Pelvic Adhesions Diagnosis

It can be hard to diagnose pelvic adhesive disease, since symptoms can vary, and there’s no specific test for it. Your health care provider may review your medical history and recommend these procedures and tests:

• Pelvic examination to check the pelvic organs for signs of tenderness, masses or abnormalities.
• Imaging tests such as ultrasound, magnetic resonance imaging (MRI) or computed tomography (CT) scans to show the pelvic organs and look for adhesions, inflammation or structural changes.
• Laparoscopy, a minimally invasive surgical procedure that can diagnose and treat pelvic adhesive disease. During laparoscopy, a provider inserts a thin, flexible tube with a camera (laparoscope) into the abdomen through small incisions. They can spot and remove adhesions or other abnormalities.
• Hysterosalpingography (HSG), a special X-ray procedure used to evaluate the uterine cavity and fallopian tubes. With HSG, a provider injects a temporary dye into the uterus and fallopian tubes and takes X-rays. These images can help find blockages or abnormalities.

Treating pelvic adhesive disease

Treating pelvic adhesive disease can help address causes, reduce symptoms and improve quality of life. You may want to consider different treatment options based on how severe your symptoms are, your preferences and your fertility goals.

You may be able to manage your symptoms with:

• Over-the-counter (OTC) pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), prescription medications or nerve blocks.
• Pelvic floor physical therapy, where you can learn and practice exercises and techniques to improve pelvic muscle strength, flexibility and coordination, which can reduce pain and improve function.
• Maintaining a healthy diet, managing stress and avoiding activities that make symptoms worse.

These methods are generally well-tolerated and the risk of complications is low. But they don’t always work for everyone. If you still have symptoms, you may want to consider surgery.

Options include:

• Laparoscopic surgery, also known as adhesiolysis, which uses specialized surgical tools inserted through small incisions in the abdomen to remove or break down adhesions. With this procedure, your provider can see and target adhesions with little or no trauma to other areas.
• Laparotomy, which is open surgery through the abdomen. You may need laparotomy if you have a lot of adhesions or adhesions that are deeply embedded.

Surgical options can relieve pain, restore pelvic function and improve fertility. But the risks of surgery include infection, bleeding, organ injury and the chance that the adhesions may come back. Your health care provider can talk to you about the pros and cons of different treatment options so you can decide which treatments you prefer.

Living with pelvic adhesive disease

Pelvic adhesive disease can be challenging. These steps can help you cope and improve your quality of life.

• Adopt a healthy lifestyle that includes regular exercise, balanced nutrition, stress management and enough sleep.
• Talk to your provider about therapies such as acupuncture, chiropractic care and mind-body practices like yoga and meditation.
• Take time for self-care activities that help you relax and reduce stress, such as hobbies, leisure activities, mindfulness exercises and creative projects.
• Talk to your health care provider about your treatment options, preferences and goals. Have regular follow-up visits with your provider to review your symptoms, see how well treatment is working and address any questions, concerns or complications. 
• Share your needs and concerns with family members and friends. Lean on them for emotional support, practical assistance and encouragement. 
• Consider joining support groups or online communities for people living with pelvic adhesive disease. Connecting with others who understand can give you validation, empathy and coping strategies.
• If you notice anxiety, depression or emotional distress, seek support from a mental health therapist or counselor for the support you need.

Preventing pelvic adhesive disease

You can’t always prevent pelvic adhesive disease, but you can reduce the risk and make it less likely the condition will come back.   

• Have regular check-ups, especially if you have a history of pelvic inflammatory conditions, endometriosis or pelvic surgeries.
• Minimize the risk of pelvic inflammatory disease (PID) and other pelvic infections by practicing safe sex, using barrier methods such as condoms and seeking care right away for sexually transmitted infections (STIs) or other pelvic infections.
• If you have endometriosis, follow your treatment plan so you can manage your symptoms and help keep the condition from getting worse.
• Talk to your health care provider about strategies to reduce the risk of pelvic adhesions if you need pelvic surgery. 
• Keep your pelvic area healthy by practicing pelvic floor exercises (like Kegels), maintaining a healthy weight, avoiding smoking and practicing good hygiene. 

Getting Care 

Pelvic adhesive disease typically affects women in their reproductive years but can affect women of any age. The pelvic adhesions can be caused by inflammation, infection or pelvic surgery resulting in scar tissue. If you are experiencing symptoms, see a Banner health care provider for early diagnosis and comprehensive care.