Surgery is the most common cause of adhesions, though infection, endometriosis, chemotherapy, radiation and cancer may also damage tissue and initiate adhesions.
Adhesions are almost an inevitable outcome of surgery and the problems that they cause are widespread and sometimes severe. Adhesions are the single most common and costly problem related to surgery and yet most people have not even heard of them. This lack of awareness means that many doctors are unable or unwilling to tackle the problems of adhesions.
Intestinal obstruction is one of the most severe consequences of adhesions. 30-41% of patients who require abdominal reoperation have adhesion-related intestinal obstruction. Adhesions involving the bowel can cause a bowel obstruction or blockage. Adhesions can also form elsewhere after surgery, such as around the heart, spine and in the hand where they may lead to other problems.
It is not unusual for several organs to be adhered to each other causing traction (pulling) of nerves. Nerve endings may also become entrapped within a developing adhesion causing severe pain. Adhesions involving the female reproductive organs can cause dyspaareunia (painful intercourse) infertility, subsequent surgery and debilitating pelvic pain.
Over 40% of all infertility problems are related to adhesions.
This risk of developing adhesions and the severity increased with age and increasing number of previous laparotomies. A study involveing 120 patients undergoing reoperative laparotomy, estimated an increase of 24 minutes in total time of operation, because of intra-abdominal adhesions from a previous surgery. A 21% risk of adhesion- related bowel perforation was identified in 274 patients undergoing relaparotomy.