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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 regulate amenorrhea in polycystic ovary syndrome?
When a woman with polycystic ovary syndrome experiences amenorrhea, the first step is to observe her body type. If she is relatively obese, it is advisable to suggest controlling diet and engaging in moderate activity to reduce her weight, that is, to lower her body mass index. After doing so, some women may regain their normal menstrual cycles. For those with a normal body type or those who still have irregular menstrual cycles after losing weight, considering oral contraceptives might be suitable. These can reduce the level of androgens in the body. For women of childbearing age who still have reproductive needs, after regulating the menstrual cycle, if normal ovulation is not resumed, ovulation induction treatments can be considered to help the woman conceive normally.
Can you still have children with uterine prolapse?
Most women with uterine prolapse are not affected in their ability to become pregnant and give birth normally. However, in rare cases, symptoms can be severe when women suffer from uterine prolapse, with part of the uterus protruding outside the vagina. This may cause friction with the underwear, leading to localized ulcers or even infections, causing purulent vaginal discharge or bleeding. This can affect the normal passage of sperm and impact normal pregnancy. For these women, anti-inflammatory treatment can be administered first. After healing, it generally does not affect normal conception. After conception, as the size of the uterus increases and moves from the pelvic cavity into the abdominal cavity, the symptoms of uterine prolapse tend to decrease.
How to Determine if a Teratoma is Benign
Teratomas in women are classified into benign and malignant categories. Benign teratomas typically have a complete capsule and grow very slowly. Some women find that the size of the teratoma does not change significantly during follow-up exams. Malignant teratomas, however, grow quickly and can present severe clinical symptoms, such as abdominal pain, bloating, and pelvic masses, with some women also experiencing fluid accumulation in the abdominal cavity. Furthermore, blood tests for gynecological tumor markers can also be used for differentiation. For example, in malignant tumors, markers such as CA-125, CA-199, and alpha-fetoprotein are elevated to varying degrees, particularly alpha-fetoprotein. During a CT scan, malignant teratomas may show unclear borders, potentially indicating invasion into the surrounding tissues. Additionally, after surgical removal of the tumor, pathological histological examination can be conducted for further differentiation. For instance, malignant teratomas tend to have a higher proportion of immature components.
What does a uterine prolapse feel like to the touch?
Under normal circumstances, the uterus of a woman is located deep in the pelvic cavity and is usually not palpable through the abdomen. When a woman has a mild uterine prolapse, the body of the uterus cannot be felt at the vulva either. It is only when a woman experiences moderate to severe uterine prolapse, with part or the entire body of the uterus protruding outside the vagina, that it becomes palpable to the touch. The exposed part can cause local hyperplasia, ulceration and other phenomena due to friction with undergarments, giving a feeling of enlargement upon touch. During gynecological examinations, it can be observed that most women with uterine prolapse have relatively lax vaginal walls. When these women cough, there is a noticeable downward movement of the cervix, which impacts the finger, and the entire cervix may appear enlarged and thickened.
Why is cervical polyp prone to recurrence?
Cervical polyps are a type of benign lesion of the cervix. However, recurrent episodes are common after cervical polyp removal surgery. This may be due to inflammation that causes the polyps; if the inflammation, such as vaginitis or cervicitis, is not fully cleared after surgery, it can stimulate the regrowth of cervical polyps. Additionally, in some women, the base of the cervical polyp may be deep, and if it is not completely removed during surgery, recurrence may occur. Furthermore, in some cases, the polyp itself may undergo malignant transformation, leading to potential recurrence after the surgery.
Symptoms of endometrial polyp malignancy
When endometrial polyps in women undergo malignant transformation, it can lead to a large amount of vaginal discharge. This discharge may be accompanied by a foul odor, which could possibly be due to an associated infection. Additionally, when endometrial polyps undergo malignant transformation and form tumors, their growth rate accelerates, and the blood supply may not meet the growth needs of the polyps. This may lead to localized ulceration and bleeding, causing women to experience irregular vaginal bleeding. This bleeding can manifest as blood streaks in vaginal discharge or as persistent vaginal bleeding. As the tumor gradually enlarges, it increases the pressure in the uterine cavity, leading to abdominal pain in some women.
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.