Pelvic adhesions (scar tissue) are usually caused by multiple pelvic/abdominal surgeries, infection, or endometriosis. Scar tissue can grow between two organs in the pelvic area making them stick together. These pelvic adhesions can occur around the bladder, bowel, ureter, uterus and ovaries. They are also more common after open surgery than laparoscopic surgery.

This scar tissue can be completely asymptomatic and not cause any problems. However, when it causes infertility, pain or gastrointestinal problems, such as bloating and constipation, surgical resection should be considered. Thorough resection of pelvic adhesions is essential in order to relieve pain and avoid new adhesions to form.

PM-PelvicAdhesions

 

Pelvic adhesions can involve different organs:

  • Bladder adhesions: these usually form after cesarean delivery. Multiple cesarean deliveries lead to dense adhesions between the bladder and the uterus. In order to avoid recurrent adhesions and pain, removal of the uterus through laparoscopic hysterectomy is recommended.
  • Bowel adhesions: these form after abdominal and pelvic surgeries like myomectomies, or after severe pelvic infection from a ruptured appendix or bowel injury. Careful dissection of the bowel with special scissors is required, and this should only be performed by an experienced surgeon.
  • Endometriosis adhesions: these can form as a result of extensive or longstanding endometriosis and can cause pain and infertility. These adhesions are usually very dense and involve important structures such as the rectum, large pelvic vessels, and ureters, they can be very difficult to resect. If the patient does not wish to preserve fertility, removal of the uterus with or without the ovaries should be considered.
  • Ureteral adhesions: these are adhesions around the tubes that connect the kidneys to the bladder. They are found in severe endometriosis. In rare cases, the extent of damage to the ureter from endometriosis requires ureteral reimplantation.

Resection of pelvic adhesions can be a very complicated procedure. In the hands of an unexperienced surgeon, it can result in injury to surrounding organs and a higher risk of conversion to open surgery. Laparoscopic resection of adhesions is the preferred method because it is safer and leads to less pain and faster recovery for the patient. Patients with severe endometriosis should seek care from a surgeon that is experienced in advanced laparoscopic procedures. Gentle handling of the tissue, minimal blood loss, and minimally invasive surgery decrease the risk of adhesion formation.

At CIGC, we perform minimally invasive resection of pelvic adhesions using the DualPortGYN technique. This approach uses only two 5 MM incisions and recovery time is 1 week. All procedures are performed in outpatient settings, and robotics are never used.

Read Dorran’s story, who was diagnosed with pelvic adhesions from endometriosis, after menopause.

BOOK A CONSULT

To schedule an appointment and get an evaluation with a CIGC specialist, call 888-SURGERY or contact us online. The DualPortGYN technique was developed by Dr. Paul MacKoul and Dr. Natalya Danilyants and has been successfully applied to thousands of GYN procedures.

The Center for Innovative GYN Care has offices in Bethesda, MD, Annapolis, MD and Reston, VA. Patients who reside outside the Washington DC area travel to CIGC for minimally invasive GYN surgery through our travel program.

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GYN conditions like fibroidsendometriosispelvic adhesionsuterine polyps or inflammation of the fallopian tubes (hydrosalpinx) can affect a woman’s ability to conceive and carry to term. Many suffer through difficulty getting pregnant or miscarriages only to realize that they have a gynecologic condition that could have been treated. A fertility evaluation by a GYN specialist early on can often make all the difference and pave the way to a healthy and successful pregnancy.


At CIGC we partner with reproductive endocrinologists to ensure patients have the best possible care from surgery to fertility treatments. Some women are actually able to conceive naturally after minimally invasive infertility surgery at CIGC.


INFERTILITY & FIBROIDS

Uterine fibroids can significantly affect pregnancy rates and are a very common cause of infertility. Letting fibroids grow can create severe GYN symptoms like abnormal bleedingpelvic pain, bloating and uterine distortion and can actually put women at a higher risk for a hysterectomy. Fibroid removal surgery increases the success rates of spontaneous pregnancy, intrauterine insemination, and in vitro fertilization.


INFERTILITY & ENDOMETRIOSIS

Endometriosis can affect fertility in multiple ways. The body responds to endometriosis by releasing excess inflammatory cells, which can cause pain, or create pelvic adhesions preventing conception. The inflammatory cells can potentially affect sperm function or impair the function of the fallopian tubes. The surgical management of endometriosis can be difficult and complex. Learn about endometriosis treatment to improve fertility.


INFERTILITY & HYDROSALPINX

The inflammation of the fallopian tubes is known as hydrosalpinx, a condition where fluid swells the tubes, making it difficult for women to get pregnant. There are multiple causes of inflammation like pelvic infections or fibroids obstructing the tubes or prior surgery causing scarring to the tubes. If the tubes are blocked most fertility doctors recommend IVF to bypass them. Learn more about the function of the fallopian tubes.


INFERTILITY & UTERINE SCARS/POLYPS

Many patients have had surgery to the uterus that results in the formation of scar tissue in the uterine cavity, which can prevent the implantation of the embryo. Removal of the scar tissue by a minimally invasive GYN specialist can allow for pregnancy to occur. Learn about removing scars or polyps from the uterus to improve pregnancy rates.

BOOK A CONSULT

At The Center for Innovative GYN Care, our advanced laparoscopic techniques are designed to provide safe and efficient minimally invasive treatment, with recovery in days rather than weeks. To get an evaluation with a CIGC specialist Dr. Paul MacKoul MD or Dr. Natalya Danilyants MD, call 888-SURGERY or contact us online. CIGC has offices in Bethesda, MD, Annapolis, MD and Reston, VA. Patients who reside outside the area travel to Washington DC for minimally invasive GYN surgery through our travel program.

CIGC Patients Get Pregnant After Infertility Surgery For Fibroids & Endometriosis

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If you are planning to conceive and struggle with GYN issues like abnormal bleeding or pelvic pain, you should see a GYN specialist. Conditions like fibroidsendometriosispelvic adhesionsuterine polyps, uterine septum and inflammation of the fallopian tubes can affect your ability to conceive and carry to term.  Many women suffer through difficulty conceiving and miscarriages or early delivery and discover they were dealing with a GYN condition that could have been treated.

babyshoes_fbkThere are minimally invasive GYN techniques that make it possible for women to recover sooner than with open, more invasive procedures. CIGC minimally invasive GYN surgeons Natalya Danilyants and Paul MacKoul have developed innovative approaches to treat many of the causes of infertility, with faster recovery and less pain.

Read about addressing GYN conditions and making sure the uterus is a healthy place for a baby to grow: Address GYN Conditions & Welcome a Baby in the New Year

CIGC specialists partner with reproductive endocrinologists and OB/GYNs to ensure that our patients get the best care. Women who’ve had trouble conceiving naturally, or with IUI or IVF treatments should consider getting a fertility evaluation. To schedule your appointment, call 888-SURGERY or contact us online. You can also get to know CIGC physicians through online patient reviews: Dr. Paul MacKoul Reviews | Dr. Natalya Danilyants Reviews