Adhesions on the ovaries: causes, symptoms, treatment, and reviews

Adhesions on the ovaries are the main cause of long-term pain and tuboperitoneal infertility among women of reproductive age. Chronic inflammation, endometriosis, surgery on the areas become malotazovoy etiological factor adhesive disease. The basis of treatment and disease prevention is to minimize the trauma of operations, use of certain medications and barrier adjuvants.

Ovaries in adhesions: what it means

Adhesions on the ovaries are formed connective cords that connect the uterus with adnexa abdominal organs. Adhesive disease in material breach of the quality of life. Chronic pain, inability to exercise reproductive force women to submit complaints to the surgeon and gynecologist.

Adhesions around the ovary in the early stages of the formation of friable, then the connective tissue becomes dense - organized. As the severity of a pathologic process in the spikes sprouting vessels and nerves, as well as their ossification occurs. In such cases, it becomes impossible to separate them.

Adhesions in the appendages is divided into several types:

• planar adhesions (Seam along the plane);
• webbed (In the form of membranes arranged transversely);
• threadlike (Thin strands between organs);
• traction (At the site of attachment forms a funnel shaped impression).

The ovaries are located in the pelvis in the vicinity of the bowel, omentum, the walls of the abdominal cavity, the bladder, the uterus. In the formation of adhesions to grow together, they can with these organs and tissues. Most often, the appendages are soldered to the uterus. Also, strands are formed between the post-surgical suture and ovaries, fallopian tubes.

Attention! Adhesions ovary and fallopian tubes are tuboperitoneal cause infertility.

As a result, proliferation of connective tissue around the ovaries and fallopian tubes egg has no chance to leave the follicle. If ovulation occurs, the germ cell of the fallopian tube, wrapped spikes can not penetrate into the uterine cavity.

From what appear adhesions on the ovaries

Causes of adhesions on the ovaries related to the traumatic and inflammatory processes in malotazovoy area. Aggravating factors are:

• surgery, In which there is injury to, and drying the leaves at the peritoneum intestinal obstruction, acute appendicitis, adnexal diseases requiring operation;
• bleeding into the abdominal cavity;
• ovary tissue ischemia (Flow violation);
• foreign bodies abdomen;
• endometriosis;
• chronic inflammatory diseases pelvic and abdominal cavity.

Important! Adhesions around the ovary may be congenital or acquired.

Congenital process is caused by developmental abnormalities and ovarian position. Acquired adhesions may be formed only in the pathological process in the previously healthy organ.

Among the causes of postoperative adhesions of the right ovary is leading an emergency appendectomy.

Adhesions after laparoscopic ovarian cyst

Cystadenoma in older women are often the cause of surgery. Removal depending on cyst size passes laparoscopic or laparotomic procedures. Last increases the risk of disease in several times.

Laparoscopy with polycystic in rare cases, can cause the formation of strands.

Endometrial cysts often lead patients to the operating table and is the cause of fibrotic adhesions following ovarian resection formation preserving organ parts.

Adhesions after ovarian cysts are localized on the one hand: the removed organ or saved in part. Salpinx also involved in the process that leads to the impossibility of fertilization on the affected side.

Adhesions after removal of uterus and ovaries

Removal of the uterus and appendages carried by laparotomy and laparoscopy. Selection of line access depends on the disease. Cancer always involves laparotomy. After such operation extensive soft spikes are formed already after 72 hours, 2 weeks later they become dense and the blood vessels to sprout.

About 20% of adhesive disease occurs one month after the removal of the uterus and the ovary, about 40% - in the course of the year.

Removal of myomas by laparotomy also becomes a cause of disease. When performing incision on the back wall of the uterus is recorded the highest frequency of formation of strands.

Ovarian cancer is the leader among the reasons for the formation of adhesions after surgery. Most often, after the removal of appendages strands are formed between intestinal loops.

Adhesions in the ovaries after cesarean

Caesarean section is abdominal surgery, so the formation of adhesions relatively high risks of ovarian. In the presence of inflammation in the pelvis likelihood of developing connective strands increases.

Important! Caesarean section formed by incision of Pfannenstiel, characterized by the formation of a low risk of ovarian adhesions.

An emergency caesarean section also increases the likelihood of adhesion formation between the uterus and the ovary. Specialists set standards: the proportion of elective cesarean section should be 60-70% of all interventions.

Adhesions in inflammatory diseases of the pelvic organs

Genital infections, in particular Chlamydia, and myco ureaplasmosis, viruses, lead to proliferation of various infectious agents to the upper reproductive tract. Infection of the uterus, fallopian tubes and ovaries leading to pelvic inflammatory disease - an inflammatory disease of the pelvic organs. Peritoneal mesothelium respond to an infectious inflammation of the growth of cells in order to limit this process plays a protective role. Thus, adhesion formation is considered in case of excessive internal PID inflammation. Pipes are impassable and soldered ovaries to the uterus.

Inflammation in the pelvic endometriosis often leads to pathology. Vigorous reaction surrounding tissue over time in the growth of the endometrium leading to adhesive disease of varying severity. Endometriosis strands formed dense and voluminous.

symptoms

Depending on the localization of adhesive strands which connect the ovary and other organs of the abdominal cavity, the symptoms may be different.

Important! Chronic pelvic pain is considered to be the most common symptom of the disease.

Pain caused by tension stretching and ovarian offset. Pain receptors are under constant agitation. Pain may be piercing, particularly when moving body turns.

Adhesions in the right ovary, which connect appendages and uterus, usually formed after appendectomy. Pain worse at ovulation and during the ensuing pregnancy worried constantly.

Adhesions of the left ovary may interfere with bowel as the descending part of the colon, passing in a straight line to the left. It notes a tendency to constipation, pain in the left iliac fossa.

Adhesive process in left, right appendages causes pain during exercise, during sexual intercourse painful menstruation.

Pronounced adhesive process manifested by sharp pains in the abdomen, a fundamental breach of bowel function. Sign bilateral adhesions is infertility. A small degree of pathology manifests symptoms.

Diagnostics

The diagnosis is based on ultrasound diagnostics and laparoscopy. In ultrasound can detect dense, fibrous strands and webbed, single, slightly expressed adhesions often not visualized. Diagnostic laparoscopy is both a method of treatment.

Laparoscopic intervention is carried out in cases of suspected disease (infertility, pain).

If the intestines are involved in the process, perform irrigoscopy - gut filling X-ray contrast agent and a picture of detecting filling defects.

If the spikes are enveloped not only the ovaries but also the fallopian tubes, it allows you to detect defects hysterosalpingography, Ultrasound hysterosalpingoscopy.

Blood tests did not show any abnormalities.

Is it possible to reduce adhesions in the ovary

Drug treatment is ineffective, as the connective tissue can not dissolve. Therefore, upon detection of the expressed adherent process struggle against it is carried out with the help of surgery. Separate treatment, folk remedies use dangerous damage of organs involved in adhesions.

Treatment of ovarian adhesions process

Treatment involves adgezioliz - operation dissection strands around the ovary, which is often done laparoscopically by. Since the operation in itself leads to the widening of adhesion, the treatment of this pathology is performed using special methods and means for preventing the return of the disease. When used plastic tube obstruction of the fallopian tubes.

During operation using barrier adjuvants which inhibit the formation of strands:

• Fibrin concentrate;
• oxidized regenerated cellulose;
• Hyaluronic acid in the solution;
• izodekstriny;
• hydrogel;
• crystalloids;
• Gel from viskozoelastichesky.

Medicines that prevent adhesions after surgery:

• nonsteroidal antiinflammatory drugs;
• steroids;
• progestogens;
• anticoagulants;
• antibiotics;
• fibrinolytic agents.

During surgery for adhesions that emerged after the operation, re-cut is carried out in Elsewhere, as access through the old scar can cause damage to the bodies involved in the pathological process.

The severity of adhesions process, the longer the operation, increase the risk of bleeding and damage to surrounding organs.

Pregnancy with a successful operation usually occurs within 6 months. In the absence of pregnancy recommend IVF.

Can I get pregnant with adhesions on the ovaries

Conception on the background of adhesions in the area of ​​the ovaries is possible. Chances are increased in one-sided process, in the absence of other problems in the reproductive sphere. If both ovaries ovulate, then the healthy appendage provide pregnancy. In the case of the propagation process, the presence of hormonal disorders, abnormalities of uterine endometrium and the overall probability of conception dramatically reduced.

In the absence of pregnancy, the more active planning should consult a doctor.

Complications and consequences

One of the most dangerous complications of the internal organs is an intestinal obstruction. Circulatory disorders of gut formed in 30% of cases after a public access operations. Adhesions create lifetime risk of developing intestinal obstruction.

Attention! In regard to the implementation of reproductive function adhesions appendages dangerous ectopic pregnancy and infertility.

Tube obstruction may be partial or complete. In this case the appendage is soldered to the uterine wall more often.

prevention

Regular visits to the gynecologist, screening for sexually transmitted infections, pelvic ultrasound will prevent infections that lead to adhesions. Timely diagnosis of endometriosis, ovarian cysts also can reduce the risk of disease.

At the heart of the prevention of adhesions around the ovaries is an adequate surgical intervention aimed at respect for the leaflets of the peritoneum. Avoidance clamping, laser, electrical impact on peritoneum, maintaining optimum blood circulation during surgery to the pelvis to minimize the risk of formation of adhesions. We do not recommend the use of her powdered talc gloves. Thread should be made of modern materials.

conclusion

Adhesions on the ovaries are dangerous and disease can be prevented by timely diagnosis diseases of the pelvic organs, a choice of sparing surgical tactics, the use of preventive measures after operations.

Reviews women