How many ＂soul three questions＂ have you met that make gynecologists feel ashamed？
Original Liang Weifeng Medical Obstetrics and Gynecology Channel
This article involves professional knowledge and is only for medical professionals to read.
An article to answer your questions
Just after the New Year, we must never forget the soul of our relatives and friends: "Did you get a raise?" Have you found someone? Have you bought a house? "
Whenever I encounter this problem, I can only talk awkwardly.
However, in the daily work of gynecologists, patients are often asked "three questions about the soul".
01
The first question of the soul: heterogeneous uterine echo? It’s over, is it a tumor!
Before answering this question, we need to find out another question, is there a homogeneous uterus on ultrasound?
The uterus is our first warm home in this world, and its structure is like a palace, surrounded by thick uterine walls, with the "uterine cavity" as the cradle of life in the middle.
The uterine wall is divided into three layers, the outer layer is serosa, which is a thin peritoneum; The middle layer is a thick muscular layer composed of smooth muscle, and there are blood vessels running through it. The inner layer is mucous membrane, that is, endometrium, which will fall off periodically with the change of female hormones.
Ultrasound is a kind of sound wave with vibration frequency greater than 20000Hz, which can spread in human body. Different human tissues have different abilities of reflecting, absorbing and scattering ultrasound. According to this physical characteristic, scientists have developed ultrasonic instruments.
Because the uterus is a three-layer structure formed by different tissues, it reflects sound waves differently, and finally the image it presents on the ultrasonic display screen has different shades of gray, which will not look very uniform.
Therefore, uneven uterine echo does not mean that you have a tumor, just like there are no identical leaves, no husband and wife with identical views, and no completely homogeneous uterus on ultrasound!
02
The second question of the soul: Pelvic effusion, did you get pelvic inflammation without washing it last time?
Brother Baoyu said that "women are flesh and blood made of water", which is scientifically explained in medicine!
The human body contains a large amount of liquid, which is called "body fluid" in medicine. The content of body fluid varies between different sexes and ages.
The body fluid content of adult women has reached about 50% of their own weight. According to the principle of "rounding off", it is not an exaggeration to say that women are made of water!
Body fluids are distributed almost anywhere in the body and play a vital role in maintaining the balance of water and electrolyte, so your pelvic cavity will not be a "dry desert". Every cup of coffee and milk tea you drink will flow into the pelvic cavity more or less in the form of body fluids.
Water flows downwards, and the female pelvic cavity is shaped like a sober-up device with a wide bottom and a thin waist. No matter whether you are lying or standing, the pelvic cavity is always the lowest place, and body fluids will accumulate at the bottom of the pelvic cavity to form pelvic effusion.
Image source network
Therefore, in most cases, pelvic effusion is not pelvic inflammation, and it has little to do with your slapping. Medically, pelvic effusion with a depth of less than 3 cm found by ultrasound is usually a physiological phenomenon without any discomfort symptoms, so follow-up observation is good.
A woman’s face is inseparable from water. Since you can accept that your face is as bright as jade and your heart is like water, you can also accept pelvic effusion with a size of < 3 cm.
03
The third question of the soul: ovarian cyst, is it ovarian cancer?
If the uterus is the cradle of life, then the ovary is the source of life.
When a woman is born, she brings her own "million possessions", that is, 1 million to 2 million primordial follicles in the ovary.
Starting from adolescence, the primordial follicles in the ovary are constantly developing and maturing under the action of hormones, and one mature follicle will be discharged in each menstrual cycle, and in some cases, two or more follicles will be discharged.
One of the signs of follicular maturation is that the "head" grows to about 2cm. If the follicle does not ovulate or atresia occurs after maturity, the follicle will grow bigger and bigger, forming a follicular cyst with a diameter of 3-5cm.
After the mature follicles are discharged, the "follicular fossa" on the ovary is wrapped by the surrounding tissues, forming a yellow corpus luteum. If the egg is not fertilized, the corpus luteum will naturally shrink after 2 weeks. If the corpus luteum does not shrink within 2 weeks, it will continue to grow up under the action of sex hormones, forming a corpus luteum cyst of 3-5cm.
Follicular cyst and corpus luteum cyst are the general names of most ovarian cysts in ultrasonic reports. Most of them belong to physiological cysts, which can disappear by themselves within 2 months without treatment.
Therefore, even if an ovarian cyst is found under ultrasound, it is not necessarily an ovarian tumor.
If the color Doppler ultrasound indicates a simple cyst of 3-5cm, don’t rush to operate. Follow up for 2-3 months for a short time, and check the gynecological ultrasound 3-7 days after menstruation to see if the cyst will disappear on its own.
If the cyst persists for more than 2-3 months, especially accompanied by abdominal distension, pain, menstrual changes and other clinical symptoms, it is necessary to consult a professional doctor about the need for surgical exploration.
Life is always full of surprises and accidents!
One day, when Jiemei earnestly explained the soul question of gynecological ultrasound to a well-dressed and fragrant patient, she suddenly threw out the ultimate question of the soul of gynecological ultrasound!
"Feelings Today, I had a hard time. I asked for leave, spent money and took time. Finally, you told me that it was all right! Then did I do this color ultrasound for nothing? So are you over-examining? And why do I do color ultrasound, there is no color on the report, and even the pictures are black and white? "
Universal circle of friends, who can tell me the answer to this ultimate question, online, etc …
References:
1. Ding Wenlong, Liu Xuezheng. Systematic Anatomy [M]. 9th Edition. Beijing: People’s Medical Publishing House, 2018.
2. Is ovarian cyst cancer? Do you need treatment? —— Wang Baojun of Beijing Maternity Hospital
This article starts: medical obstetrics and gynecology channel
Author: Liang Weifeng, Qilu Hospital, Shandong University
Editor in charge: Sweet
Original title: How many "Three Questions of the Soul" have you met? 》
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