Uterus Adhesion After C-Section: Causes, Concerns & Pregnancy Risks

Question
A few months ago I underwent an emergency appendectomy (laparoscopy) and they also discovered a hemorrhagic ovarian cyst that they removed. The surgeon took a few pictures of my uterus and ovaries during the surgery so I could provide them to my OB/GYN. When my OB saw the pictures he noticed my uterus is attached to my abdominal wall from a c-section I had about 9 months ago. He was concerned because he said the adhesion is very high on the uterus and may cause problems when I get pregnant again. He is recommending another laparoscopic procedure to cut the adhesion loose. Here are my questions:

1) Does this happen often and what are the risks to getting pregnant with the adhesion still attached? (If I hadn't had the appendectomy, I never would've known about it in the first place.)

2) What is the likelihood that the laparoscopic procedure will heal properly and that it won't just re-attach again?

Any other information you can provide would be greatly appreciated. My husband and I would like to conceive again soon. Another surgery will delay our plans, but we want to make sure we are doing what's right. Thanks!

Answer
Hi Julie,

Since I'm not a doctor, I can't give you as detailed an answer as you'd probably like, but here's what I do know about adhesions, having undergone 1 c-section myself, and also an appendectomy.

When adhesions are separated and removed through surgery, these procedures are highly successful, and help roughly 60% of all patients. However, the slip side is they can form again, and do so in about 70% of cases.

Your doctor said the untreated adhesion "may" cause problems in a future pregnancy. Unfortunately, I don't know how that translates statistically, but I bet it's not higher (and is probably much lower) than the 70% adhesion reoccurance rate. In other words, if I were in your shoes, I would be likely to attempt conception, rather than rush to surgery. And during your pregnancy, you would want to be a little more alert for things like abdominal pain (more than than the usual aches and pains and pulling sensations), premature rupture of your membranes, and also signs of preterm labor.

All the best to you, whatever you decide!
Ann S