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2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14
Removal of the uterus is called hysterectomy in medicine. Such operations to remove the main female genital organ are performed quite often, if there are certain indications for that. According to statistics, almost a third of women after 45 years have undergone such a surgical procedure. And many are worried about the question, what will be the consequences after it?
The most common consequence after such a surgical intervention is the formation of an adhesive process. What are adhesions, what are their symptoms and why are they dangerous, let's look at it together.
Adhesions in the uterus, what is it?
Adhesions are seals of connective tissue that form between the peritoneum and internal organs or between organs. In most women, after a hysterectomy, this type of seal is formed. They appear especially often after a cesarean section.
During the operation, the abdominal cavity is dissected and when the peritoneal wound is closed, the process of fusion of fibrinous deposits is disrupted, which affects the formation of seals.
The reasons for the development of adhesive disease
The adhesion process after surgery can occur for many reasons.
These include:
- the duration of the operation itself;
- the type of injury (the more traumatic the operation, the greater the risk of seals);
- great blood loss;
- bleeding of internal organs;
- infection and inflammation of the genitals;
- genetic factor;
- hypoxia or tissue ischemia;
- drying of tissues during the operation;
- separation of adhesions that were before;
- the presence of foreign bodies in the fallopian tubes, ovaries.
The appearance of neoplasms can also be due to the fact that talcum powder from the doctor's gloves or thin fibers from gauze or cotton swab get into the uterine or peritoneal cavity.
Endometriosis can also cause them. With its development, a small amount of menstrual blood enters the peritoneal cavity through the fallopian tubes. If the immunity is good, then the cells of the uterine mucosa are removed on their own, if not, then there is a high risk of the appearance of compacted formations.
Symptoms of adhesion formation after surgery to remove the uterus
The manifestation of adhesive disease after surgery can manifest itself in the form of pain, which can be constant or periodic with increasing force.
In addition, the following symptoms may appear:
- disorder of urination and defecation;
- flatulence;
- temperature increase;
- attacks of nausea and vomiting;
- lowering pressure;
- general weakness and malaise.
Adhesive disease can develop not only after the removal of the main organ, connective tissue adhesions can be found in the organ itself too.
Most often they are located between the inner part of the surface of the walls of the uterus. With a high degree of damage to the uterine cavity, menstruation may be absent for a long time.
Because of this, the function of ovulation and the menstrual cycle is disrupted, changes occur in the structure of the uterine walls and the further development of pathologies that lead to infertility. Therefore, the presence of adhesions in the uterus is closely related to pregnancy.
Reasons for the formation of adhesions in the uterus
The reasons why an adhesive process can form inside the uterus are varied:
- inflammation and infection in the genitals;
- trauma to the genitals during miscarriage, abortion, childbirth, installation of the spiral;
- genital surgery;
- frozen pregnancy;
- hormonal disorders;
- the development of genital tuberculosis;
- radiation therapy.
The main symptoms of the presence of adhesions in the uterus
The main sign of the presence of adhesive disease is pain in the lower abdomen. They can worsen at different times in the menstrual cycle. If the formations are located in the lower part of the uterus, the pain will be more severe. Bloody discharge during menstruation will be scanty and long. There is an overgrowth of the lumen of the uterus, and this causes an interruption of the cycle, the development of inflammation.
Such changes have an impact on future pregnancy. She may be interrupted, or the woman will not be able to conceive a child at all. Therefore, it is necessary to regularly undergo examinations by a gynecologist to exclude the development of synechia.
Formation of adhesions on the uterus after cesarean
In a caesarean section, an incision is made in the main female genital organ to remove the baby. In places where the incision was made, seams remain.
So the body restores the integrity of damaged tissues or organs. When scarring, fibrin is released, which sticks together soft tissues.
It so happens that fibrin, when gluing, captures the loops of the intestine or the organs of the small pelvis.
As a result, synechiae appear, the pain from which a woman often perceives as a normal reaction in the postpartum recovery period.
However, after the operation, if pain in the lower abdomen appears that lasts too long, you should still be alert and consult a doctor.
So, the signs of the presence of synechia after cesarean include:
- pain in the pelvis;
- disruption of the intestines;
- constipation, diarrhea, severe bloating;
- intestinal obstruction.
Synechiae after cesarean is dangerous because the second pregnancy after a certain time may not occur at all. The genitals stick together, as a result, the ovum cannot fix properly. Often the next pregnancy is ectopic.
Diagnostics, treatment
The examination begins with a gynecological examination using an ultrasound scan. In addition, magnetic resonance imaging is done, thanks to which you can see the condition of the genitals.
Another examination method is laparoscopy. With its help, you can assess the severity of the disease and treat adhesions at an early stage. With the help of micromanipulators, dissection and removal of synechiae are performed. Synechiae can also be removed by laser therapy, aquadissection, electrosurgery.
Why are adhesive formations dangerous?
In an advanced stage, the disease can lead to the fact that the fallopian tubes stick together, and the fertilized egg will not be able to move further along them to gain a foothold. In this case, fertilization does not work. To get pregnant, a woman is forced to undergo an IVF procedure and then completely remove the fallopian tube.
Prevention methods
After laparoscopy, so that new formations do not appear, the following methods are used:
- Wrapping the ovaries and tubes with a polymer self-absorbable film;
- The introduction of a special barrier fluid - dextran, povidine;
- Physiotherapy.
Also, after the operation, the doctor prescribes antibiotics that remove inflammation in the peritoneum. Anticoagulants are prescribed that thin the blood and prevent the appearance of synechia. Physiotherapeutic procedures are prescribed: electrophoresis, ultrasound.
They normalize the functions of the genitals, restore the endometrium and prevent the development of relapse after the operation.
Thus, adhesive formations that appear after surgery are dangerous. Therefore, it is important to identify them on time according to the main signs, undergo a full examination and treatment in order to avoid serious complications that can lead to infertility.