What can be done to reduce the likelihood that new adhesions will form?
Adhesions are fibrous bands connecting structures that normally are separate. Adhesions develop as a response of normal tissue to some type of injury or trauma (as in surgery). In most cases, patients who undergo surgery for endometriosis will form new adhesions at the site of the surgery. Adhesion formation may cause infertility by impairing the function of the ovaries and fallopian tubes. Adhesions also may cause pelvic pain and small bowel obstruction.
There are some newer preventive treatments that can be used during surgery to help prevent adhesions from forming. These include rinsing the pelvic cavity with special solutions and placing a piece of protective material (such as ADEPT®) into the pelvic area to serve as a barrier. The barrier keeps the surfaces from rubbing together after surgery, which can lead to adhesion formation. The barrier dissolves and is absorbed when it is no longer needed.
In some cases, a woman will have to undergo additional surgery to remove adhesions formed from previous surgery. Fortunately, the advancement of laparoscopic surgery and the development of these new preventive treatments can reduce the chances of adhesion formation.
What is the outlook for treatment of endometriosis?
While many women find success with the current treatments for endometriosis, medication and surgery do have side effects and don't work for everyone. Researchers are continuing to investigate new and improved treatment strategies. One area of study is focusing on the role of the immune system in the development of endometriosis, and enhanced hormonal agents are being studied as a possible treatment option.