There was a significant association between the presence of anterior compartment adhesions and chronic pelvic pain. In women with a history of no surgery other than Cesarean section(s) ( n = 220), an increasing number of Cesarean sections (odds ratio (OR) 3.4 (95% CI, 2.1–5.5)) and a postoperative wound infection (OR 11.7 (95% CI, 3.5–39.5)) increased the likelihood of adhesions developing in the anterior pelvic compartment. Adhesions in the vesicouterine pouch were the most common and were found in a total of 79 (25.6% (95% CI, 20.7–30.5%)) women. On ultrasound examination, 139 (45.1% (95% CI, 39.7–50.7%)) women showed evidence of adhesions within the pelvis. ResultsĪ total of 308 women were recruited into the study.
Medical and surgical history was recorded and a structured questionnaire was used to enquire about any history of pelvic pain and urinary symptoms. In all women, both transvaginal and transabdominal scans were performed in order to identify the presence of pelvic adhesions.
This was a prospective observational study of women in whom one or more Cesarean sections had been performed > 12 months previously and who attended for a gynecological ultrasound examination. To investigate the prevalence and location of pelvic adhesions in women with a history of Cesarean section and to identify risk factors for their formation and symptoms associated with their presence.
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