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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
What are the symptoms of yeast vaginitis?
When women suffer from candidal vaginitis, they will produce a cottage cheese-like vaginal discharge, along with intense itching of the vulva. The itching, especially severe at night, is the most intense among symptoms of vaginitis and can disrupt normal sleep. Moreover, the discharge is thick and adheres to the vaginal walls, making it difficult to expel. There can be congestion and swelling of the vulva due to the poor elasticity of the vulval skin and mucous membrane, which can lead to painful cracking during intercourse. Additionally, the infection can spread to the urethral opening and urethra, causing frequent urination and urgency in women, and it can also be transmitted to men through sexual activity.
What are the causes of uterine prolapse?
There are many causes of uterine prolapse in women, for instance, the most common one occurs during pregnancy and childbirth, especially when methods such as forceps delivery are used, which may damage the pelvic floor muscles or injure the vaginal wall. This causes damage to the pelvic floor muscles, and if not properly recovered postpartum, it can lead to prolapse. Additionally, some women might suffer from conditions like chronic pharyngitis, chronic bronchitis, long-term coughing, or have liver diseases or malignant tumors leading to a significant build-up of ascites. Frequent heavy physical labor or even simple obesity can increase abdominal pressure, causing uterine prolapse.
What are the symptoms of vulvitis?
When women experience inflammation of the vulva, the clinical symptoms are generally similar. Firstly, we may observe some abnormal secretions in the vulvar area, such as purulent secretions with a foul smell, accompanied by local itching. Furthermore, when the inflammation in the female vulvar area is severe, it can lead to local skin mucosa congestion, edema, and reduced elasticity. This can cause severe pain during walking due to friction, or during intercourse due to mechanical irritation, and may even lead to painful bleeding. Additionally, in some women, the inflammation may be intense enough to form small abscesses locally, meaning small lumps may appear or small white pus spots may be present on the local area.
What are the symptoms of vulvar lichen sclerosus?
Vulvar lichen sclerosus, also known as lichen sclerosis, is one of two conditions, the other being epithelial hyperplasia, characterized by the appearance of white patches on the vulva. Both conditions are marked by severe itching as a common symptom, though they differ in subtle ways. For instance, in the case of lichen sclerosis, the affected skin and mucous membranes become less elastic and thinner, as seen with the shrinking of the labia minora. Women may experience a burning sensation locally and pain during intercourse. When epithelial hyperplasia occurs, the local skin and mucous membranes thicken, often showing scratch marks due to extreme itching.
Uterine fibroid examination items
When suspecting that a woman has uterine fibroids, the first step is to perform a routine gynecological examination by opening the vagina with a speculum. This is necessary because some women's uterine fibroids are located on the cervix; at this point, it is possible to see an increased size of the cervix and the fibroid may be visible protruding from the cervix. Moreover, during the bimanual gynecological examination, one may find that the uterus is enlarged and irregularly shaped with localized protrusions. Generally, the mobility is quite good. Additionally, some auxiliary examinations can be combined, such as the most common transvaginal ultrasound or pelvic abdominal ultrasound. For suspected submucosal uterine fibroids, a hysteroscopic examination can also be performed for diagnosis.
How to treat endometriosis in the pelvic cavity?
When women suffer from pelvic endometriosis and the symptoms are not too severe—for instance, if the pain is relatively mild—they can be clinically observed during menstruation. If dysmenorrhea occurs, oral administration of non-steroidal anti-inflammatory drugs such as indomethacin can help alleviate the symptoms. However, some women may experience more severe symptoms and may require pseudopregnancy treatment with drugs, such as oral contraceptives or progestin-based medications. Another approach involves using GnRH analogues, a method known as 'medical oophorectomy.' If symptoms are severe and treatments are ineffective, surgical intervention might be considered. Surgical options include electrocoagulation of endometriotic lesions in the pelvis, sharp or blunt dissection of adhesions, which can also improve the pelvic environment and potentially enhance fertility in women. (Note: Medication should be taken under the guidance of a doctor.)
What are the clinical manifestations of uterine prolapse?
When women experience uterine prolapse, the clinical symptoms vary depending on the severity of the condition. For instance, mild uterine prolapse often does not cause any discomfort. Severe uterine prolapse, however, may be due to the pulling of the uterus, leading to a reflex tension in the surrounding ligaments and causing congestion in the pelvic area. Women may feel pain in their sacral or lower abdominal area, which intensifies with excessive fatigue or prolonged standing. Some women may also experience stress urinary incontinence or changes in bowel behavior, such as constipation.
Can ovarian cysts cause infertility?
Women with ovarian chocolate cysts may experience effects on their reproductive function. When the cysts are small, they typically do not significantly impact fertility. However, as the cysts grow in size, they can compress the normal ovarian tissue, causing ovulatory disorders and leading to infertility. Additionally, certain types of ovarian cysts, such as chocolate cysts, can cause adhesions in the female pelvic area. For instance, they may result in abnormal fallopian tube function, leading to infertility due to tubal factors. These cysts may also alter the pelvic environment, making conception difficult. If the ovarian cysts are malignant or capable of secreting hormones, they can also affect normal ovulation, leading to infertility.
What to be aware of during a functional uterine bleeding curettage?
When women experience dysfunctional uterine bleeding, if oral medical therapy is ineffective, diagnostic curettage can be used to stop bleeding and to understand the causes of the bleeding. Before undergoing curettage surgery, women should not have sexual intercourse within five days to avoid infections in the reproductive tract. During the curettage process, it is crucial to thoroughly scrape the entire uterine wall, especially the areas around the corners of the uterus. If any abnormal scrapings, such as dirty, greyish-white substances that resemble endometrial cancer, are encountered during the scraping, the procedure should be terminated immediately to avoid causing uterine perforation. For one month after the surgery, sexual intercourse, sitz baths, and swimming should be avoided to prevent infections in the reproductive tract.
How to treat cervical erosion?
Cervical erosion in women is considered a physiological phenomenon, and it usually does not require special treatment. Treatment is only necessary if the woman experiences contact bleeding or has particularly thick secretions that affect sperm passage. Treatment options include using traditional Chinese medicinal suppositories or physical therapies such as common cervical treatments like microwave therapy, cryotherapy, and electrocautery, all of which are very effective for cervical erosion. If the erosion is extensive, it may be necessary to perform cervical TCT and HPV tests to determine the presence of CRN lesions. If there are CRN lesions, such as middle to high-grade lesions, a cervical conization surgery might be considered.