Patient's question:
Increased leukorrhea, slightly yellow, pain during sexual activity.Doctor's answer:
If the above symptoms appear after acute pelvic genital organ inflammation, it can be considered as chronic adnexitis. Even without a history of acute illness, the presence of the above series of symptoms can highly suspect it. If only mild thickening of the parametrium without masses is found during examination, tubal patency testing can be performed. If it proves that the fallopian tubes are blocked, the diagnosis of chronic tubal patency testing can be basically established.(1) Abdominal pain: Lower abdominal pain of varying degrees, mostly a subtle discomfort, with aching, fullness, and a sense of heaviness in the waist and back, often aggravated by fatigue. Due to pelvic adhesions, there may be pain during bladder or rectal fullness or emptying, or other bladder/rectal irritation symptoms, such as frequent urination or tenesmus.
(2) Menstrual disorders: The most common are frequent menstruation and excessive menstrual flow, which may result from pelvic congestion and ovarian dysfunction. Chronic inflammation leading to uterine fibrosis, incomplete uterine involution, or abnormal uterine position due to adhesions can all cause excessive menstrual flow.
(3) Infertility: The fallopian tubes themselves may be damaged, leading to blockage and infertility, with secondary infertility being more common.
(4) Dysmenorrhea: Due to pelvic congestion, it may cause congestive dysmenorrhea. Pain usually begins one week before menstruation and worsens as the menstrual period approaches, until menstruation occurs.
(5) Other symptoms: Such as increased leukorrhea, painful intercourse, gastrointestinal disorders, fatigue, reduced tolerance to labor, or mental and neurological symptoms and depression.
(6) Physical examination:
1. Abdominal examination: Mild tenderness in both lower abdominal areas is common, with few other positive findings.
2. Gynecological examination: The cervix is often eroded or everted, with mucopurulent leukorrhea. The uterus is usually retroverted or retroflexed, with reduced mobility compared to normal. Moving the cervix or uterine body may cause pain. In mild cases, thickened fallopian tubes can be felt in both adnexa. In severe cases, irregular and fixed masses of varying sizes can be palpated in both pelvic sides or the posterior aspect of the uterus, often with tenderness. Thick-walled, adhesive masses are often abscesses, while thin-walled, high-tension, and slightly mobile masses are often hydrosalpinx.