Adhesions After C Section: Symptoms, Treatment & Prevention

Adhesions After a C-Section – Symptoms and Prevention Tips

When it comes to delivering a baby, some women opt for a C-section while others may have to undergo this surgery because of some health complications they might be facing while pregnant. Sometimes even an emergency at the time of labour may warrant a C-section. Whatever may be the reason for a woman to undergo a C-section, complications such as adhesions may arise after a few months or even after a few years of the delivery. So adhesions after a C-section? Browse through this post and learn more about adhesions and about the symptoms of this condition. Also, find out how you can prevent it.

What Are Adhesions?

Abdominal adhesions are a common complication of surgery. When your body undergoes the surgery, tough tissue bands may form between your abdominal tissues and organs, which are known as adhesions. It is difficult to prevent or stop them from forming. They may appear like spider webs or nylon strands that surround the organs of your body. These strands are powerful and may cause an obstruction in the blood flow or cause disruption in the functions of various internal organs.

How Do Adhesions Form After a C-Section?

Abdominal adhesions are very common, especially after abdominal surgeries such as a C-section. There is a very less likelihood of its occurrence during a laparoscopic surgery because the incision is comparatively small. However, during a c-section, a bigger incision is made. Therefore, there are more chances of trauma or injury to the peritoneum.

The peritoneum is a clear membrane that covers the abdominal organs. But when this protective and slippery lining gets damaged during a c-section, the body’s immune system gets rolling and starts healing itself. This leads to the formation of sticky scar tissue, which is also known as fibrin matrix and inflammation.

In most cases, these scar tissues or bands dissolve with the help of a biochemical process, which is also known as fibrinolysis. But during a surgical procedure, fibrinolysis may not happen that effectively because of low levels of blood chemicals that are required for the process. This means the tissues or bands do not dissolve but instead they develop into adhesions. This may occur a few weeks, few months or even years after you may have undergone a C-section. Most abdominal surgeries can cause the risk of abdominal adhesions. However, C-sections pose a much higher risk.

What Are the Symptoms of C-section Adhesions?

Here are some symptoms of adhesion pain after C-section adhesion:

  • Trouble in standing erect or straight.
  • Unexplained pain in the abdomen years after undergoing a C-section.
  • Bloated or swollen tummy
  • Pain during sexual intercourse
  • Pain or tenderness in your scar
  • Intense menstrual pain
  • Severe pelvic pain
  • Secondary infertility
  • Back pain
  • Vomiting

A woman with abdominal pain

What Are the Visual Characteristics of Adhesions After a C-section?

You can establish whether or not you have adhesions following a c-section by observing some simple signs. If you have an indented c-section scar, which is thick and raised, then you may have adhesions. Also, if your scar is darker than the rest of your skin colour, chances are you may have dense adhesions, which may be irrespective of the fact that the scar protrudes out, lays flat, or is indented.

What Are the Risk Factors for Developing Adhesions After Cesarean Delivery?

Understanding the risk factors associated with the development of adhesions after a cesarean delivery is crucial for expectant mothers and healthcare providers alike. Here, we will explore key factors that increase the likelihood of adhesion formation in post-C-section cases.

  • You are an older mother
  • You’ve had multiple previous cesareans or abdominal incisions
  • You are overweight
  • You’ve suffered a postpartum infection

What Are the Possible Complications?

Here are some complications of adhesions that can arise after a C-section:

  • Adhesions can cause dyspareunia or pain during sexual intercourse.
  • Adhesions may result in infertility too.
  • Some women may experience pelvic pain because of adhesions.
  • Adhesions may cause complications and difficulties in further abdominal surgeries.

How to Treat C-section Adhesions?

C-section adhesions, or the formation of scar tissue following a cesarean section surgery, can cause discomfort and complications for some individuals. Fortunately, there are several treatment options available to alleviate the symptoms associated with these adhesions. In this guide, we’ll explore these treatments, their advantages, and their potential disadvantages.

1. Massage

Massage therapy is a non-invasive and cost-effective approach for addressing C-section adhesions. It involves manual manipulation of the abdominal area to break down scar tissue and alleviate discomfort.

Advantages

  • Massage therapy is non-surgical and carries minimal risk.
  • It can provide relief from pain and discomfort associated with adhesions.
  • Massages may enhance abdominal flexibility and movement.
  • Compared to surgical options, massages are generally more affordable.

Disadvantages

  • The effectiveness of massage therapy can vary from person to person, and not all adhesions may respond well.
  • The relief provided by massage is often temporary, and adhesions can return over time.
  • Some individuals may not be suitable candidates due to the severity or location of adhesions.

2. Laparoscopy

Laparoscopy, or minimally invasive surgery, involves small incisions and the use of a camera and specialized instruments to visualize and treat adhesions within the abdominal cavity.

Advantages

  • Laparoscopy involves smaller incisions, reducing the risk of complications and scarring.
  • Patients typically experience shorter recovery times compared to laparotomy.
  • Surgeons can precisely target and remove adhesions, minimizing damage to healthy tissue.
  • Patients often experience less postoperative pain compared to open surgery.

Disadvantages

  • Laparoscopy requires specialized surgical skills and equipment.
  • Complex or extensive adhesions may be challenging to address with laparoscopy.
  • The use of carbon dioxide gas to inflate the abdomen during laparoscopy can cause discomfort.
  • Like laparotomy, laparoscopy can also lead to the formation of new adhesions over time.

3. Laparotomy

Laparotomy is a surgical procedure involving a large incision to access and remove adhesions in the abdominal area, offering a direct and comprehensive approach to adhesion treatment.

Advantages

  • Laparotomy allows for the direct removal of adhesions, providing potential long-term relief.
  • Surgeons can target specific adhesions and address them effectively.
  • The procedure enables a thorough assessment of the abdominal cavity for any additional issues.
  • Patients may experience immediate relief from symptoms.

Disadvantages

  • Laparotomy is a major surgery, involving a large incision, which carries surgical risks.
  • Recovery time is longer compared to less invasive options like laparoscopy or massage.
  • The procedure leaves a substantial scar, which may be cosmetically concerning.
  • Surgery itself can lead to the formation of new adhesions.

How to Prevent the Formation of C-section Adhesions?

It is important to learn that all surgeons are aware of the fact that adhesions may result in complications. Therefore, a number of measures adopted by the surgeons aim at minimising the risk of C-section scar adhesions:

  • The use of certain medications may reduce the chances of adhesions.
  • By closing the peritoneum post, a caesarean section will be less likely to cause adhesions.
  • By creating a barrier between the damaged tissues to prevent them from sticking may minimise the occurrence of adhesions.
  • One of the most effective and best ways to reduce or prevent the risk of bowel adhesions after a C-section or other kinds of complications is by opting for a vaginal delivery if possible.

FAQs

1. How Common Are Adhesions After Cesarean Delivery?

Abdominal adhesions after c-section are relatively common. Studies indicate that up to 90% of individuals who undergo cesarean sections may develop adhesions to some extent. Adhesions are essentially areas of scar tissue that form as part of the natural healing process after surgery. While they are common, not all individuals who have cesarean deliveries will experience symptoms or complications related to adhesions. 

2. Are Caesarean Adhesions Dangerous?

Adhesions post c-sections themselves are not inherently dangerous, but they can potentially lead to complications in some cases. While many individuals with adhesions experience no significant issues, some may develop symptoms or complications, such as chronic abdominal pain, bowel obstructions, or fertility problems. In rare instances, adhesions can contribute to severe complications that require medical intervention. 

Reducing the risk of adhesions is one of the best ways of saving yourself from this condition rather than having them surgically removed in the later stages of your life. For more information on this topic, it is suggested that you speak with your doctor and learn about the possible risks and options you can have.

References/Resources:

1. Drollette. C. M., Badawy. S. Z.; Pathophysiology of pelvic adhesions. Modern trends in preventing infertility; National Library of Medicine: National Center for Biotechnology Information; https://pubmed.ncbi.nlm.nih.gov/1371547/; February 1992

2. Morales. K, Gordon. M, et al.; Postcesarean delivery adhesions associated with delayed delivery of infant; National Library of Medicine: National Center for Biotechnology Information; https://pubmed.ncbi.nlm.nih.gov/17466702/; May 2007

3. Parisio-Poldiak. N, Morel. E, Hua. C, Gibbs. S, Billue. D; Cesarean Section Complications Followed by Bladder Cystotomy and Gross Hematuria Due to Unknown Dense Scar Tissue; PubMed Central; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781874/; December 2020

4. González-Quintero. V, González-Quintero. F; Preventing Adhesions in Obstetric and Gynecologic Surgical Procedures; PubMed Central; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672996/

5. Rice. A, King. R, Reed. E, Patterson. K, Wurn. B, Wurn. L; Manual Physical Therapy for Non-Surgical Treatment of Adhesion-Related Small Bowel Obstructions: Two Case Reports; PubMed Central; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4470113/; February 2013

6. Lyell. D; Adhesions and perioperative complications of repeat cesarean delivery; National Library of Medicine: National Center for Biotechnology Information; https://pubmed.ncbi.nlm.nih.gov/22114993/; October 2011

7. Salim. R, Kadan. Y, Nachum. Z, Edelstein. S, Shalev. E; Abdominal scar characteristics as a predictor of intra-abdominal adhesions at repeat cesarean delivery; National Library of Medicine: National Center for Biotechnology Information; https://pubmed.ncbi.nlm.nih.gov/18178195/; January 2008

8. Elprince. M, Taha. O, Ibrahim. Z, et al.; Prediction of intraperitoneal adhesions using striae gravidarum and scar characteristics in women undergoing repeated cesarean sections; PubMed Central; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033650/; April 2021

Also Read:

Back Pain After C-Section
Recovery After a C-Section
How to Recover after C-section Delivery
Reasons of Leg Pain After C-section Delivery

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