Endometriosis adhesions are pieces of scar tissue that develop inside the bodies of women who have endometriosis. The adhesions can be thin and pliable or thick and fibrous. Endometriosis adhesions can develop between the ovaries and attach to the side of the pelvis, or they can form between body organs, such as the bladder and kidneys.
Endometriosis adhesions cause pain, particularly when moving. Other than pain, adhesions are difficult to diagnose. They are not visible on imagining equipment, such as CT scans or ultrasounds, and most physicians have difficulty diagnosing them through a pelvic examination. An experienced gynecologist who is familiar with endometriosis may be able to diagnose endometriosis adhesions by taking a detailed medical history and performing a pelvic exam.
Laparoscopic surgery is a definitive way to diagnose endometriosis adhesions. During laparoscopy, the surgeon makes a small incision below the navel, and uses that opening to access the abdominal cavity. The physician can not only see inside the abdomen and determine if adhesions are present, they can also remove them at the same time. Open surgery, where the abdomen is opened with a large incision, is not recommended for treatment of adhesions, as making a large opening may lead to the creation of additional adhesions from scar tissue that develops after surgery.
Endometriosis adhesions can cause different complications, depending on where they are located. In addition to pain, adhesions can lead to problems with mobility, digestive issues, bowel obstructions, urinary problems and infertility. Surgical removal is the only recommended treatment for adhesions.
Endometriosis is most common in women between the ages of 25 and 44, affecting between 7 and 15 percent of this age group. Women who have their first pregnancy after the age of 30, women who have long menstrual periods, and those with immediate family members, such as a mother or sister, with the disease have an increased risk of developing endometriosis. Endometriosis occurs when small pieces of the endometrium, or uterine lining, grow outside of the uterus. These pieces of endometrium may attach to the outside of the uterus, ovaries, fallopian tubes, bladder, kidneys, intestines, or vagina.
Complications arise because the uterine tissue that develops outside the uterus still bleeds during the woman's menstrual cycle. The blood remains trapped in the abdominal cavity, where it causes inflammation, cramps, swelling, and pain. Doctors treat endometriosis through pain relief and slowing the progression of the disease. Over the counter and prescription anti-inflammatory medication can ease the pain. Hormonal birth control slows the progression of the disease.