Adhesions and Infertility
Adhesions and scarring form after injury, surgery, inflammation or trauma. Pelvic adhesions can join structures with strong glue-like bonds that can last a lifetime. Adhesions (or scarring) are a leading cause of female infertility and the primary cause of blocked fallopian tubes. They form as a natural part of healing as the body responds to tissue insult.
Adhesions can form anywhere in the body. When they form within the delicate structures of the female reproductive tract, they tend to glue down structures that are designed to move freely, in order to function correctly.
Adhesion formation is the first step in the body’s healing process. Adhesions surround areas as they heal, with strong glue-like fibres that create tiny but powerful bonds. These bonds may be shaped like curtains, ropes, woven patterns, or a combination of these (see our general adhesions page for more detail.)
Adhesions or scarring anywhere in the pelvis can cause pain or infertility.
Causes of Adhesion Related Infertility
There are four main causes of the adhesions that cause infertility:
- Infection (e.g. vaginal, bladder, yeast)
- Inflammation (e.g., endometriosis, chlamydia, PID)
- Surgery (any surgery to the pelvis, abdomen, hip or back)
- Trauma (fall onto tailbone, back or hip, abuse)
It is an unfortunate fact that once adhesions form, they generally remain in the body for a lifetime. Adhesions may occur in pain-sensitive structures, or they may glue down reproductive structures without causing discomfort. Thus, any woman who has experienced any of the four causes listed above may have adhesions that cause infertility, whether or not she experiences pain.
Diagnosing the Adhesions that Cause Infertility
In cases like blocked fallopian tubes, adhesion-related infertility is relatively easy to diagnose by a minimally invasive dye test called a hysterosalpingogram (HSG). In other cases, diagnosis of adhesions may be suspected by a thorough review of the patient’s history, with a focus on the four events noted above. In these cases, the physician, patient or physical therapist may suspect adhesions, even thought they cannot directly visualize them.
The only definitive diagnosis of pelvic adhesions is made by surgery, performed under general anesthesia. During the procedure, the physician will try to cut or burn any adhesions that are accessible. Most physicians tend to avoid cutting in any area where they might do further damage, such as near the bladder, intestines or fallopian tubes.
While surgery may help, many physicians and patients are confounded by the fact that surgery is also a leading cause of adhesion formation. Thus the surgery to remove adhesions may cause more adhesions and scarring, as the body repairs itself in the weeks after the surgical procedure.
Treating Pelvic Adhesions with Surgery
Lysis of pelvic adhesions involves surgery and anesthesia.
Until recently, lysis of adhesions was the only choice medical science offered to treat pelvic adhesions. This involves cutting or burning the pelvic adhesions under general anesthesia, via laparoscopy or laparotomy (open surgery).
While lysis of pelvic adhesions can be effective, surgery has two major drawbacks:
- it carries risks from anesthesia and infection, and
- despite the best skills of the finest surgeon, the body creates more pelvic adhesions as it heals from the surgery designed to remove them.
A study in Digestive Surgery showed that more than 90% of patients develop adhesions following open abdominal surgery and 55% to 100% of women develop adhesions following pelvic surgery.1 Another study reported that 35% of all open abdominal or pelvic surgery patients were readmitted to the hospital more than twice to treat post-surgical adhesions during the 10 years after their original surgery.2 Thus, surgery itself has been implicated as a major cause of adhesion formation and many patients become trapped in a cycle of surgery-adhesions-surgery – with no end in sight.
Treating Pelvic Adhesions with Clear Passage Therapies®
Belinda Wurn, PT treats a patient with her manual physical therapy which has been shown to reduce adhesions, decrease pain, and improve reproductive function, in peer-reviewed medical journals. We know pelvic adhesions well. We faced this situation 20 years ago when the physical therapist director of Clear Passage Therapies®, Belinda Wurn, developed severe adhesions after pelvic surgery and radiation therapy to her abdomen. Unable to work due to the pain, and having seen the devastating and debilitating effects of pelvic adhesions in her own patients, she was determined to find a non-surgical way to address pelvic adhesions.
With her husband, massage therapist Larry Wurn, Belinda took a much deeper look at the etiology and biomechanics of adhesion formation. They found that the chemical bonds that attached each of the tiny collagen fibers to its neighbor appeared to dissipate or dissolve when placed under sustained pressure over time. Withthis knowledge, they developed the Wurn Technique® to unravel the bonds between the crosslinks that comprise adhesions.
The “hands-on” work practiced at Clear Passage Therapies® clinics is designed to reduce or eliminate adhesions, crosslink by crosslink. It has been shown in peer-reviewed medical journals to reduce adhesions, decrease pain, and improve soft tissue mobility, without the risks of surgery or drugs.
Visit our “what treatment is like” web page for more information, or click the link at the bottom of this page now, to complete a medical history questionnaire and apply for a free, in-depth consultation.
- Liakakos T, Thomakos N, Fine PM, Dervenis C, Young RL. Peritoneal Adhesions: Etiology, Pathophysiology, and Clinical Significance. Dig Surg. 2001; 18: 260-273. PMID 11528133.
- Ellis H, Moran BJ, Thompson JN, Parker MC, Wilson MS, Menzies D, McGuire A, Lower AM, Hawthorn RJ, O’Brien F, Buchan S, Crowe AM. Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet Br J Med. 1999; 353: 1476-80. PMID 10232313.
