When carrying out my research, prior to my myomectomy, I was more focused on reading about the nature of the fibroids, and the procedure itself. I came across the words “scar tissue” and “adhesions” but glazed over them, thinking they were of no concern to me. A few days after my surgery, a friend of mine visited, and she asked what I was doing to prevent scar tissue formation. I was like “Huh?!”. Luckily, I had a doctor’s appointment a few days later, so I threw this question at him. I was expecting him to say something along the lines of “Nah! You don’t have to worry about that! It doesn’t concern you at all”. To my shock, he told me that it was a possibility. He informed me that it was all dependent on how well my body was able to heal itself. Essentially, just as I had an external scar, there were also going to be internal scars, which would heal just as well, or as badly. As I left his office, I rejected it (typical Nigerian style), and proceeded to push that information to the back of my mind. Hopefully, I would be part of the lucky ones for whom this was never an issue.
Exactly a year later, when I had been married 5 months, I underwent a hysteroscopy to check out my uterus. The hospital I was using at the time was the cheaper, but not wiser, option, so it was no surprise when I got an extremely shallow report, which stated that my uterus was in good condition. It wasn’t until I had another hysteroscopy and laparoscopy with my longtime Ob/Gyn, the one who had performed my myomectomy, that it was revealed that I had extensive uterine scarring and adhesions. The adhesions had even caused my fallopian tube to fuse to my bowel. Luckily, and as evidenced by the procedure video, these were cleared 90% during the procedure, and I was waved along to continue with my TTC efforts. But it definitely got me thinking. It seemed to me like I had solved one problem, only to create another. I had gotten rid of my fibroids, only to get scar tissue in return.
My curiosity was piqued, and I decided to read up more about the condition, even though mine had apparently been cleared. My research revealed abdominal surgery is the most common cause of abdominal adhesions, with other common causes being the inflammation of internal organs (such as appendicitis), as well as infections like pelvic inflammatory disease. Not surprisingly, these adhesions sometimes hinder conception by making it difficult for the fertilised egg to implant in the uterine wall. Wow!
It made me wonder how I could have gone on for almost 2 years, without a clue that I had them. Going by the state of my uterus, surely there could have been a red, or even yellow, flag somewhere, at sometime. I later found out that adhesions and scarring can be asymptomatic (like mine was). Some women, on the other hand, have mild to chronic abdominal or pelvic pain, often misinterpreted as endometriosis, appendicitis, or even ovulation,
It then led me to the question of how these can be avoided. What can we do to avoid the occurrence of adhesions. The unfortunate truth is hardly nothing. As long you have opted for, or are mandated to have, abdominal surgery, it is a risk you run. And it all boils down to how well your body can heal itself. Some people are able to heal well, and some aren’t. Take, for example, 2 people scalded with the same degree temperature of boiling hot water. One person might have severe burn scars for life, while some might have only a hint of a discolouration. Two people might have the same type of knife wound, but whilst some will have only a hit of line, some might have a thick, elevated scar. There was a girl in my secondary school who suffered severe keloids from a botched attempt at piercing a 2nd ear hole. Not only did she never get this 2nd hole, she was left with large keloids on her ear lobe. So too with surgery, sometimes the scars heal well, and other times they form a convoluted spider web in your uterus.
Nowadays, most abdominal surgeries can be performed laparoscopically, or through other non-invasive methods. For me, this is music to my ears, as it means there is now the possibility to reducing one’s chances of forming these adhesions. A good friend of mine had her fibroids removed vaginally. Not only was she up on her feet in no time, her doctor had inserted a balloon in her uterus, which remained there for 2 weeks, to prevent the incidence of her uterine walls sticking to each other, or any other internal organs. For me, that was pure genius!
If your fibroids are too large to remove laparoscopically, or you are scheduled for a caesarian section, do not despair. Not only is there the likelihood that you might not develop these adhesions, even if you do, these can be cleared by laparoscopy. Mine were 90% cleared, despite the fact they had been bad enough to leave my uterus in a mangled mess. So, if it is confirmed that you do have adhesions, you need to immediately have a discussion with your Ob/Gyn about what treatment options are good for you!
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