Endometriosis UK

Adhesions from Surgery

A few weeks back in the ER, the dr told my laproscopy can cause adhesions which can cause further complications.

But doesn't endometriosis itself cause adhesions?

Correct me if I'm wrong but from what I've learnt the scar tissue from the endo results in adhesions between organs and sometimes the actual endo connects stuff.

I haven't had surgery yet, I'm just trying to get my mom to agree so I can get it (17) and she's worried about adhesions.

2 Replies

Hi Hannah. Yes endo can cause adhesions but so can surgery. If you haven't had surgery yet then it would be from the endo. The more surgeries you have the more chance of adhesions forming. Also some people are more prone to them than others. So it's a case of waking up the risks. You need to do what is best for you . Good luck.

1 like

There is some controversy as to whether endo bleeds - some say it doesn't whilst there is evidence that the early red vesicular peritoneal phenotype does. This is thought to account for why early endo can be so painful. In any event endo causes inflammation and the body's response is to heal it and scar tissue forms as it heals. Due to the repeating cyclical inflammation of endo the damage does not get chance to fully heal and scar tissue builds. Effectively the scar tissue is the response to tissue damage. Surgery clearly causes tissue damage too.

'Adhesions' refers to scar tissue that extends between two or more structures across the peritoneal cavity and joins them together with fibrous bands. Typically they will form between two injured surfaces that are close together so after a lap that removes endo from many separate places there is scope for such adhesion formation.

The inflammation involved with endo and surgery causes a protein called fibrin to be produced and deposited on the damaged tissue. This is the protein involved in blood clotting and acts as a glue to seal the injury and develop the 'fibrinous' adhesion. In an isolated event once healing has occurred the adhesion can be dissolved away by enzymes. However, when healing is compromised, for example by repeated inflammation such as seen with endo, collagen and other structural substances are laid down to form permanent dense adhesions as we often see with established endo.

The critical element is the skill of the surgeon so that surgery is as minimally invasive as possible in order to minimise tissue damage. There are also adhesion barriers that can be used with variable results. So you need to ensure that your surgeon is highly skilled in excising endo and should question him/her as to what barriers are proposed.

1 like

You may also like...