Dense adhesion between rectum and uterus - #14779

Hello Ratna By going through your history and evaluation of your health status i must say that the dense adhesions between the rectum and uterus can sometimes be a result of previous infections, surgeries, or conditions like endometriosis. With your history of tuberculosis treatment, it’s good to hear that you has normal hormonal balance, but primary amenorrhea can be concerning. For treating dense adhesions, the most common approach is surgical intervention, often through a procedure called laparoscopy. This minimally invasive surgery can help to separate the adhesions and restore normal anatomy . As by concerning about your age and future pregnancy related concern I am suggesting you to visit a gynecologist for better evaluation and treatment.

Thank you

Please evaluate for intrauterine adhesions and proceed with hysteroscopic adhesiolysis + postoperative estrogen therapy and cavity stent placement. Assess for any residual genital TB.

Primary amenorrhea can be a complex issue, especially if caused by dense adhesions between the uterus and rectum. This condition, often associated with pelvic adhesions or fibrosis, can sometimes result from previous pelvic infections, surgeries, or inflammatory conditions. Given that your wife has a normal hormonal balance, it seems the underlying issue is likely structural. One of the modern treatment options for dense adhesions is minimally invasive surgery, such as laparoscopy, which allows doctors to cut and remove these adhesions safely. Laparoscopy has become a common approach due to its reduced risks compared to open surgery, faster recovery times, and lower postoperative pain. However, even with advanced techniques, surgery always carries potential risks like infection, bleeding, or recurrence of adhesions. Pre-surgical imaging, such as MRI or pelvic ultrasound, can help map the extent of adhesion and guide the surgical approach. It’s crucial to have a comprehensive evaluation from a gynecologist specialized in reproductive health and possibly a colorectal specialist depending on the adhesion’s severity. Considering her age and past medical history with tuberculosis suspicion, all details should be transparently shared with the surgical team to tailor treatment for her needs. Furthermore, addressing post-surgical prevention of adhesion recurrence may also involve medications or physical therapy, which should be part of the consultation. Although there’s no such thing as a “risk-free” surgery, careful preoperative planning, experienced surgeons, and a clear understanding of the procedure can significantly minimize risks, enhancing the chances of a successful outcome.

Dense adhesions inside the uterus causing primary amenorrhea are usually due to Asherman’s syndrome, and the most effective modern treatment is hysteroscopic adhesiolysis, where the adhesions are gently removed using a camera-guided procedure. Success depends on how severe the scarring is, and treatment is often followed by estrogen therapy and sometimes a uterine balloon to prevent the adhesions from reforming. Please consult an Infertility Specialist / Reproductive Endocrinologist experienced in hysteroscopic surgery to evaluate the severity and discuss the safest treatment plan.