Women unaware of health risks of surgical adhesions

Apr 5 2007

Although more than half of the country's women will have some type of pelvic surgery and are therefore at risk for surgical adhesions, a survey released this month by the not-for- profit National Women's Health Resource Center (NWHRC) finds that women are largely unaware of the health risks associated with adhesions.

Surgical adhesions occur when tissue in the abdominal cavity adheres, or gets stuck to other tissue. Adhesions commonly form following pelvic surgeries, such as hysterectomy, tubal ligation, cesarean section, and cyst removal. Left untreated, adhesions can cause infertility, abdominal pain, and bowel obstruction.

The survey of 1,000 women showed respondents strongly believe women should be informed about surgical adhesions prior to surgery (69%). Conversely, an overwhelming majority of women (80%) who had pelvic surgery were not informed about adhesions prior to their surgery. Of the women in the survey who suffer from adhesions, seven out of ten (70%) say they would have taken special precautions to protect themselves from getting adhesions if they had been aware of possible adhesion-related complications.

Susan Jones*, a human resources director and mother of three from McLean, Virginia, has experience with the long-term effects adhesions can have on a person's health. All of Jones's children were delivered by cesarean section. Due to adhesions caused by these three surgeries, she suffers from reoccurring abdominal pain and has been advised not to have any more children because of the increased difficulty of delivering a baby surrounded by such a large amount of scar tissue.

"My first c-section only took about 10 minutes for the doctor to get the baby out," said Jones. "My second c-section took nearly 45 minutes and my final c-section took nearly an hour and a half. My doctor had such a hard time maneuvering around the scar tissue to get to my baby."

"If I had known about adhesions," continued Jones, "I would have talked to my doctor about what can be done to reduce my risk for getting them."

Like Ms. Jones, half (51%) of survey respondents were not aware that preventative measures can be taken to lower your risk of adhesions and an even higher proportion (68%) of women that had undergone surgery did not know if their surgeon took specific steps to guard against adhesions.

"Preventive measures to reduce the incidence of adhesions are the mainstay of limiting the complications related to adhesions," stated Dr. Glenn Schattman, Associate Professor of Obstetrics and Gynecology at the Weill Medical College of Cornell University. "These include using minimally invasive surgical procedures, meticulous surgical technique, keeping tissues moist, reducing bleeding and the use of adjuvant adhesions prevention barriers to keep the tissues from sticking to each other."

"It's important to understand that once adhesions form, they are hard to get rid of," continued Dr. Schattman. "Adhesions can cause blockages of the intestines, fallopian tubes causing infertility and pain."

When faced with pelvic surgery, women said they were most concerned about short-term surgical issues such as the general recovery process (60%), immediate surgical results (59%) and post surgical pain (59%).

"Along with their immediate post-surgery concerns, women need to make adhesions part of the pre-surgery dialogue with their health care provider," stated Elizabeth Battaglino Cahill, RN, executive vice president of the NWHRC. "We hope that this adhesion awareness campaign can give women the tools they need to understand the health risks of adhesions and how to protect themselves from this life-long internal scarring."