What are spikes in gynecology, treatment of adhesions in women
Many women undergo various kinds of operations, but not everyone knows that the consequences of surgical intervention can greatly affect women's health. This applies to adhesions that are formed on the female organs and can become a serious obstacle to maternity. Spikes in the uterus appear due to infectious diseases, operations on pelvic organs, abortions and inflammatory diseases.
What are spikes (synechia)?
What is a spike in gynecology is nothing but strands consisting of connective tissue. Their appearance in the fallopian tubes and ovaries leads to infertility..
Adhesive process can be formed between any organs, but most often it occurs in the abdominal cavity..
With inflammation, a small swelling of the tissues may appear, and a film of protein - fibrin - begins to form on the surface of an organ. This film holds the organs together. The soldered organ is immobilized, and this leads to various consequences. Thus, the body struggles with the spread of inflammation. In the uterus cavity, the synechiae can splice the front wall from the posterior one, form "pockets" when growing, and also infect the cervix and fallopian tubes.
But not because of every inflammation can go the process of formation of adhesions. If a woman in time to seek medical help, the appearance of synechia can be prevented.
Particular attention deserves uterine synechia, or Asherman's syndrome. In this case, the synechiae is located in the lower part of the uterus and in the cervical canal, which can prevent the normal rejection of menstrual blood. This can cause severe pain. In severe cases, up to 75% or more of the uterine cavity is infected with the spreading of the adhesive process to the fallopian tubes. This condition threatens infertility.
There are several stages of development of adhesive processes in the uterus:
- Formation of fine synechia, which occupy no more than 1/4 of the uterine cavity. At the same time, spikes in the pipes are not yet formed.
- The process gradually spreads, the synechia occupy more than 50% of the uterine cavity. Fallopian tubes are also involved, partial obstruction is present.
- The synechia almost fills the internal uterine surface (75% or more). Obstruction of the fallopian tubes is observed.
The causes of the formation of spikes in the uterus:
- Inflammation of the pelvic organs.
- Various infections and diseases transmitted through sexual contact.
- Childbirth, which entailed serious complications (including delayed parts of the placenta).
- Prolonged retention of the fetal egg in the uterine cavity with a regressing pregnancy.
- Uncontrolled use of the IUD.
- Operative intervention affecting female reproductive organs, for example, removal of fibroids, ovarian cysts or appendix.
All these factors can lead to the formation of adhesions, and in the future - to infertility.
Those women who plan pregnancy, it is necessary to undergo ultrasound examination - on ultrasound specialist necessarily find out whether a woman has a soldering or other pathology.
Spike in fallopian tubes
After abortion or other operations in the fallopian tubes, inflammation can begin because of the infection that has got there. As a result of inflammation, spikes can form - films that cover the cavity of the uterine tube partially or completely. If a woman does not turn to a doctor in a timely manner, the process becomes irreversible. Because of the adhesions, the fallopian tubes can not work properly, the risk of an ectopic pregnancy increases. Very often all this leads to the removal of fallopian tubes.
In general, the formation of adhesions passes without any visible symptoms, and very often their presence becomes apparent only when it is impossible to become pregnant. That is, the woman herself can not determine whether she has any adhesions. The formation of adhesions in the fallopian tubes does not disrupt the menstrual cycle, does not lead to the appearance of secretions or something unusual, so the diagnosis can only be made by a specialist after an ultrasound examination or laparoscopy.
Diagnosis of uterine adhesions
Currently, there are only two methods of diagnosing adhesions in the uterus -sonosalpingoscopyandsalpingography. Whensalpingographya special solution is introduced into the fallopian tubes, and then they are X-rayed. In this case, clearly visible all the growths and other formations in the fallopian tubes. The procedure is usually performed only before ovulation. Whensonosalpingoscopythe solution is also introduced into the fallopian tubes, and then ultrasound is performed, which results in the subsequent treatment.
After the woman was diagnosed with the final diagnosis, the doctor needs to find out at what stage of development this disease is. Specialists distinguish three stages of development of adhesions:
- The sprains are located only on the walls of the fallopian tubes, and there is a sufficient distance between them to move the fertilized egg. At this stage it is still possible not to resort to surgical intervention.
- The second stage of the development of the disease is characterized by the fact that the neoplasms are between the ovary and the fallopian tube, and do not allow the ovum to move. In this case, laparoscopy is usually performed.
- The third stage of the development of the disease is complete obstruction of the fallopian tubes due to the extensive proliferation of neoplasms. At the same time, promotion of the egg is impossible. Operative intervention is considered to be an effective method.
All this proves the need for an ultrasound scan before planning a pregnancy or during a planned examination of the patient.
How to treat the synechia?
At present, a very large number of women face this problem. But they should not despair, as medicine can offer really effective methods for treating adhesions.
Laparoscopy is a type of surgical intervention that is used not only to treat this disease, but also for diagnosis. The patient receives a general anesthetic, then in the abdominal cavity microscopic holes are made through which a laparoscope is inserted. With its help, you can very accurately establish the state of female reproductive organs. At this time, through the cervical canal, a specialist introduces a special liquid that is brightly colored, and already along its progress can be seen and concluded - whether there is a spike and what kind they are - with full or partial obstruction. After diagnosis, doctors face a different task: they need to remove these formations from the uterine tube.
Laparoscopy makes it possible to completely clean the fallopian tube from growths, and at the same time minimizes the probability of their reappearance. Unfortunately, this method is not effective for complete obstruction of the tubes, since after the operation the ciliated epithelium inside the tube can not be restored.
Adhesive education in the ovaries
Occurrence of adhesions on the ovaries means that they are connected to the nearest organs. Ovaries usually coalesce with the uterus itself. Due to adhesions, there may be a violation of blood circulation in the ovaries and infertility.
The reasons why adhesive processes can begin:
- presence of sexual infections;
- cesarean section or other operations in the pelvic cavity;
- ectopic pregnancy.
Symptoms of adhesions in the ovaries:
- pain during sex or physical exertion;
- frequently repeated pains in the lower abdomen or in the sacrum;
- irregular menstrual cycle.
Diagnosis is carried out using the same laparoscopy and magnetic resonance imaging. But the main method is still considered to be laparoscopy, in which specialists use a laser, water trickles or electrodes. In this case, in addition to surgical intervention, you will need treatment with antibiotics, drugs that prevent the formation of blood clots and vitamins. In addition, the patient simply needs to move a lot, since movement does not allow spikes to form.
What are dangerous spikes?
The formation of adhesions not only makes the organs immovable, but can easily hit the neighboring organ, and it is impossible to predict where the disease will go. For example, episiotomy - forced incision of the vagina during childbirth, in the future can cause adhesion process, which will affect the intestines and cause the bladder and the uterus to fall. After the simplest operation - removal of appendicitis, in women and girls, adhesive processes in the ovaries and fallopian tubes can occur, which in the future will lead to infertility.
Adhesions during pregnancy
Such an unpleasant thing, like the appearance of adhesions during pregnancy, can cause pain in the abdomen of a woman. This disease usually manifests itself in a disorder of the intestine - strong constipation or diarrhea, frequent fever, vomiting and pain. In the chronic course of the disease, only often recurring pains in the abdomen can occur. It happens that the disease does not appear at all.
If the adhesions during pregnancy were found, the woman should refuse such procedures as tomography and laparoscopy, as they can cause various complications in the development of the child. All that is permitted during pregnancy is to make the diagnosis with ultrasound.
Sometimes the presence of synechia in a woman is detected only during pregnancy, and on the one hand it is even good - it means that the adhesive process has not yet affected the childbearing function. On the other hand, this is bad, since it is during pregnancy that the methods for treating adhesions are very limited. Synechia in late pregnancy can cause a dangerous pathology - the growth of the placenta to the wall of the uterus.
Spikes after amputation of the uterus
After such a serious operation as a hysterectomy, spikes in the abdominal cavity may appear. Adhesive processes disrupt the work of the intestines, cause unpleasant sensations and pain. In order to avoid the appearance of synechia, after the removal of the uterus, a woman needs to receive physiotherapy - these procedures well help to resolve scarring and make them more elastic and soft.
Do not forget about physical activity - after removal of the uterus, the woman needs mobility, so that no new adhesions form. If, within a few weeks after hysterectomy, there are signs of increased temperature, swelling of the scar from the operation, spotting, then the woman needs to appear urgently the doctor.
If the patient neglects treatment, the disease can provoke the appearance of an obstruction of the intestine, and this will entail another operation. Sometimes the adhesion does not make itself felt - short-term pain, a slight upset or bloating, which quickly passes. Absence of symptoms of the disease does not mean that it does not exist. Asymptomatic leak also affects the body of a woman badly. Moreover, patients mistakenly believe that they have recovered and do not seek help from their doctor.
Prophylaxis of an adhesion disease
Those methods of prevention that exist at the time are considered not very effective, so specialists are constantly looking for new solutions.
In order to prevent spikes from arising after various operations, a woman needs to restore the proper functioning of the intestine. For this, special stimulating drugs are needed. Without them, the intestines will return to normal in about 4 days, but during this time the adhesions can already form.
Before planning a pregnancy, the expectant mother needs to undergo a complete examination with her doctor in charge - a gynecologist, who will determine exactly whether the woman has a synechia, or not. If the patient showed soldering tubal tubes with partial patency, then it will help laparoscopy - a small operation to restore patency. If the fallopian tubes are completely closed, then the woman can still become a mother with the help of IVF - in vitro fertilization.