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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 is a teratoma surgically removed?
When a woman has an ovarian teratoma, treatment should be determined based on the specific age of the woman, whether the teratoma is benign or malignant, and other factors. For example, if the woman is relatively young and has a benign teratoma and wishes to preserve her fertility, she can undergo ovarian teratoma excision surgery, which can be performed either laparoscopically or through an open surgery. During the operation, the entire teratoma can be completely separated and placed in a specimen bag to prevent contamination of the woman's pelvic cavity and avoid chemical peritonitis or granuloma. If the teratoma is malignant, then it is necessary to remove the adnexa and perform a comprehensive staging surgery. After surgery, based on the results of the pathological examination, it will be decided whether additional treatments such as radiotherapy or chemotherapy are needed.
Secondary infertility is how it comes about?
Secondary infertility is when a woman has been pregnant before but has not conceived after a year of not using contraception. The causes of secondary infertility are divided into male factors and female factors. Common male infertility factors include older age or habitual smoking and drinking, leading to decreased sperm quality. Female infertility factors are more numerous, such as excessive sexual activity during reproductive years or weak immune system leading to pelvic inflammatory disease. This inflammation can affect the fallopian tubes, causing blockages and resulting in infertility due to tubal factors; it can also spread to the endometrium, causing endometritis and altering the intrauterine environment, making conception difficult. Some women may suffer from endometriosis, which can also lead to infertility. In some cases, women who have had uterine procedures may experience adhesions in the cervical canal and uterine cavity or abnormal uterine shapes, leading to infertility. Additionally, some women experience significant blood loss after childbirth, leading to pituitary necrosis, hormonal imbalances, and ovulation disorders, which can affect normal conception.
How is endometritis diagnosed?
When suspecting endometritis in women, the first step is to inquire about the medical history. Most women exhibit abnormalities in their menstrual cycle, and some only show changes in the amount of menstruation. Ultrasound examination of the reproductive system shows no organic lesions, and the hormone panel is normal. During a gynecological examination, tenderness in the uterine body may be observed. Sometimes, ultrasound examination suggests that the endometrium is thin and uneven. Performing a hysteroscopy, localized hyperemia and edema of the endometrium can be seen, and diagnostic curettage plays a certain role in diagnosis.
What should I do if cervical polyps keep recurring?
Women with cervical polyps, although benign, have a characteristic of recurring. When this happens, it is important to first identify if there are any factors promoting their recurrence, such as recurrent vaginal inflammation in women. This inflammation can affect the cervix and cause recurrent cervical polyps. At this point, it is advisable to first conduct a vaginal discharge test to determine the type of vaginal inflammation and treat it with medication appropriate for the specific type of vaginal inflammation. Once the vaginal inflammation is treated, the recurrence of cervical polyps can be reduced. Additionally, for unexplained recurrent cervical polyps, it is necessary to regularly follow up and check, trying to ensure early detection and removal of cervical polyps to prevent an increase in size or number of polyps.
Can pelvic effusion cause infertility?
Usually, pelvic effusion in women does not lead to infertility. For instance, physiological conditions in women, such as during the menstrual period or around ovulation, can lead to a small amount of leakage in the pelvic cavity. During an ultrasound, this may appear as a small amount of pelvic effusion, which is usually absorbed normally and does not affect pregnancy. However, if a woman's pelvic effusion is due to inflammation, and this inflammation affects the fallopian tubes or ovaries, causing inflammation in these areas, it might impact the woman's ability to conceive normally.
Malignant manifestations of ovarian teratoma
When ovarian teratomas are small, they usually do not exhibit any clinical symptoms. When teratomas become malignant, they grow faster, and if too large, may cause women to experience abdominal distension and pain. The pulling of surrounding tissues can also lead to pain in the lower abdomen on one side in women. When ovarian teratomas are severely malignant, they can invade or compress surrounding tissues, leading to related symptoms like compression of the fallopian tubes, causing infertility; or compression towards the bladder, causing frequent and urgent urination in women. The texture of teratomas is uneven. In certain special circumstances, such as when a woman suddenly changes her position, torsion or rupture of the teratoma can occur, causing acute lower abdominal pain and other symptoms of acute abdomen. Additionally, in the late stages of the disease, symptoms such as emaciation and anemia can also appear.
Can low estrogen cause infertility?
If a woman's blood test reveals low estrogen levels, it may affect normal conception. Firstly, with low estrogen levels throughout the menstrual cycle, there can't be a peak change, which may lead to abnormal ovulation or anovulation. Additionally, if estrogen levels are low, the endometrium cannot proliferate effectively, leading to insufficient endometrial thickness and making it difficult for the fertilized egg to implant. Some women may conceive despite these issues; however, due to insufficient hormone levels, they may experience abdominal pain, vaginal bleeding, threatened miscarriage, or even arrested fetal development.
What should I do if the menstrual pain is very severe?
If women experience severe dysmenorrhea, they should first undergo routine examinations to rule out organic lesions, which are the possibility of secondary dysmenorrhea. For example, we should initially conduct gynecological examinations, pelvic ultrasounds, or combine other auxiliary examinations such as pelvic CT and MRI scans to rule them out. Some women may suffer from conditions such as endometrial polyps, ovarian chocolate cysts, or uterine fibroids, leading to severe dysmenorrhea. The treatment methods vary depending on the different causes. For instance, if a woman has endometrial polyps, hysteroscopic electrosurgical resection of the polyps can be performed. If it has been ruled out that the woman has organic lesions of the reproductive system and the possibility of secondary dysmenorrhea, it is possible that she has primary dysmenorrhea. She can take non-steroidal anti-inflammatory drugs orally during menstruation to relieve the pain, or regularly take short-acting contraceptive pills to suppress ovulation and alleviate the symptoms of dysmenorrhea.
Menopausal osteoporosis manifestations
Women experience osteoporosis during menopause, generally occurring in the later stages of menopause, which is between 9-13 years after menopause. During this period, women may develop osteoporosis. In the early stages, women can experience pain in the lower back, limbs, and joints, which is actually a manifestation of rapid bone loss. Later on, some women may develop a hunched back. Due to the increased brittleness of their bones, they are prone to various fractures, with vertebral fractures being the most common. This is followed by fractures of the distal radius and the neck of the femur.
Is cervical polyp not very serious?
In most cases, cervical polyps in women are benign lesions of the cervix caused by chronic inflammation. If the polyp is small, typically the clinical symptoms are not severe, or there may even be no symptoms at all. Some women might experience a small amount of vaginal bleeding or blood-streaked discharge after intercourse or a gynecological examination. When the size of the cervical polyp increases, the clinical manifestations can be more severe, such as bloody discharge or bleeding after intercourse. In very rare cases, regardless of the size, cervical polyps may be cancerous. In such cases, it is necessary to remove them promptly and perform a histopathological examination to determine whether the lesion is benign or malignant.