Reduce Pain and Problems from Childhood Surgeries

Congenital adrenal hyperplasia (CAH)

Congenital adrenal hyperplasia (CAH) refers to a family of inherited disorders associated with an inability or deficiency in the ability to produce cortisol, a hormone made by the adrenal glands. In affected individuals, the disease begins early in gestation and leads to conditions that manifest at birth.

In some females, congenital adrenal hyperplasia causes an excess of androgen. This often comes to medical attention due to physical anomalies in the female infant’s urogenital and reproductive structures, when she is born.

Classical congenital adrenal hyperplasia (CCAH) is considered a relatively common condition in Europe and North America, affecting one in 15,000 newborns. Overproduction of androgen hormones in classical CAH can cause the clitoris to become enlarged in the female infant to the point that it may look like a small penis. Further, the labial folds may be joined to resemble the scrotum.

These external anomalies do not affect the function of the internal female reproductive organs, which remain intact. However, the extent of the anomaly may be so great that the female infant may initially be misidentified as a male. The several stages and progression into Classical CAH are shown in a sliding scale at the bottom of this web page.

In addition to medical (hormonal) treatment, parents of affected infant girls often want to save their daughter from a lifetime of embarrassment due to her visible anomaly. Thus, many parents of infants with classical congenital adrenal hyperplasia choose to schedule the child for one or more reconstructive genital surgeries. These may begin as early as infancy.

While the early surgery may help the child look more “normal,” these surgeries can leave scarring and adhesions that can cause pain and dysfunction during their youth. Other young ladies experience problems later in life, especially as they pass puberty and begin to consider sexual activity.

Adhesions after CAH surgeries

At whatever age surgery is performed, it can cause severe scarring and adhesions at the delicate tissues of the vagina, perineum, clitoris, labia or vulva. The adhesions which formed at such an early age may result in significant problems later in life, such as very painful intercourse or other types of sexual dysfunction, (e.g. decreased desire, lubrication and orgasm).

Adhesions form naturally to help the body heal from a surgery. With a tensile strength of nearly 2,000 pounds per square inch, these adhesions bind tissues in place, keeping the delicate structures in this area frozen or glued down after a surgery, inflammation, or other physical trauma. Like tiny but very strong straight-jackets, these adhesions form wherever we heal, binding down tissues that should be able to move freely, as they did before surgery.

Non-surgical treatment for CAH adhesions

The therapists at Clear Passage Physical Therapy understand the physical scars that occur at the female reproductive organs. We have been treating post-surgical vaginal adhesions for two decades. Our work in this area began over 20 years ago, when our director began her search for relief from her own post-surgical vaginal and pelvic adhesions. We have treated pelvic and vaginal adhesions women in hundreds of women since that time.

We use our hands to slowly peel apart adhered tissues, always working with respect, and within your comfort and tolerance levels. Like gently breaking apart a nylon rope composed of hundreds of tiny strands, we work to detach the adhesions from structures that are causing your pain, tightness, or dysfunction.

We also understand the need to treat these delicate tissues in a ‘safe place,’ with the dignity and sensitivity your unique situation requires. While our work is physical, we also understand the psychological issues that can naturally accompany a lifetime of pain, dysfunction, or simply knowing that you are somehow different from everyone else. We are always glad to consult and work with your physician or counselor before, during, or after therapy.

Our physical work tends to open doors of mobility, which have not existed in your body for years – or decades in most cases.

Most of our post-surgical patients find that when we free them of adhesions that formed so many years ago, their bodies become much more mobile and pain-free. This paves the way for them to move on in their lives, less hindered by the physical scars, pain and dysfunction that have been their unwanted companions for a lifetime.

All of our work is done by sensitive, caring therapists in private treatment rooms. To learn more, please click here to apply for a free consultation with one of our therapist directors.