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Post TLH and BSO. Observed vaginal white discharge, yeast infection and urine infection. Suggest the treatment?

Mar 2013
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Practicing since : 1998
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post TLH & BSO vaginal white discharge observed after 5 days of surgery, yiest infection medication(oral & vaginal application) executed after completion of medication course discharge increased in colorless watery form and continued, in addition urine infection observed therapy running till date...
patient data sheet . Name—Mousumi Sen Sex—Female Age—46( DOB-04/05/1967)
Blood group—A +ve
Issue -- one son only. DD-- 23rd may 1987
BP- normal BS—normal(glycated hemoglobin 5.8%), PP(glucose 75g) 150mg/dl
Allergy --- Sulphur drugs & steroid.

Thyroid problem—T3 & T4 normal against high TSH medicine—75mcg eltroxin

Nonfunctioning goiter with Cold cystic nodule at left lobe of thyroid gland as per USG , FNAC & Tc99m Scan
Presently about 2months an uncomfortable feel of a moving(up and down) hard bead below right lobe of thyroid gland.

TLH& BSO with specimen removal by Morcelation done on 30th Aug 2013
Doctor’s Discharge note in attachment.
Note -- all instruction followed except HRT (1 tab Livial 2.5mg daily) yet to be started.
Reason—patient’s grand mother(maternal) breast cancer in history.
post surgery specimen histology report--
uterus-- liomyoma
cervix--- chronic cervicitis
ovaries-- small follicular cyst
Posted Fri, 25 Oct 2013 in Vaginal and Uterus Health
Answered by Dr. Aarti Abraham 30 minutes later
Brief Answer:

Detailed Answer:
Thanks for writing to us with your health concern.
Some amount of watery discharge is common after surgery.
This is normal as long as there is no itching, bad odour or crampy abdominal pain.
Please complete the therapy for the urine infection.
You are justified in not starting the HRT given the high family history risk of breast cancer.
The biopsy report is absolutely normal, and shows leiomyoma, which is a benign tumour of the uterine wall.
There is no indication of any malignancy ( cancer ) in the report.
As the surgery has taken place less than a month ago, I hope the stitches have been removed.
I hope you have had follow up visit with your surgeon to evaluate the stitches and the healing of the tissues post surgery.
The patient should take good rest for 6 weeks after surgery, avoid stress, intercourse, exertion, lifting heavy weights etc.
Apart from that, your history is fine with no alarming factors.
Please do ask me any specific questions if you wish to.
All the best.
Looking forward to hearing from you.
Take care.
Above answer was peer-reviewed by
Follow-up: Post TLH and BSO. Observed vaginal white discharge, yeast infection and urine infection. Suggest the treatment? 21 hours later
Thanks for your answer
Further query
, the watery discharge does not have any bad ordure , itching is occasional at low frequency may be 3/4 times a day
no sediment/deposits observed till yesterday, today thin layer of whitish deposit observed
no crampy abdominal pain till date
pl confirm if the discharge relates to yiest .or fungal infection?
or if any correlation with Ph imbalance ?
suggest respective therapy if possible. also instruct do s/donot s if medication enhances the problem.
how long patient safe if infection persists?
Answered by Dr. Aarti Abraham 1 hour later
Brief Answer:

Detailed Answer:
The discharge does not appear to be related to any infection as there is no particular itching / bad odour.
Yeast / fungal inspection can be confirmed only by actually looking at the vagina, and confirmed by doing swab testing.
Infections after hysterectomy are more common as the normal vaginal flora and pH gets disturbed due to hormonal deficits.
However, with proper care, they can be avoided.
Keep the area clean.
Wash thoroughly daily gently with lukewarm water.
Hot sitz bath with gentle disinfectant solution can be done.
Good nutritious diet will help, yoga can be done in moderation.
The patient is quite safe , as there is no major fever / malodourous discharge etc.
However, if you havent had a post operative check up, then make sure that is done immediately.
I would be glad to assist you with any further queries.
Take care.
Above answer was peer-reviewed by
Follow-up: Post TLH and BSO. Observed vaginal white discharge, yeast infection and urine infection. Suggest the treatment? 2 days later
thanks again for your reply.
patient is also suffering from cystitis. two times urine c/s based antibiotic course as prescribed by doctor completed. problem repeats from4th to 7th days post instruct/prescribe the needful.
Answered by Dr. Aarti Abraham 13 hours later
Brief Answer:

Detailed Answer:
Repeated urinary tract infection , for this please do the followin g-
1. Please have complete blood sugars tested - fasting blood sugar, post prandial blood sugar, glycosylated hemoglobin .
2. Ultrasound abdomen of the urinary tract and kidneys.
3. Plenty of water daily at least 5 - 6 litres.
4. Consider taking HRT ( due to local dryness ( atrophic vaginitis ).
Take care.
Above answer was peer-reviewed by
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