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Shen Li Wen
Obstetrics and Gynecology
About me
Engaged in obstetrics and gynecology work for more than twenty years, serving as the deputy chief physician of the obstetrics and gynecology department. Familiar with the diagnosis and treatment of common and frequently-occurring diseases in obstetrics and gynecology.
Proficient in diseases
- Uterine fibroids, ovarian cysts, cervical cin lesions, HPV infection, dysfunctional uterine bleeding, gynecological inflammation. Report interpretation, pregnancy care, gestational hypertension, gestational diabetes, breastfeeding, postpartum care and health.
Voices
How to perform surgery on cervical polyps
According to the different shapes of cervical polyps in women and the varying depths of their stalks, the surgical methods also vary. For instance, if a woman discovers a small cervical polyp with a thin stalk that isn’t located too deeply, it can be treated in an outpatient setting. Usually, the stalk is clamped with a hemostatic forceps, then continuously twisted until it naturally breaks off, and the bleeding is generally not substantial, often not requiring hospitalization. However, for some women with larger cervical polyps and broader stalks located deeper within, especially when the stalk is deep within the cervical canal, performing a cervical polyp removal surgery in an outpatient setting may result in incomplete removal of the stalk, and the bleeding can be more significant. In such cases, hospitalization is usually required to perform an electrosurgical excision of the cervical polyp under hysteroscopy, during which the stalk can be completely removed and the bleeding can be thoroughly controlled.
Why does cervical polyp bleed?
Cervical polyps in women are prone to bleeding, which is somewhat related to the causes of their formation. Most cervical polyps occur due to infection of the cervix, leading to proliferative changes. The tissues in these polyps lack muscle fibers, so when they bleed due to contact, there is no way to constrict and close off the bleeding vessels. Furthermore, cervical polyps are soft and fragile, easily bleeding upon contact. Additionally, the surface of cervical polyps is susceptible to invasion by external pathogens, prompting infections, which can exacerbate the occurrence of vaginal bleeding in women.
What are the symptoms of infertility?
There are many causes of infertility, so depending on different reasons, the clinical manifestations also vary. For instance, some women suffer from infertility due to abnormal ovulation, which could manifest as abnormalities in the menstrual cycle such as prolonged absence of menstruation, like in polycystic ovary syndrome, or irregular vaginal bleeding. Some women have uterine factors that cause infertility, such as common post-multiple intrauterine operations leading to intrauterine adhesions, where a woman might experience reduced menstrual flow or even amenorrhea, accompanied by painful menstruation. Additionally, infertility in some women might be due to cervical factors, possibly presenting with thick vaginal discharge, contact bleeding, or blood-tinged discharge. Partially, some women might have ovarian endometriomas, which can cause severe painful menstruation and increased menstrual volume, among other symptoms.
Do Nabothian cysts of the cervix cause infertility?
Women with cervical Nabothian cysts will not become infertile because of them. Cervical Nabothian cysts are actually cysts of the cervical glands. Abnormal substances, such as squamous epithelium during the healing process, have entered the gland ducts, blocking them and preventing the contents of the cysts from escaping. They merely indicate the squamo-columnar junction of the cervix and do not affect the cervical canal or cause it to narrow, nor do they affect vaginal secretions or female infertility. However, if a woman has a particularly large single cervical cyst or multiple cervical gland cysts, they may cause cervical hypertrophy. When the cervix is enlarged, there might be hyperplasia in the interstitial part and possible formation of fibrous tissue. This could potentially affect the dilation of the cervix during childbirth.
The harm of dysmenorrhea
Some women experience severe dysmenorrhea, where the pain can radiate to the root of the thigh, affecting their normal sleep and concentration during the day, which in turn affects their work efficiency. Some women experience such severe dysmenorrhea during their menstrual period that they even need to take leave from work to rest at home. Additionally, some women may suffer from secondary dysmenorrhea, which is linked to underlying diseases. For example, conditions like adenomyosis, endometriosis, and endometrial polyps can alter the internal environment of the uterine cavity and change its coagulation state, leading to increased menstrual flow. This can cause anemia due to blood loss and also affect normal pregnancy.
How to stop bleeding from a cervical polyp
Bleeding caused by cervical polyps in women can be due to infection or post-coital because the polyp tissue is relatively fragile, leading to bleeding. In most cases, the bleeding stops on its own without the need for medical intervention. However, some women may need to go to the hospital for treatment. For instance, local application of Chinese patent medicine with hemostatic properties can be used to stop the bleeding. Alternatively, iodine-soaked gauze can be applied for compression hemostasis. If the clinic has a LEEP (Loop Electrosurgical Excision Procedure) device available, electrocoagulation with the LEEP device can also be used for hemostasis. In cases where the cervical polyp is inflamed, leading to bleeding, anti-inflammatory treatment should also be administered alongside other hemostatic methods to effectively stop the bleeding.
Do cervical polyps require hospitalization?
Generally, women with cervical polyps can undergo a minor removal surgery in an outpatient setting, and hospitalization is not necessary. This is because cervical polyps are usually not very large and have a thin, long stalk connected inside the cervical canal. In the outpatient setting, the polyp on the cervix can be clamped with hemostatic forceps, followed by minor excision, or the cervical forceps can be directly rotated to cause ischemia and hypoxia at the base of the stalk, making it fall off on its own. However, some women may have larger cervical polyps, especially those with deeper and broader bases. If polyp removal surgery is performed in an outpatient setting, it may be difficult to locate the base of the polyp to completely remove it, and there could be considerable bleeding during the surgery. Additionally, cervical polyps in some women may be an indication of cervical cancer or endometrial cancer. In such cases, hospitalization and surgical treatment are typically required.
What's the matter with ovarian teratoma pain?
The causes of lower abdominal pain in women with ovarian teratomas are complex. Firstly, as the teratoma grows in size, it can, due to gravity, pull on surrounding ligaments, causing pain on one side of the lower abdomen. When the teratoma is particularly large, it can also compress nerves in the pelvis, leading to neuropathic pain. Moreover, teratomas are heterogeneously textured. If they are quite mobile and not adhering to surrounding tissues, sudden changes in body position, or an increase in uterine size during the mid-pregnancy, might shift the position of the teratoma. This can lead to torsion of the stalk, causing local ischemia and hypoxia, and resulting in acute lower abdominal pain.
Do teratomas hurt?
Teratomas themselves do not cause pain, especially when they are relatively small, women often have no clinical symptoms. As the size gradually increases, the tumor pulls on the surrounding ligaments, causing abdominal discomfort, such as a feeling of abdominal heaviness, or even abdominal pain. Some women may also experience infection or adhesions with surrounding tissues, leading to abdominal pain. Additionally, some women may have malignant transformation of their teratoma, which invades surrounding tissues and nerves, possibly causing headaches. A small number of women may experience a change in the position of the teratoma after pregnancy or urination, leading to torsion, which can obstruct the blood flow to the tumor, resulting in necrosis and bleeding, causing acute abdominal pain.
Is it serious if a cervical polyp bursts?
The texture of cervical polyps in women tends to be more fragile, and they may have inflammatory cell infiltration on their surfaces, which could also affect coagulation functions. If rupture occurs, the bleeding could last longer. Some women with cervical polyps experience minor ruptures and minimal bleeding, which can be quickly stopped using simple compression hemostasis or by applying traditional Chinese medicines locally. However, if the rupture area of the polyp is large, ordinary methods may not suffice to stop the bleeding. Particularly, some cervical polyps in women may indicate carcinogenic changes, as cancer can grow rapidly, possibly outpacing the blood supply, leading to local rupture and shedding. In such cases, the resulting bleeding can be fatal and difficult to control.