Brief Answer:
Thoughts on this

Detailed Answer:
Hello Ms. XXXXXXX

It's possible that the pressure generated from coughing caused a tear along the scar from the past surgery, if it is definitely coming from the vagina and not the bladder.

The tear may be small. There may be small blood vessels at the scar site that are weaker and more prone to bleeding if they are stressed.

I recommend that you go in to have a pelvic exam - both a speculum exam to see where the bleeding is coming from, and a bimanual exam to try to find the location of the pressure feeling and check if there are any abnormalities on palpation.

Depending on how strong your symptoms are, you can wait to see your doctor, if he or she is in tomorrow. Or you can go in to an urgent care clinic today. If you have any further signs of bleeding, I recommend the urgent care.

If you do go in to the urgent care, I have 2 pieces of advice:
1. Request specifically to see a doctor. Many places now save money by staffing mostly with PA and NPs. They do not have the depth of knowledge or training a doctor does.
2. Don't touch your eyes, nose, or mouth until you have come home and thoroughly washed your hands and alcohol wiped your phone and any thing else you may have handled while there. There are a lot of germs at an urgent care, including flu right now.

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Brief Answer:
Information

Detailed Answer:
One way to differentiate: you can ask the clinic to do a urinalysis, and put in a tampon so that bleeding from the vagina does not entire the urine specimen. If you don't have tampons anymore, most clinics can provide one.

Also, if there is bleeding from the vagina, they will most likely be able to see that during speculum exam.

For figuring it out on your own, it can be harder. Usually pink trace bleeding from the vagina has a bit of mucus in it where blood from the bladder does not, but that is not always reliable.

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