When our body feels unwell, we naturally think of going to the hospital to see a doctor, but what about when the body is not unwell? The health examination is aimed at the "healthy people" who usually have no self-conscious symptoms.
Now many units have arranged the benefits of health examinations for employees, under the annual health examination, there are always people who find some problems of large or small, and even a small number of people are found to have early cancer or precancerous lesions. This is the meaning of health screening:
It uses the form of screening to detect potential causative factors, early lesions and functional abnormalities in the early clinical stage of disease incubation and asymptomatic, so as to achieve early intervention for pathogenic factors, early detection, early diagnosis and early treatment of early lesions.
I work in the obstetrics and gynecology department, and every year when it comes to the census of women's diseases, I am always busy for a while, and the women who have problems with the physical examination are both worried about their diseases and glad that they can be treated in time before the disease worsens. So, what do the descriptions on women's health checkups represent?
Cervical Naartens cyst
The first stop of the gynecological physical examination is the routine physical examination, and the doctor understands the general situation of the patient through naked eye observation and internal consultation touch. For example, whether there are vegetations in the vulva, whether the vagina is hyperemic, whether there is atrophy, whether the vaginal discharge traits are normal and whether there is odor, whether there are no vegetations in the cervix, whether there are erosion-like changes, whether the size, shape and texture of the uterus are normal, whether there are no lumps in the appendages, whether there is tenderness, etc.
Many patients ask me worriedly when treating other diseases: During the physical examination, the doctor said that I had a cyst in my cervix. Do I need treatment?
The term cyst doesn't sound particularly friendly, but this "cyst" on the cervix is very kind. The cervix is the outlet of the uterus, protruding downwards deep into the vagina, and is a cylinder with a channel in the middle. There are mucus-secreting glandular ducts in the cervix, and the outlet of the glandular ducts in some special places is blocked by newborn cervical epithelial cells, resulting in the inability to discharge the mucus secreted inside, and the retention forms a cyst, the so-called "Nea's cyst". It is the result of physiological changes, does not mean that there is any inflammation, and generally does not require treatment.
Schematic diagram You can feel that on the left is a normal cervix and on the right is a Cervical Naartens cyst.
Cervical erosion-like changes
It is also the "cervical erosion" of the past. With the advancement of medicine, people have long realized that the so-called "cervical erosion" is not equivalent to the real erosion of ulcers, and may only be physiological changes.
Physiological "cervical erosions" do not need treatment, but inflammatory stimulation can also lead to erosion-like changes, this change is pathological, need to be treated, CINIII level (including cervical intraepithelial neoplasia of severe atypoverty and carcinoma in situ) the appearance is also very similar to "cervical erosion", in order to exclude malignant lesions, doctors often recommend further examination.
The WHO advocates that all women over the age of 18 who have sex should have a cervical smear cytology once a year.
Cervical scraping was once an important method of screening cervical cancer, scraping off exfoliated cells on the surface of the cervix through a small wooden board and then smearing it. However, due to the small number of cells obtained, poor tableting, and easy to cause false negatives, it has now been replaced by a more efficient thin-layer liquid-based cytology technique – that is, the TCT test routinely included in the physical examination program.
Traditional pap smear examination.
The sensitivity of TCT for high-grade cervical lesions can be as high as 85% to 90%, which is of great significance for screening cervical cancer and precancerous lesions. HPV DNA testing is also sometimes present in physical examinations because high-risk HPV infections are closely related to the development of cervical cancer and can help determine how to deal with epithelial cell lesions that do not have a clear meaning.
Cervical cancer is easy to find in the early stage of physical examination, regular physical examination, early detection, cervical cancer is not difficult to cure. Maybe originally, Mei Gu could have been singing and acting until now...
Manifestations of different stages of cervical cancer, the leftmost is the normal cervix, and the right is aggravated sequentially.
Uterine fibroids
Ultrasound examination is also an essential part of the health examination, so I have to say about uterine fibroids.
Uterine fibroids are so common that 20% of women over the age of 30 have uterine fibroids, and because small fibroids are mostly asymptomatic, the actual incidence may be much higher than 20%. Uterine fibroids are the most common benign tumors of the female genitalia, and the chance of malignancy is very small, so if the uterine fibroids are found, they do not have to be too nervous, and only when the uterine fibroids grow to cause excessive menstruation, prolonged menstruation or even long-term blood loss and anemia, or frequent urination, urgency, bloating, constipation and other compression symptoms, or infection, degeneration and other complications, there is a need for treatment.
Asymptomatic microfibroids can be followed up every 3-6 months and do not require special treatment. Especially in women close to menopause, fibroids can atrophy or even disappear after menopause.
Ovarian cyst
This is a very big topic, the tissue composition of the ovaries is very complex, it is the organ with the largest number of primary tumor types in various organs in the body, and the structure and outcome of different types of ovarian tumors are very different. Ultrasound examination is the easiest way to find ovarian tumors, and benign tumors of the ovaries are often found incidentally during health checkups because of their small size and no symptoms.
The left side is a normal ovarian and the right side is an ovarian cyst.
Ovarian cysts sometimes have physiological cysts that are frightening, mostly follicular cysts or luteal cysts. Doctors who encounter this cyst, which may be physiologically altered, will generally recommend that they be reviewed after a period of time, because it will disappear automatically within 2 to 3 months.
However, if the re-examination does not disappear, or even becomes larger, it is considered to be an ovarian tumor. Benign ovarian tumors generally grow slowly, mostly on one side, smooth, good mobility, clear boundaries, and can often be seen inside a bag of water during surgery. Malignant tumors grow rapidly, mostly bilaterally, with irregular shapes and poor mobility. Tumors are often solid or cystic, often accompanied by ascites, and common manifestations of malignant tumors such as significant wasting, fatigue, and mental decline.
When I think of ovarian cysts I think of bubbles and then worry that it will burst...
Once the ovarian tumor is diagnosed, surgery is recommended, on the one hand, to remove the lesion, on the other hand, it is also to clarify the diagnosis, if it is a benign tumor, there is nothing to worry about, if it is a malignant tumor, not only the scope of surgery needs to be increased, but also further radiotherapy and chemotherapy and long-term follow-up monitoring may be required after surgery.
All in all, an annual gynecological physical examination is still necessary. Although it is a natural law of life, old age, illness and death - none of you want to die early, do you? If the disease can be detected and treated early, the benefits of existing medical technology can be maximized.
Author: Flying knife breaks the rain
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