Peritoneum

Definition - What does Peritoneum mean?

The peritoneum is the thin membrane that lines the abdominal cavity. It also wraps around the organs in the abdomen, including the ovaries, fallopian tubes, and uterus. Because of its proximity to these reproductive organs, problems with the peritoneum can physically interfere with a woman’s fertility.

FertilitySmarts explains Peritoneum

The peritoneum provides support for the organs in the abdominal cavity and helps to hold blood vessels in place. It is made of a very thin layer of cells, some of which produce a slippery fluid that allows all the contents of the abdomen to move smoothly and function properly, even though they’re all packed into a very small space. However, this tissue can easily become damaged by infection, injury, or surgery. After trauma, the peritoneum tries to heal itself. As the peritoneum tries to grow new cells, these new cells tend to stick to other nearby peritoneal tissues, causing adhesions. These adhesions prevent the organs from moving as freely as they should and can also prevent them from functioning properly.

One of the most frequent causes of peritoneal adhesions is endometriosis, a common disease that affects 10-15% of women and 24-35% of women experiencing infertility. In women with endometriosis, small sections of the cells that normally make up the lining of the uterus grow in other places, such as the ovaries, fallopian tubes, bowel, bladder, and other organs covered in the peritoneum. During the menstrual cycle, when the uterus sheds its lining in the form of blood, the endometrial sections outside the uterus also react. However, there is nowhere for the broken-down tissue to go, so it causes inflammation in those areas, followed by healing and potential peritoneal adhesions. This can be very painful and can lock organs into incorrect positions. If ovaries and fallopian tubes are locked into the wrong positions, this can prevent ovulation, prevent eggs from reaching the fallopian tubes once released, and prevent any eggs from traveling down the fallopian tubes properly. The only effective treatment for endometriosis is surgery to remove adhesions and endometrial patches, but the surgery itself can cause even more adhesions. In addition, the patches caused by endometriosis can regrow in time.

Sometimes, cancer can start developing in the peritoneum and move into the ovaries or fallopian tubes, resulting in ovarian epithelial cancer or fallopian tube cancer. These cancers, if untreated, can ultimately require the removal of the organs, eliminating any chance of a woman having her own children.

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