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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
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.
How is endometrial cancer detected?
When women experience irregular vaginal bleeding, or vaginal bleeding reoccurs after menopause, and uterine endometrial cancer is suspected, the first step is to conduct a routine gynecological examination to identify whether the bleeding originates from the uterine cavity or the cervix. Additionally, an ultrasound examination can be conducted to observe the condition inside the uterine cavity, the thickness of the endometrium, whether the thickness is uniform, and whether there are any abnormal growths, to understand whether the woman might have uterine endometrial cancer. However, these methods usually cannot provide a diagnosis and only serve to assess or suggest the possibility of endometrial cancer. For a definitive diagnosis, a hysteroscopy or diagnostic curettage can be performed, and the results of the pathological examination can confirm the diagnosis.
What tests are done for secondary infertility?
The most common cause of secondary infertility in women is blocked fallopian tubes. In this case, a hysterosalpingography with iodine oil should be performed to understand the patency of the fallopian tubes and the specific location of the blockage, which can guide future treatment. Additionally, if a woman has abnormal vaginal discharge, a routine gynecological examination should be conducted to check for any cervical lesions. A vaginal secretion test should be performed to see if vaginal inflammation is affecting normal pregnancy. Some women experience infertility after having an abortion or induced abortion, and for these women, it's also worth considering whether uterine issues are causing secondary infertility. A hysteroscopy can be done to investigate this. When a woman experiences secondary infertility, her sexual partner or spouse should also be examined to assess sperm quality and any potential obstacles in the sperm delivery pathway.
The graded treatment for uterine prolapse is what?
According to the severity of female uterine prolapse, it can be categorized into first, second, and third degrees. For first and second degrees, non-surgical treatment methods can be used, such as the commonly practiced anal contraction exercises, which are a type of pelvic floor muscle training. The specific method involves contracting the anus for three seconds, then relaxing, and repeating this action 15 to 30 times per set. Depending on one's physical condition, two to three sets can be done each day. Generally, significant results can be seen after six to eight weeks of consistent practice. Additionally, some women who refuse surgery, such as older women, can also use a uterine pessary. Moreover, for mild or moderate uterine prolapse, treatments such as acupuncture and taking traditional Chinese medicine orally, such as Bu Zhong Yi Qi Tang, can be used. For severe uterine prolapse, surgery is often necessary, but the specific choice depends on various factors such as the woman's age, reproductive needs, and quality of life requirements. For example, older women in their seventies or eighties who might have poor physical condition and possibly no sexual activity might consider undergoing a vaginal closure procedure.
Do cervical polyps differentiate between benign and malignant?
Under normal circumstances, cervical polyps are considered benign hyperplastic lesions of the cervix, possibly related to the body's hormone levels or caused by inflammatory stimulation resulting in inflammatory polyps. However, sometimes malignancies of the endometrium or cervix can also present as polyp-like growths. It is usually impossible to distinguish benign from malignant lesions just by visual inspection. Therefore, whenever cervical polyps are found, it is common practice to perform a surgical removal of the cervical polyp and then conduct a histopathological examination to differentiate between benign and malignant lesions.
How is endometritis treated?
When women develop endometritis, it is mostly caused by mixed bacterial infections. In such cases, broad-spectrum antibiotics can be used for anti-inflammatory treatment. For example, under generally good conditions, oral cephalosporin or penicillin antibiotics can be used for treatment. If a woman's physical condition is poor, intravenous infusion therapy can also be administered. Additionally, if a woman experiences changes in her menstrual cycle, such as heavier menstrual flow or irregular vaginal bleeding, oral hemostatic drugs can be used for bleeding control. During non-bleeding periods, women can also opt for abdominal microwave therapy to promote the absorption of inflammation.
Why does vulvitis keep recurring?
Women frequently experience recurrent episodes of vulvitis for various reasons. A common issue is that during treatment, the medication used is not suitable for their condition as they do not get their secretions tested before starting medication. Additionally, even if the medication is appropriate, some women do not complete the full course of treatment and stop taking the medicine once symptoms improve, which can lead to recurrence. Furthermore, some women have lower resistance around their menstrual period or during menstruation, making them more susceptible to recurrent episodes. Another factor contributing to recurrent vulvitis includes untreated underlying causes such as diabetes, urinary incontinence, or fecal fistula. Some women do not frequently change their underwear or pay attention to the cleanliness of the vulvar area, which can also lead to recurrent inflammation. (Please use medication under the guidance of a professional physician and do not self-medicate.)