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Pelvic Cyst

  Pelvic cysts are often caused by incomplete treatment of acute pelvic inflammatory disease and delayed healing. Due to long-term inflammatory stimulation, the surrounding tissues of pelvic organs become thickened and adherent, making it difficult for anti-inflammatory drugs to be effective. Therefore, the condition is stubborn, prone to recurrence, leading to a gradual decline in the patient's physical condition and slow recovery. Pelvic cysts belong to the gynecological diseases of traditional Chinese medicine, such as leukorrhea, mass and dysmenorrhea. The mass mainly originates from the reproductive organs of the pelvis, such as the ovaries, uterus, fallopian tubes, and other organs or tissues, such as the appendix, rectum, bladder, and retroperitoneal tissue. The location, size, hardness, mobility, tenderness, and relationship between the mass and surrounding tissues are very important for clinical treatment and prognosis. Pelvic cysts are often associated with recurrent infections of pelvic inflammatory disease. Patients with pelvic cysts should be treated early to prevent further growth or deterioration of the mass, which may affect fertility.

  The main symptoms of pelvic cysts in female pelvic structure are lower abdominal pain, low back pain, extreme fatigue, sexual dissatisfaction, dysmenorrhea, and premenstrual breast pain. The pain often worsens a few days before the menstrual period, and lessens on the first or second day after the period, and there are also a few cases that continue to hurt. The pain also worsens after standing, running, or sexual activity.

  If a pelvic cyst has cervical erosion, timely treatment is effective. Severe patients should persistently and seriously perform the kneeling chest position for more than 10 minutes from noon to evening, then rest in the lateral recumbent position, which can generally significantly alleviate or mitigate severe pelvic pain and other symptoms. If the lateral recumbent position therapy is effective but cannot be consolidated, surgical treatment can be considered. When choosing the surgical method, the patient's age, the need for fertility, the duration of symptoms, and whether there are organic lesions should be considered, and the surgical method should be selected accordingly. The round ligament suspension procedure, the broad ligament injury repair procedure, is suitable for young, infertile patients with severe pelvic congestion syndrome due to broad ligament injury. Total abdominal hysterectomy and salpingo-oophorectomy is suitable for women over 40 years old.

Table of Contents

1. What are the causes of pelvic cysts
2. What complications can pelvic cysts easily cause
3. What are the typical symptoms of pelvic cysts
4. How to prevent pelvic cysts
5. What laboratory tests are needed for pelvic cysts
6. Dietary taboos for patients with pelvic cysts
7. The routine method of Western medicine for the treatment of pelvic cysts

1. What are the causes of pelvic cysts

  Pelvic cysts are often associated with recurrent infections of pelvic inflammatory disease. Due to long-term inflammatory stimulation, the surrounding tissues of pelvic organs become thickened and adherent, making anti-inflammatory drugs difficult to be effective. Therefore, the condition is stubborn, recurrent, leading to the patient's physical condition becoming weaker day by day and recovery being slow. Because the formation of cysts is due to severe adhesions after pelvic surgery or inflammatory injury, the exudate of fibrin is organized and adherent, encapsulating the tissues of the fallopian tube and ovary with secretory function, causing the secretory fluid and exudate to gradually accumulate in the space between adhesions, expanding into a single cystic cavity.

  Physiological pelvic fluid is produced by the ovary, as the ovarian hormones in peritoneal fluid are mainly estrogen. If the peritoneum is infected or damaged, its absorption ability decreases, and the fluid secreted by the ovary may be encapsulated by the surrounding scarred peritoneum, forming a pelvic pseudocyst. The injury to the pelvic peritoneum after pelvic surgery (hysterectomy) can cause or lead to postoperative pelvic adhesions, or incomplete hemostasis during surgery can lead to postoperative pelvic hematoma, which are the main reasons for the formation of postoperative pelvic cysts.

2. What complications can pelvic cysts easily cause

  Pelvic cysts rarely cause clinical complications. Only pelvic cysts that occur after hysterectomy may lead to complications such as adnexal fluid collection, ovarian tumor, and ovarian chocolate cyst. Hysterectomy is a common surgical method in gynecology, used to treat benign gynecological tumors. After hysterectomy, pelvic cysts can present with various pathological conditions such as adnexal fluid collection, ovarian tumor, and ovarian chocolate cyst. How gynecologists correctly handle pelvic cysts after hysterectomy is a common clinical issue.

3. 3

  What are the typical symptoms of pelvic cysts?

  Pelvic masses in young girls and postmenopausal women are often ovarian malignant tumors; the masses in adolescent girls may be due to congenital malformations of the reproductive tract or malformations causing menstrual flow obstruction; women of childbearing age between 20-30 years should first consider pregnant uterus, ectopic pregnancy, or pelvic inflammatory mass; women between 30-40 years are more likely to have uterine fibroids or ovarian chocolate cysts; in addition, ovarian tumors can occur in women of any age. The clinical characteristics of pelvic cysts are as follows:

  (1) During the operation, most of the cysts are wrapped around surrounding organs, and in severe cases, the pelvis appears to be sealed and frozen. The base of the cyst has no pedicle, and during separation, the cyst has no obvious capsule, the cyst wall has no layers, and it can gradually thin and break down layer by layer, and sometimes the ostium of the fallopian tube fimbria can be seen inside the cyst cavity.

  (2) Many patients seek medical attention due to 'infertility'.

  (3) Ultrasound often shows: 'There are light bands separating the cysts inside'.

  (4) During the examination, the cysts often feel smaller than those shown by ultrasound, and the boundaries are unclear, with the cysts being fixed. They are soft and have low tension, often more than 10cm in size.

  (5) There is a history of lower abdominal surgery or inflammation many years ago or in childhood.

  (6) It is impossible to determine the tissue source by removing the cyst wall tissue for pathological examination.

  (7) Cysts are more common on the left side.

  (8) Antibiotic treatment has no significant effect, and sometimes it can slightly shrink.

4. How to prevent pelvic cysts?

  Pelvic cysts are often caused by incomplete treatment of acute pelvic inflammatory disease and subsequent delay. Due to long-term inflammatory stimulation, the surrounding tissues of pelvic organs become thickened and adherent, making it difficult for anti-inflammatory drugs to be effective, thus the condition is stubborn, recurrent, and leads to a gradual decline in the patient's physical condition and slow recovery. Pelvic cysts often occur with recurrent infections of pelvic inflammatory disease. Patients with pelvic cysts should seek early treatment to prevent further growth or deterioration of the mass, which may affect fertility. Prevention is better than treatment, so how can pelvic cysts be prevented? The following experts introduce the preventive measures for pelvic cysts.

  (1) Avoid high levels of tension and mental stimulation, and maintain an optimistic mood and sufficient energy.

  (2) It is important to frequently change underwear and avoid wearing tight or synthetic fiber underwear. Chronic pelvic inflammatory disease patients can benefit greatly from traditional Chinese medicine enema treatment, which has the effects of promoting blood circulation, removing blood stasis, softening hard lumps, dispersing nodules, clearing heat and detoxifying, or warming the uterus and dispersing heat. Nursing staff should use good language, a warm, amicable, and sincere attitude to communicate with patients, and assess the patient's psychological state by combining subjective and objective data. For existing psychological problems, guidance, persuasion, and comfort should be provided to enhance the patient's confidence in recovery and actively cooperate with treatment.

  (3) Strictly follow the doctor's advice on medication, and ensure timely and thorough treatment. The disappearance of symptoms does not mean complete cure. Continue to consolidate treatment for a period of time, and only when all indicators are normal can it be considered cured.

  (4) During menstruation, after abortion, and after the insertion or removal of the intrauterine device, vaginal bleeding may occur. It is strictly forbidden to have sexual intercourse, swimming, taking a bath, or taking a sauna bath. Change sanitary napkins frequently, as the body's resistance is low at this time, and pathogenic bacteria are easy to take advantage of and cause infection.

  (5) Do a good job of contraception, try to reduce induced abortions, and avoid unclean sexual life. Eliminate various infection routes, keep the perineum clean and dry, wash the external genitals with clean water every night, and use separate basins for each person.

  (6) Strengthen physical exercise, improve body resistance. Appropriate physical exercise is conducive to enhancing physical fitness, improving blood circulation, and accelerating the absorption of inflammation. Pay attention to changes in weather, prevent a decrease in body resistance due to cold, and induce infection.

5. What laboratory examinations are needed for pelvic cysts

  How to examine pelvic cysts? Pelvic cysts are a kind of gynecological tumor in women, and their incidence rate has been increasing in recent years, causing great distress to women. If pelvic cysts are not discovered and treated in time, they may worsen and ultimately harm life safety. So, how should pelvic cysts be examined? The following experts introduce the specific examination methods for pelvic cysts.

  1. Examination: Ultrasound examination to check for masses.

  2. Examination and analysis of pelvic cysts: pregnancy test, whole digestive tract X-ray, hysterosalpingography, intravenous pyelography, ultrasound diagnosis or CT, MRI, and in some special cases, abdominal puncture, laparoscopy, laparotomy, and other methods.

  3. Self-examination method: frequent urination, but without pain or urgency, or with constipation, feeling an enlarged lower abdomen, tight pants waist. A mass can be felt in the lower abdomen, especially clear in the morning, and disappear after urination.

6. Dietary taboos for patients with pelvic cysts

  The diet of patients with pelvic cysts should be light, and the diet should be rich in sufficient nutrition. Suitable foods include milk, spinach, yam, cabbage, rapeseed, mushrooms, lean meat, eggs, crucian carp, apple, pear, jujube, peanuts, black rice, and so on.

  Patients with pelvic cysts should correct their偏食 and abnormal eating habits, and should not often eat刺激性 foods such as crab, hairtail, crucian carp, goose meat, dog meat, chili, green onions, garlic, longan, tangerine, and other fruits and vegetables.

7. The conventional method of Western medicine for treating pelvic cysts

  Common pelvic cysts are often seen in ovarian tumors, which can occur at any age, but the histological type of the tumor may vary. Epithelial ovarian tumors are more common in women aged 50 to 60, while germ cell ovarian tumors are more common in young women under 30. The ovary is located deep in the pelvic cavity, and early lesions are not easy to detect. Once symptoms appear, they are mostly late-stage and should be highly vigilant. They can be divided into epithelial tumors, germ cell tumors, sex cord stromal tumors, and metastatic tumors. So, how to treat pelvic cysts? The following experts introduce the treatment methods for pelvic cysts.

  First, Benign Tumors

  Surgical treatment, including laparotomy and laparoscopic surgery, even vaginal surgery to remove the tumor.

  Second, Malignant Tumors

  (1) Surgical Treatment

  1) Comprehensive staging laparotomy.

  2) Re-staging surgery: Refers to the first surgery not being performed for accurate staging. Comprehensive exploration without medication and completion of accurate staging.

  3) Tumor cell reduction surgery: Make every effort to remove the primary tumor and all metastatic tumors, so that the diameter of the residual cancer focus is

  4) 'Intermediate' tumor cell reduction surgery: For some advanced ovarian cancers that are estimated to be difficult to completely remove, several courses (less than 6 courses of non-whole courses) of chemotherapy are first administered, followed by tumor cell reduction surgery. It may facilitate the tumor reduction surgery, for large tumors, fixed, with a large amount of ascites, preoperative 1-2 courses of chemotherapy are first administered, known as preoperative chemotherapy, to reduce ascites, shrink the mass, loosen it, and improve the quality of surgery.

  5) Repeated tumor cell reduction surgery: Refers to surgery for residual tumors or recurrent tumors, but if there are no effective second-line chemotherapy drugs, the value of the operation is limited.

  (2) Chemotherapy

  1) Indications: Chemotherapy is an important treatment measure for advanced ovarian cancer, and it must be timely, adequate, and standardized. Chemotherapy guarantees the efficacy of surgery, and the two methods are indispensable. For ovarian malignant tumors except for high-grade differentiated tumors (ⅠA), all those in stage ⅠB and above should receive adjuvant chemotherapy after surgery. Chemotherapy should also be considered for stage ⅠA with pathological grade 3 (G3).

  2) Common Chemotherapy Regimens: There are many chemotherapy regimens for the treatment of ovarian cancer, and different regimens should be selected according to the pathological type of the tumor. It is generally believed that combination chemotherapy is superior to monotherapy, and combination chemotherapy is usually adopted.

  3) Chemotherapy Routes and Duration: Chemotherapy routes should mainly be systemic chemotherapy (intravenous or oral), and can also be combined with intraperitoneal chemotherapy, arterial catheter chemotherapy, or interventional chemotherapy.

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