Unexpected Pathology: Severe Pelvic Adhesions

Stephen E. Zimberg, M.L. Sprague
In: Gynecologic and Obstetric Surgery · 2016 · pp. 94–96 · doi:10.1002/9781118298565.ch32 · W2495749757
other OA: closed CC0
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Abstract

The discovery of severe pelvic adhesions at the time of pelvic surgery is a challenge requiring patience and sound surgical technique. This chapter discusses the adhesion formation, risks of adhesions, and adhesiolysis, citing the case of a 40-year-old female presents with complaints of pelvic pressure, menorrhagia, severe dysmenorrhea, dyspareunia, abdominal bloating, and anemia. Adhesion formation is usually the result of previous surgery but can occur from endometriosis or pelvic and abdominal inflammatory processes, such as pelvic inflammatory disease or bowel disease. Meticulous surgical technique includes minimizing tissue trauma, achieving optimal hemostasis, minimizing the risk of infection, and avoiding contaminants such as glove powder, urine, or fecal material. An instrument that can be helpful in extensive adhesiolysis is the lighted ureteral stent. Prevention of abdominal and pelvic adhesions is preferable to having to deal with the immediate and long-term complications as well as reoperations.

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Condition tags

endometriosisdysmenorrheadyspareunia

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last seen: 2026-06-04T00:00:01.174412+00:00
License: CC0 · commercial use OK