Could Pelvic Pain After C-Section Be Adhesions to Abdominal Wall?

Article presents 10 cases of chronic pelvic pain after C section that resolved with lysing adhesions of uterus to abdominal wall. – called it the “Captive Uterus”

Med Hypotheses. 2019 Jan;122:98-102. doi: 10.1016/j.mehy.2018.10.010.
Captive uterus syndrome: An unrecognized complication of cesarean sections?
Hardy I et al
https://www.ncbi.nlm.nih.gov/pubmed/30593433

Common symptoms:

  • early onset lower abdominal pain that persists
  • may radiates to  groin
  • maybe exacerbated by breastfeeding (oxytocin responsible for  ejection of milk causes contractions of the uterus )
  • aggravated by certain movements and posture changes  – lying-sitting-standing
  • deep thrust dyspareunia with sex

Pelvic exam would show:

  • uterus is subinvoluted
  • uterus attached to the abdominal wall
  • cervix is high
  • some cervical motion tenderness as a result of adhesions
  • no local dyspareunia causes

All cases treated with surgery were virtually cured.

 

Comment – hope posting this helps someone…

those from Canada take heart:

I. Hardy  – Centre Hospitalier Universitaire de Sherbrooke, Obstetrics and Gynaecology Division, Canada
S. Rousseau -Centre Hospitalier Universitaire de Montréal-Hôtel-Dieu, Former Chief of the Fertility Division, Canada

 

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