SYMPTOMS

What is pelvic effusion?

When standing, due to the relatively low position of the pelvis, fluid may accumulate in the pelvic cavity, which is called pelvic effusion^[1]. Pelvic effusion is a symptom rather than a disease. The composition of pelvic effusion may include inflammatory exudate, follicular fluid, cyst rupture fluid, blood, etc. Based on pathological factors, pelvic effusion can be classified into physiological pelvic effusion and pathological pelvic effusion^[1].

What is physiological pelvic effusion?

Physiological pelvic effusion refers to the accumulation of fluids secreted by the peritoneum, greater omentum, and intestines in the pelvic cavity. These fluids usually serve to lubricate and protect organs and tissues^[1]. Since the pelvic cavity is relatively lower when standing, these fluids accumulate there, forming pelvic effusion. During ovulation, menstruation, or shortly after menstruation, small amounts of pelvic effusion may occur due to the release of follicular fluid or minor retrograde menstrual blood flow into the pelvis. These are normal phenomena, and patients typically experience no discomfort.

What is pathological pelvic effusion?

Pathological pelvic effusion is often secondary to conditions such as pelvic inflammatory disease, vaginitis, cervicitis, or endometriosis^[1]. It may also occur in patients with advanced ovarian malignancies, pelvic tuberculosis, or liver cirrhosis, as well as in cases of ruptured ovarian cysts, ectopic pregnancy rupture, or corpus luteum rupture. Patients often experience symptoms such as lower abdominal distension, abdominal pain, and abnormal vaginal discharge.

TREATMENT

How to Prevent and Alleviate Pelvic Effusion?

After first ruling out physiological causes, it is crucial to actively identify pathological factors and provide timely treatment.

Exercise for at least half an hour daily to improve cardiovascular function, boost immunity, and strengthen the body's defenses.

Maintain good personal hygiene and healthy habits. Pay attention to genital hygiene and practice moderate sexual activity (generally 1–2 times per week)^[2].

Stay optimistic and calm, avoiding extreme emotional fluctuations.

DIAGNOSIS

Does physiological pelvic effusion require a hospital visit?

Physiological pelvic effusion generally does not require treatment. If a small amount of pelvic effusion occurs after ovulation, during menstruation, or just after menstruation ends, without symptoms such as abdominal pain, increased discharge with odor, fever, or other discomfort, medical attention is unnecessary^[1].

When should pathological pelvic effusion prompt a hospital visit?

Pathological pelvic effusion requires timely medical treatment if the following abnormalities are observed:

• Obvious symptoms of pelvic inflammatory disease: Accompanied by lower abdominal discomfort or abnormal vaginal discharge, with noticeable lower abdominal tenderness or uterine motion tenderness during examination. (Note: Uterine motion tenderness refers to pain experienced by the patient when the doctor gently moves or lifts the cervix during a gynecological examination^[2].)
• History of ovarian cysts: Sudden pain on the side of the cyst, with ultrasound showing significant pelvic effusion. If ovarian torsion is suspected, immediate treatment is required even in the absence of pelvic effusion^[1].
• Early pregnancy stage: If intrauterine or ectopic pregnancy has not been confirmed, sudden lower abdominal pain on one side and ultrasound findings of an adnexal mass with pelvic effusion should raise suspicion of ectopic pregnancy rupture, requiring immediate treatment.
• Sudden lower abdominal pain during the mid-to-late menstrual cycle, rectal pressure (especially after intercourse or activity), with ultrasound showing pelvic effusion, suggesting corpus luteum rupture, requires further evaluation and management by a doctor.

POTENTIAL DISEASES

What are the possible causes of pelvic effusion?

• Poor personal hygiene during menstruation: The vaginal environment during menstruation is conducive to bacterial growth^[2]. Using unclean sanitary pads or toilet paper, or having sexual intercourse during menstruation can provide opportunities for bacterial proliferation, leading to pelvic inflammatory disease and the production of inflammatory fluid.
• Spread of inflammation from adjacent organs: Patients with appendicitis or peritonitis are prone to concurrent pelvic inflammation^[2]. Those with vaginitis, ascending infections, or cervicitis may also develop pelvic inflammation, resulting in pelvic effusion.
• Postpartum or post-abortion infection: After childbirth or abortion, the body's immunity is low. If personal hygiene is neglected, bacteria in the vagina and cervix may ascend, causing pelvic infection and subsequent effusion^[2].
• Postoperative infection in gynecological surgery: After procedures such as induced abortion, hysterosalpingography (tubal patency testing), or intrauterine device insertion/removal, infections may occur if surgical sterilization is inadequate. Poor postoperative hygiene or engaging in sexual activity too soon can also lead to pelvic infection and effusion.
• Other disease-related factors: Such as ectopic pregnancy, ovarian cyst rupture, corpus luteum rupture, or advanced malignant tumors.