Commonality
Pelvic adhesions are a common condition, particularly after pelvic surgery, infection or inflammatory conditions such as endometriosis. However, they are often overlooked because they may not appear clearly on routine scans.
Causes
Pelvic adhesions usually develop as part of the body’s healing response after inflammation, infection or surgery.
Common causes include:
Previous pelvic or abdominal surgery
Caesarean section
Fibroid surgery
Laparoscopic surgery
Severe pelvic infections
Miscarriage management procedures such as dilation and curettage (D&C)
Symptoms
Symptoms vary depending on the location and severity of the adhesions.
Common symptoms include:
Chronic pelvic pain
Pain during intercourse
Pain with bowel movements or urination
Difficulty conceiving
Changes in menstrual flow or cycle pattern
Unexplained pelvic discomfort following surgery
Some women may have no symptoms, and adhesions are sometimes discovered during fertility investigations or surgery.
Effects on Fertility
Pelvic adhesions can affect fertility in several ways. Scar tissue may:
Block or narrow the fallopian tubes
Distort the shape of the uterus
Interfere with embryo implantation
Cause pelvic inflammation that affects reproductive function
For some women with unexplained infertility, pelvic adhesions may be an underlying cause. Early diagnosis and treatment may help improve fertility outcomes.
Diagnosis
Pelvic adhesions can be difficult to diagnose because they are not always visible on routine imaging tests.
Diagnosis may involve:
A detailed review of symptoms and medical history
Pelvic ultrasound
Saline infusion ultrasound (sonohysterography)
MRI scanning in more complex cases
Diagnostic laparoscopy
Diagnostic laparoscopy is considered the most reliable way to identify pelvic adhesions, especially when pelvic pain or infertility remains unexplained.
Treatments
Treatment depends on symptom severity and reproductive goals.
Conservative management may include:
Monitoring mild symptoms
Pain management strategies
Pelvic physiotherapy
If adhesions cause ongoing pain or fertility problems, surgery may be recommended. Surgical options include:
Laparoscopic adhesiolysis (keyhole surgery)
Robotic-assisted surgery
Fertility-preserving surgical techniques
During surgery, specialised anti-adhesion barriers or gels may be used to reduce the risk of scar tissue reforming.
Minimally invasive surgery aims to remove scar tissue while reducing recovery time and lowering the risk of further adhesions forming.
Ongoing Care
Ongoing care may include:
Monitoring symptoms over time
Follow-up after surgery
Pain management support
Fertility assessment where needed
Further review if symptoms return or worsen
Individualised follow-up helps ensure symptoms and fertility concerns are managed appropriately.
Living with the Condition
Living with pelvic adhesions can be difficult, particularly when symptoms such as chronic pelvic pain or fertility problems affect daily life and emotional wellbeing. Because adhesions are not always visible on routine scans, some women may experience delays in diagnosis.
With specialist assessment and appropriate treatment, many women experience improvement in symptoms and quality of life.
When to See a Specialist
You may benefit from specialist assessment if you experience:
Persistent pelvic pain
Pain after previous pelvic surgery
Difficulty conceiving
Unexplained pelvic symptoms despite normal scans
Specialist evaluation can help identify whether pelvic adhesions may be contributing to symptoms or fertility problems.