Pelvic Scar Tissue (Adhesions) 

Pelvic scar tissue refers to thick bands of tissue within the female reproductive system that result from trauma.  

Adhesions are bands of scar tissue that join two internal surfaces of the body together that are not usually connected. With pelvic scar tissue, the affected surfaces are within the female reproductive organs. Pelvic scar tissue can develop as the body is attempting to repair itself, which is why adhesions can form after surgery, a pelvic infection or as a response to another condition like severe endometriosis.  

Causes of Pelvic Scar Tissue 

Like other forms of scar tissue, pelvic scar tissue or adhesions can occur as the body responds to physical trauma to the affected area. Previous pelvic surgery is the most common cause of adhesions, though pelvic infections such as pelvic inflammatory disease (PID) and advanced stages of endometriosis may also lead to scar tissue.  

Signs & Symptoms of Pelvic Scar Tissue 

Because scar tissue often forms after surgery or other severe trauma, the accompanying signs often go unnoticed, and many individuals mistakenly attribute these symptoms to the underlying cause.  

When scar tissue is particularly dense, however, possible symptoms may include: 

• Pain in the lower abdomen or bowels due to restricted muscle movement 
• Pain during sexual intercourse 
• Intestinal obstruction in severe cases 

Typically, pelvic scar tissue will show its presence by further aggravating the symptoms of another disease, such as IBS or endometriosis. 

Diagnosing Pelvic Scar Tissue 

Diagnosing pelvic scar tissue can be difficult, especially as physicians cannot typically feel the adhesions during a pelvic exam. Tests like ultrasounds, CT scans and MRI scans also do not detect pelvic scar tissue in most cases, so a thorough look into the patient’s history and a pelvic examination may help in determining whether adhesions are present. If scar tissue is suspected, then a diagnostic laparoscopy (a procedure that allows a doctor to view the tissue and remove it if necessary) may be utilized.  

Treating Pelvic Scar Tissue 

When pelvic scar tissue is diagnosed and the symptoms are causing the patient pain or discomfort, then a surgery known as adhesiolysis can be performed to remove the adhesions. During a laparoscopy, which can also be used in the diagnosis of pelvic adhesions, a doctor will make a small incision to better view the scar tissue and remove it through the same opening. This procedure typically yields better results than more invasive methods, which can often lead to further scar tissue developing.  

The gynecologic healthcare professionals at Tampa General Hospital’s Women’s Institute recognize the signs of pelvic scar tissue and can diagnose and manage these adhesions successfully using personalized methods of treatment.