Pelvic Adhesive Disease (PAD)

Definition - What does Pelvic Adhesive Disease (PAD) mean?

Pelvic adhesive disease is a condition that occurs when adhesions or scars bind pelvic organs together. Scars are bands of tissue that form as the injured body area heals itself. These scars not only form on the skin externally, they also develop internally. Any previous abdominal or pelvic surgery or infection can trigger the formation of bands of scar tissue in the pelvis. These bands of scar tissue that cause the organ surfaces to adhere to one another are termed as pelvic adhesions. Pelvic adhesions are often a cause of infertility.

FertilitySmarts explains Pelvic Adhesive Disease (PAD)

Various factors can trigger the formation of pelvic adhesions. These include:

  • Pelvic inflammatory disease (PID): The inflammatory process in the long-run can damage the thin double layer of tissue covering the abdominal and pelvic organs, called peritoneum. These organs then stick to one another because of a defective and inflamed peritoneum.
  • Sexually transmitted disease from chlamydia or gonorrhea
  • Abdominal surgery
  • Pelvic surgery
  • Endometriosis: When cells of the uterine lining relocate to an abnormal position outside the uterus, an inflammatory process is incited that gives rise to scars and adhesions (similar mechanism as PID)
  • Appendicitis
  • Ruptured ovarian cysts

Some women with the pelvic adhesive disease may feel chronic pelvic pain, pain during intercourse, pelvic pressure, bad menstrual cramps, and pain or discomfort during bowel movements.

Sometimes, affected women may have no symptoms at all, other than infertility. Pelvic adhesions can compromise the fertility potential of a woman. These adhesions can form around the uterus, ovaries, and fallopian tubes. In the first place, obstruction of the fallopian tubes can disrupt the transit of egg to the fallopian tube. Alternatively, if the sperm is able to fertilize the egg, blockage of the fallopian tubes may still interrupt the passage of the fertilized egg towards the uterus for implantation. Moreover, adhesions around the ovary may interfere with ovulation.

In women suspected of having the pelvic adhesive disease, the doctor will perform a procedure like a laparoscopy or a hysteroscopy to directly visualize the pelvic organs. Additionally, an X-ray procedure referred to as hysterosalpingogram may show blocked fallopian tubes or adhesions within the uterus, suggesting pelvic adhesive disease.

Laparoscopic surgery also allows for dividing or breaking down the adhesions, with a procedure called adhesiolysis. In vitro fertilization (IVF) may be the ideal choice for women impactred by pelvic adhesive desiase to get pregnant.

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