Patient's question:
Medical history and treatment outcomes:On November 22, 2005, a D&C (dilation and curettage) was performed, along with the presence of first-degree cervical erosion. The vaginal discharge test results showed: white blood cells >10, Gram-negative bacteria positive, and Ureaplasma urealyticum positive. After the surgery, intravenous drips were administered for several days, along with one or two vaginal suppositories and medication for over a decade. Later, a follow-up examination revealed: no growth of mycoplasma in bacterial culture, a smooth cervical surface, 5-10 white blood cells, and fewer Gram-negative bacteria. Subsequently, medication was administered three more times (consolidation + health care).
Due to sexual activity within the first month after the surgery, a transvaginal ultrasound examination was conducted on December 29, revealing anechoic areas in the pelvic cavity measuring 2.62.8 cm, with the uterine cavity in the central position and the uterine wall returning
Doctor's answer:
Hello: The treatment includes the following points:1. General treatment: Alleviate patients' concerns, boost confidence in treatment, improve nutrition, exercise regularly, maintain a balance between rest and activity, and enhance the body's immune resistance.
2. Chinese medicine treatment: Chronic pelvic inflammation is mostly of damp-heat type, with the primary treatment principle being clearing heat and draining dampness, as well as invigorating blood circulation and resolving stasis. The herbal formula includes: Salvia miltiorrhiza 18g, Paeonia lactiflora 15g,angelica sinensis 12g, Persicae Semen 9g, Lonicera japonica 30g, Taraxacum mongolicum 30g, Poria 12g, Moutan Cortex 9g, and Rehmannia glutinosa 9g. When pain is severe, Corydalis ternata 9g can be added. Some patients may have a cold congealing and qi stagnation type, with the treatment principle being warming the meridians, dispersing cold, and promoting qi circulation and blood flow. Commonly used is modified Guizhi Fuling Decoction. For qi deficiency, add Codonopsis pilosula 15g, Atractylodes macrocephala 9g, and Astragalus membranaceus 15g.
3. Physical therapy: Warm stimulation can promote local pelvic circulation, improve tissue nutrition, enhance metabolism, and facilitate the absorption and resolution of inflammation. Common methods include shortwave, ultrashortwave, iontophoresis (which can be combined with various drugs such as penicillin and streptomycin), and paraffin therapy.
4. Other medications: When using anti-inflammatory drugs, α-chymotrypsin 5mg or hyaluronidase 1500U can be administered intramuscularly, once every other day, for 5–10 sessions as a course, to aid in the absorption and resolution of adhesions and inflammation. In cases of local or systemic allergic reactions, the medication should be discontinued. In certain situations, antibiotics may be used concurrently with dexamethasone, with oral dexamethasone 0.75mg administered three times daily. When discontinuing, the dosage should be gradually reduced.
5. Surgical treatment: If there are masses such as hydrosalpinx or tubo-ovarian cysts, surgical intervention may be performed.