Pelvic Adhesions
Some women who suffer from pelvic pain are found after an evaluation to have a good deal of internal scar tissue called adhesions, especially after having multiple surgeries said Dr. Obianwu.
"The patients may have no idea what is causing it," he said. "The challenge of scar tissue, or adhesions, is that you can not detect them with ultrasound CT scan, an MRI or any other diagnostic test."
"The only way to understand what is causing the pain is to see inside directly, do a scope to visualize the area and determine the cause of pain."
Scar tissue, he said, can be caused by previous pelvic infection, endometrial disease, or previous abdominal or pelvic surgery. Those previous surgeries can include Cesarean sections, which have been on a steep rise in recent decades.
"The C-section rate is now approaching 30-to-40 percent, depending on the institution," said Dr. Obianwu. "Many of these women later in life present to us with pelvic pain due to a lot of scar tissue from that surgery."
Whatever the reason, adhesions can appear anywhere in the pelvis and the surgeon said the robotic surgical system, called the daVinci® System, provides a superior method of locating, securing and eliminating the scar tissue. "The good thing about the robot is that you can get into all the angles and tunnels, anywhere you want to go. It doesn't have the limitations of the conventional laparoscope." (See Advantages of Robotic Surgery.)
