connective tissue occurs. In cases where the scars after the operation are more than normal, the internal organ begins to fuse tightly with other organs, preventing them from functioning properly. It is this process that is referred to as adhesive disease, which has its own symptoms and requires additional treatment under the supervision of a doctor.

Reasons for the development of adhesions

The appearance of adhesions after surgery largely depends on the professionalism of the surgeon who performed this intervention. A specialist in the field of surgery must have excellent skills in applying sections and sutures, the quality of operating materials and the technical equipment of the clinic itself also matter. Because the quality of the operation depends on it. If there are doubts about the professionalism of the surgeon or there are no ideal conditions in the clinic, then you should look for another hospital or buy the necessary and high-quality materials on your own that will be used during the operation.

Probably, each of us has heard from various sources that there are cases when, during the operation, due to the negligence of a doctor or medical staff, some suture materials, tampons, gauze, or some surgical instruments were left inside. The presence of these factors also contributes to the formation of adhesions after surgery.

Postoperative adhesions are most often formed after surgery on the intestines or pelvic organs. So adhesions after surgery to remove the uterus can form as a result of inflammatory processes or infection. The presence of adhesions after surgery on the reproductive organs often leads to the development of infertility or other disorders. A fairly common cause of the development of adhesive disease after surgery is tissue hypoxia, when the internal organ does not receive enough oxygen. Adhesions after surgery on the organs of the reproductive system are often formed with endometriosis, and in the intestine after surgery for appendicitis, intestinal obstruction or stomach ulcers. Adhesions appear after an abortion, surgery on the ovaries, heart or lungs. Thus, it can be concluded that adhesions after surgery can appear for many reasons, but in any case they cannot be left without due attention of the doctor, since their appearance significantly impairs the functionality of internal organs and often causes complications.

Symptoms of adhesions after surgery

The process of formation of adhesive disease is quite long and directly depends on the organ that was submitted to the surgical intervention. The main symptom of adhesions after surgery is pain in the area of ​​the surgical scar. Initially, there is no pain syndrome, but as the scar thickens, it has a pulling character. Pain is aggravated after physical exertion or other body movements. So after surgery on the liver, pericardium or lungs, pain is felt with a deep breath. If intestinal adhesions after surgery, then pain manifests itself with sudden movements of the body or physical exertion. The presence of adhesions on the pelvic organs causes pain during intercourse. In addition to pain, there are other symptoms of adhesions after surgery, but it is important to note that the clinical picture directly depends on the localization of adhesions and disorders in the body. Consider the most common signs of postoperative adhesions:

• violation of defecation;
• frequent constipation;
• nausea, vomiting;
• complete absence of stool;
• pain on palpation of the postoperative suture;
• redness, swelling of the external scar;
• increase in body temperature;
• labored breathing, shortness of breath.

In cases where adhesions have formed after removal of the uterus or surgery on the ovaries, fallopian tubes or vagina, a woman feels pain during intercourse, pulling pains in the lower abdomen, menstrual irregularities, various discharges from bloody to gray with an unpleasant odor. The formation of adhesions after surgery should be monitored by a doctor, but if they appear a few weeks or months after surgery, then the patient needs to seek help on his own.

Possible Complications

Adhesions are a rather complex complication after surgery, which can not only disrupt the functioning of internal organs, but also provoke complications, including:

• acute intestinal obstruction;
• necrosis of the intestine;
• peritonitis;
• infertility;
• violation of the menstrual cycle;
• bending of the uterus;
• obstruction of the fallopian tubes;
• ectopic pregnancy.

Complications of adhesive disease often require immediate surgical care.

Diagnosis of the disease

If you suspect the presence of postoperative adhesions, the doctor prescribes a series of laboratory and instrumental examinations to the patient:

• A clinical blood test will show the presence or absence of an inflammatory process in the body.
• Ultrasound examination (ultrasound) - visualizes the presence of adhesions.
• X-ray of the intestine.
• Diagnostic laparoscopy.

The results of the research allow the doctor to determine the presence of adhesions, consider their shape, thickness, determine how the internal organs work, and prescribe the necessary treatment.

Treatment of adhesions after surgery

Treatment of adhesions directly depends on the state of health of the patient. In order to reduce the development of adhesive disease, the doctor in the postoperative period prescribes anti-inflammatory drugs, various enzymes for the resorption of adhesions, less often antibiotics, and also advises to move more, which will prevent displacement and "gluing" of organs to each other. A good result can be obtained from physiotherapeutic treatment: mud, ozocerite, electrophoresis with medicinal substances and other procedures.

In cases where the postoperative period has passed without suspicion of the presence of adhesive disease, but after a while the patient still has large scars, severe symptoms appear, the only correct solution will be to repeat the operation, but to remove adhesions. Removal of adhesions after surgery is carried out by several methods :

Laparoscopy - the introduction of a fiber optic tube into the abdominal or pelvic cavity with a microscopic camera. During the operation, two small incisions are made, into which a manipulator is inserted with instruments that allow you to dissect adhesions and cauterize bleeding vessels. This method of surgical intervention is less traumatic, since after its implementation there is a minimal risk of complications, and the patient himself can get out of bed already on the 2nd - 3rd day.

Laparotomy - provides full access to the internal organs. During the operation, an incision of about 15 cm is made. With the help of special equipment, the adhesions are excised and removed. This method of surgical intervention is performed in cases where it is not possible to perform laparoscopy or with a large number of adhesions.

After the operation, the doctor cannot give a 100% guarantee that adhesions do not form again. Therefore, the patient needs to periodically visit a doctor, strictly adhere to his recommendations and carefully monitor his health.

Folk remedies for the treatment of adhesions after surgery

In addition to the conservative and surgical method of treating adhesive disease, many seek help from traditional medicine, which can prevent the growth of adhesions in the early stages. It is important to remember that the treatment of adhesions with alternative methods can only be used as an adjunct therapy to the main treatment. Consider a few recipes:

Recipe 1. For cooking, you need 2 tbsp. Flax seeds, which need to be wrapped in gauze and dipped in boiling water (0.5 l) for 3-5 minutes. Then the gauze with seeds should be cooled and applied to the sore spot for 2 hours.

Recipe 2. You will need dried and well-chopped St. John's wort in the amount of 1 tbsp. l. Grass should be poured with 1 cup of boiling water and boiled over low heat for about 15 minutes. After the broth, you need to drain and take ¼ of a glass three times a day.

Recipe 3. For cooking, you need aloe, but one that is less than 3 years old. Aloe leaves should be put in a cold place for 2 days, then chopped, add 5 tablespoons of honey and milk, mix well and take 1 tbsp. 3 times a day.

Recipe 4. You need to take 1 tbsp. milk thistle seeds, pour 200 ml of boiling water, boil for 10 minutes, let cool and strain. The finished broth should be drunk warm, 1 tbsp. l 3 times a day.

Prevention of adhesions after surgery

It is possible to prevent the appearance of postoperative adhesions, but for this, maximum care must be taken both by the doctor during the operation and by the patient himself after the operation. It is very important to follow the doctor's recommendations, move more, follow a diet, avoid physical exertion, and prevent the possibility of infection entering the suture that remained after the operation. If you do not follow all the recommendations, reduce the risk of developing adhesive disease is reduced several times.

In addition, if after the operation there are pains in the abdomen, a violation of the stool, vomiting, do not self-medicate, you should immediately call an ambulance. Adhesive disease is a rather serious disease, which in some cases can lead to the death of a person.

Adhesions are adhesions that connect different tissues and organs. The presence of adhesions in the uterus and appendages contributes to the development of infertility.

Human organs are covered with a serosa, which makes them slippery, they slide freely when in contact with each other without causing harm. In this case, the body fully performs its functions, is in good condition, has a full blood supply. With the formation of adhesions, there is a restriction of the movement of the organ, its attachment to another organ or tissue. This leads to impaired blood supply, reduced functionality, congestion and the development of various diseases and pathological conditions.

Adhesions can occur for various reasons - they can be congenital or acquired. Congenital adhesions are formed in the presence of a congenital pathology of organ development. Acquired adhesions are formed as a result of intracavitary bleeding, in place of which connective tissue subsequently grows, after inflammatory processes. Adhesions that have become strong are difficult to remove, sometimes it is no longer possible to remove them.

Adhesions are divided into two types: external adhesions - located between organs, and internal - located inside the organ. They can be single or multiple - adhesive disease develops. Connective tissue grows into the serous membranes of organs, disrupting their mobility and functioning. In almost all cases, adhesions form after surgery. Adhesive tissues are like a thin film at the beginning of development, or like thick fibers when the disease goes far. Adhesions can grow in all organs, from the heart to the genitals. Also, adhesions are formed after severe inflammatory and infectious processes, as a result of organ injury. The formation of adhesions can begin a long time after the injury, in places where hematomas form in the mesentery, in the retroperitoneal space. The outflow of blood is disturbed, exudation into the abdominal cavity is disturbed, the "lubrication" of the organs disappears, which allowed them not to injure each other, to be in slip. As a result, the organs begin to rub against each other, adhesions are formed.

The development of adhesive disease or not after the surgical operation will begin, for the most part depends on the skill of the surgeon, on the quality of the surgical materials used by him and the equipment of the clinic. After the operation, the surgeon applies stitches to the operated organ using certain materials. If the surgeon has good skills in suturing, then the suture will quickly heal, the adhesive process will begin, which belongs to the normal recovery processes in the body. If the suture was applied unprofessionally, a large scar will form, the tissues of the injured organ will begin to fuse with other organs and tissues - postoperative adhesive disease will develop. The formation of collagen fibers begins on the third day, connective tissue on the seventh day, and the formation of adhesions ends on the twenty-first day. Soft and loose tissues in twenty-one days turn into very dense, sprouted blood vessels, in a month nerve endings will form in adhesions. Adhesive disease is very dangerous, so it should be treated as early as possible.

Symptoms of adhesion formation

The main symptom of adhesions after surgery is pain in the area of ​​the surgical suture, which acquires a pulling and aching character. The pain increases with physical exertion, running, jumping, turning and tilting the body. The formation of adhesions after surgery on the lungs causes pain with a deep breath, with sudden movements there is pain after surgery on the intestines, after surgery on the uterus or ovaries - pain during intercourse.

Adhesions can cause disorders in the form of a complete absence of stools, constipation, constant nausea, vomiting, debilitating aching pain, high fever, redness and swelling of the postoperative suture, and shortness of breath. After surgery on the uterus or ovaries, adhesions can cause menstrual irregularities, discharge, in severe cases, infertility, and great weight loss. The formation of adhesions in the uterus can occur after spontaneous abortion or curettage, as a result of the development of endometriosis, pregnancy pathologies, after the use of an intrauterine device.

Adhesions (synechia) in the abdominal cavity are pathological growths of connective tissue between organs or between organs and the wall of the peritoneum, arising from a variety of reasons. As a rule, the development of adhesions is due to the presence of a long-term inflammatory process, as well as as a result of surgery (removal of the appendix, caesarean section, etc.)

Adhesions in the fallopian tubes and uterus is one of the causes of female infertility. Adhesions in the fallopian tubes occur due to inflammation (salpingitis, adnexitis, endometriosis). Spikes can close the entire lumen of the fallopian tube, after which the promotion of the egg through them becomes impossible, and conception cannot occur.

Adhesive disease after surgery on the genitourinary organs of a woman or intestines can provoke the development of acute intestinal obstruction, necrosis of the intestines, obstruction of the fallopian tubes. As a result, necrosis of intestinal sections may occur, a new operation will be required, during which an area of ​​​​intestinal necrosis, adhesions, which provoked a violation of blood circulation in the organs, will be removed.

Extensive adhesive disease begins after peritonitis, the process includes the intestines, kidneys, uterus, appendages. An infection that has entered the abdominal cavity with peritonitis contributes to the increased development of adhesive disease. Adhesive disease can lead to ovarian necrosis, which will die as a result of circulatory disorders, the process can spread further and provoke complete infertility. The development of adhesive disease in the ovary is characterized by irregular menstruation.

The development of adhesive disease can be affected by hereditary predisposition to the formation of adhesions. This is due to an increase in the synthesis of enzymes that react to any damage to cells by the active formation of adhesions, provoking the growth of connective tissue.

Radiation therapy can provoke the development of adhesive disease. In the treatment of oncological diseases, adhesions often occur after tumor irradiation.

For the diagnosis of adhesive disease, ultrasound, PCR (diagnosis of pathogens using polymerase chain reaction), diagnostic laparoscopy, MRI - magnetic resonance imaging are used.

Treatment of adhesive disease

The fight against adhesions includes both conservative and surgical methods of treatment.

Conservative methods are aimed at resorption of adhesions; in this case, the use of anti-inflammatory drugs (for example, a course of aloe injections) is indicated, as well as physiotherapy, with which the adhesions soften and become more elastic.

Prevention of the development of adhesive disease after surgery consists in the appointment of anti-inflammatory drugs, in a certain physical activity, which reduces the possibility of organ fusion. For the prevention of adhesions after surgery, injections of enzymes that inhibit the development of adhesions, a diet are prescribed. The prescribed therapeutic diet consists of fractional nutrition, excludes fatty foods, with preservatives and dyes, takes into account the body's needs for enzymes and amino acids.

Surgical treatment of adhesions

Surgical methods for the treatment of adhesions include primarily laparoscopy. Surgical intervention is indicated in the later stages of the adhesive process, when it is not possible to remove adhesions (and restore the patency of the fallopian tubes) in any other way. Recovery after laparoscopy is faster, the likelihood of re-formation of adhesions is small.

The second surgical method for removing adhesions is a laparotomy. This surgical method is used in cases where it is impossible to remove all adhesions by laparoscopic access. Laparotomy is an open approach through an incision in the anterior abdominal wall. Laparotomy is used with a large number of adhesions, with advanced adhesive disease, with severe disorders in the functioning of organs, where an urgent operation is required.

In most cases, the onset of the adhesive process is asymptomatic. At the moment when a woman seeks help, adhesive disease has already developed. Surgical removal of adhesions does not always solve all problems. Removal of adhesions cannot restore the impaired functionality of organs, restore the destroyed structure. Many women have undergone many years of treatment for adhesions in the fallopian tubes, but pregnancy has not occurred. Violation of the structure and functionality of the organ led to infertility. The main factor influencing the reduction in the formation of adhesions is the minimization of damage during surgery, thorough sanitation of the abdominal cavity, quick stop of bleeding, prevention of foreign bodies entering the abdominal cavity, and the use of special methods that reduce the risk of developing adhesive disease.

The adhesive process in the small pelvis is a connection, soldering of the female internal genital organs (uterus, fallopian tubes, ovaries), as well as the ligaments supporting them, among themselves and / or with the organs surrounding them. Treatment of adhesions in gynecology - surgical (in advanced cases), or conservative, incl. "popular" means.

REASONS FOR THE FORMATION OF ADMISSIONS ON THE OVARIANS

Why do adhesions of the uterine appendages (ovaries and fallopian tubes) occur and why are they dangerous? They appear after an inflammatory process, acute infection, STDs, and surgical interventions in the abdomen. As a result, the normal mobility of internal organs is disturbed. As a result, the nerves and blood vessels that feed these organs are pinched, and their function begins to suffer. Based on the causes, all the symptoms of this process and their further consequences for women's intimate and reproductive health follow ...

ADHERENT PROCESS OF THE PELVIC ORGANS IN WOMEN IS OFTEN CAUSED BY:

• Inflammation of the appendages
• gynecological operations,
• genital tract infections,
• hypothermia, cystitis,
• surgical abortion,
• surgical interventions,
• intrauterine manipulations,
• Setting up the spiral
• Endometriosis.

Symptoms of adhesions in the pelvis

• Periodic pulling pains in the lower abdomen,
• Sometimes back pain
• cycle disorder,
• Pain during intercourse
• painful menstruation,
• Infertility.

Adhesions on the ovaries are characterized by different symptoms, which can be single or combined with each other. A letter from one patient will help to understand, displaying characteristic signs with tightened appendages:

"... During the examination, the gynecologist felt adhesions on my left ovary, which was a complete surprise for me. I wanted to know why they appear, how dangerous they are and what means can be used to remove them? The doctor explained that hypothermia, for example, coldness, could be the reasons appendages, abortions, infections. And how they affect the ability to have children and carrying a pregnancy. Launched adhesions can be removed by surgery, but in my case, not everything is so bad and can be treated with conservative methods, what exactly - he will say after passing tests and ultrasound. Now it became clear , why I was worried about periodic pains in the ovaries, sometimes on the right, sometimes on the left and in the lower abdomen, especially during intimacy and after physical exertion in fitness. with my health, I don’t want an impact on the reproductive ability, and on everything else too ... "

Stages and degrees

Symptoms of the adhesive process in the area of ​​​​the appendages (ovaries and tubes) depends, first of all, on the severity of the pathological formation. In gynecology, the following degrees of adhesions of the appendages are distinguished:

I stage. Single thin adhesions are localized near the ovary, fallopian tube, uterus and neighboring organs, but practically do not displace the affected structures and prevent the movement of the egg. During vaginal examination, these adhesions of the ovary give more or less pronounced sensitivity in the right and / or left half of the abdomen, in the projection zone of the appendages. With this degree of ovarian adhesive process, treatment is best and more effective in combination with the methods listed below.
II stage. The ovary is connected by dense adhesions to the fallopian tube or other organs, while more than 50% of its surface remains free. The adhesions interfere with the capture of the egg by the fimbriae. On palpation during a gynecological examination, there is pain in the area of ​​​​the appendages along the lateral arches, their mobility is limited.
III stage. More than half of the ovary is covered with numerous dense adhesions. The fallopian tubes are impassable due to deformation and overlap of the lumen. Displacement during examination is almost impossible due to fixations and a sharp painful reaction.

PHOTO OF COMMERCIAL PELVIC ORGANS IN WOMEN

What are the consequences of untreated adhesions of the ovaries with the uterus and neighboring organs?
Most often, this is infertility, pain in the lower abdomen and during sexual intercourse, displacement and bending of the uterus, obstruction of the fallopian tubes, ectopic pregnancy, and various menstrual irregularities. Therefore, given the variety of causes that cause pain in the lower abdomen and other manifestations similar to the symptoms of adhesions, it is necessary to consult a good gynecologist! A formal approach to the problem will not give an effective and lasting result.

Adhesions in the pelvis?
We treat effectively and without surgery!

In our gynecology, the treatment of adhesions of the pelvic organs and inflammation of the appendages in a chronic form is carried out only after a comprehensive examination and the exclusion of other possible causes of pain in the lower abdomen! The effectiveness of the course of treatment of the adhesive process "according to gynecology" directly depends on the correct diagnosis.

EXPLORATORY SURVEY

• Look at the chair
• Ultrasound of the pelvic organs,
• Swabs for flora, PCR,
• Clinical blood test.

MEDICAL THERAPY

• Antibiotics (during an exacerbation of inflammation, according to indications),
• anti-inflammatory drugs,
• restorative therapy,
• Procedures and preparations for resorption of adhesions (enzymes + treatment described below),
• Injections of a placental preparation for the endometrium,
• Plasma therapy.

What to do if the gynecologist found adhesions? Have you had an abortion or miscarriage, inflammation of the ovary, or an attack of acute cystitis? Do not despair - special procedures in the clinic will help you, some of which are classified as so-called. "folk" methods, the effectiveness of which in terms of treatment and prevention is confirmed by our many years of experience in their application. This allows you to soften the adhesions on the ovaries, make them thinner and more extensible, reduce and even completely stop pain in the appendages. Since the manifestations of the disease are caused by anatomical disorders, the use of painkillers alone will not have an effect. Description of the basic techniques, see below, other procedures, details and details are discussed in the clinic at the doctor's appointment.

Treatment of adhesions in the pelvis with folk remedies

1. Massage for adhesions.
   Gynecological massage with pelvic adhesions affects not only directly on the internal genital organs of a woman, but also on her body as a whole. Such exposure has a very positive effect on health in general. In the first sessions, you will feel some soreness, as the nervous system reacts to this kind of exposure. However, over time, the discomfort will stop, which will indicate the positive dynamics of the process of treating adhesions. Massage improves blood circulation in the pelvis, the mobility of the uterus, removes its displacement. Moreover, the greater the severity of the adhesive process in the female organs, the more force the gynecologist needs to apply; the number of sessions will also increase. This "folk" remedy shows high efficiency, subject to proper training of the doctor and his practical experience in this matter. Our gynecologists carry out such delicate manipulations carefully, controlling the patient's condition. After the very first massages of the ovaries and appendages with adhesions, the blood flow in the area of ​​the “clamped” pelvic muscles improves, venous congestion is eliminated, which increases the likelihood of becoming pregnant. At the same time, the state of the intestines is normalized, and the overall tone of the body is increased. As an added bonus, pain during menstruation may decrease.
2. Mud treatment.
   Therapeutic mud, which is used by the clinic in the form of vaginal or rectal administration, as well as "mud pants", is a complex balm of natural origin, the composition of which includes a huge amount of minerals, vitamin-like substances and biologically active components. This composition allows the mud to have a range of effects; it has anti-inflammatory, analgesic, and disinfecting effects, which, in combination with other methods, significantly increases the chances of curing adhesions in the pelvis.
3. Leeches for spikes.
   Hirudotherapy in gynecology in the treatment of adhesions of the fallopian tubes and ovaries shows good efficiency, especially in combination with other means (massage, physiotherapy). Positive results are more often observed in the early stages of the process, when there are no significant disturbances in the location of the internal genital organs. In the presence of an extensive adhesive adhesive process, obstruction of the pipes, an operational approach to the problem is shown; hirudotherapy can be useful at the stage of rehabilitation to prevent organ adhesions in the postoperative period.
4. Autohemotherapy.
   This folk remedy for the adhesive process refers to an immunocorrective auxiliary technique. Treatment with autohemotherapy for adhesions in gynecology will increase the metabolism in the body, improve immunity, activate the process of lymph and blood flow. Remove slags and toxins from the body, increase vitality.

Physiotherapy	Massage of the uterus, appendages	Vibromassage
Leeches for spikes	Healing mud	Laser therapy

Service cost

Adhesions in the pelvis, which thousands of women are trying to treat or remove, remains one of the most common and difficult to diagnose gynecological diseases. The reasons for this can be very different, from frequent inflammation of the appendages, to complications after infectious processes in the genital area and previous STDs. Therefore, only an integrated approach to the problem can give positive results. Modern gynecologists recommend treating adhesions on the ovaries preventively, that is, in order to prevent their occurrence. This implies the appointment of resolving therapy as soon as an inflammatory process in the internal genital organs was diagnosed or after an operation on the uterus or appendages, as well as after an abortion.