Treatment for C-Section Adhesions

Over the past several years giving birth by cesarean section has become increasingly more popular. In China, which has the highest rate of c-sections in the world, 46% of babies are born by cesarean section and it is estimated that one-quarter of those operations were not necessary. Closer to home, cesarean section surgery is the most common operation in the US where over 30% of all babies are born this way. The convenience it offers, in terms of being able to "plan your life" as well as the thought of avoiding labor has become a criterion for some women to have an elective c-section.

However, even though the use of an epidural to provide pain relief and the elimination of possible hours of labor all seem quite wonderful, in contrast to a vaginal birth a c-section will leave a scar across the abdomen of a woman that often results in the development of adhesion.

How Adhesion Forms from C-Section

Adhesion is a medical term used to describe scar tissue development. During a cesarean section procedure, the surgeon will open the abdomen with an incision and then open the uterus with another incision. After the abdominal wall has been opened and the birth has taken place, the surgeon will close the different layers of the incision with sutures. The trauma that is caused to the abdominal area produces scar tissue internally (adhesion) that can potentially lead to complication and pain in the abdomen.

As time goes on, the scar tissue builds upon itself and the organs within the abdominal cavity become entangled in the web of adhesion. They may become compressed or attached to other organs and pulled from their positions creating pain and cramping. Since the cramping can mimic menstrual cramping, adhesion is often misdiagnosed. Some women, after a c-section, experience extreme abdominal pain and others encounter infertility as scar tissue envelops the uterus and ovaries.

Medical Treatment of C-Section Adhesions

Since adhesions don't show up on ultrasound or x-ray, they can be difficult to diagnose. If, by the process of elimination, other potential causes of abdominal pain are eliminated, then the doctor will likely diagnose the problem as adhesions. If this is the case, then the doctor will typically prescribe drugs with the hope of decreasing any inflammation caused by the adhesions thus reducing pain. The drugs can be helpful, but they don't eliminate the pain. If the problem persists, many doctors recommend the surgical method of dealing with adhesions, called adhesiolysis. This is a laparoscopic method of freeing the nerves from the scar tissue and injecting medication close to the nerve root so that it will reduce the inflammation. Although the adhesions the doctor is able to see may be removed, the very fact that this is another surgery allows for more adhesions to form. In many cases, adhesions return.