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Why am i bleeding after the removal of polyp from the uterus?

Mar 2013
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Practicing since : 1998
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12/9/13- a large polyp removed from the uterus 1/8/14 - discharge and pain at the lower abdomen 1/28/14- ultrasound revealed distended uterus with fluid 1/3014- drained the fluid (old blood) from the fluid 1/31/14- pain and fresh spotting of blood 2/1/14- increased pain 2/2/14- discharge of old and fresh blood 2/3/14- large amount of discharge, fresh blood almost looked like the period (I am postmenopausal) 2/4/14 to 2/7/14- continue to have pain but minimum spotting. I have lower abdominal pain every day, but spotting or discharging sporadically. I was told that the pain is from the blood going through the cervix (it is tight and small). My doctor wants me to be patient and wait, but did not tell me what I am waiting for, and I am not getting better. There is not a course of follow up set up to monitor my condition. I need to know: 1. Is this course of recovery normal? 2. Why am I still bleeding 2 months after surgery? 3. What should I do next?
Posted Sat, 1 Mar 2014 in Vaginal and Uterus Health
Answered by Dr. Aarti Abraham 1 hour later
Brief Answer: EXPLAINED BELOW Detailed Answer: Hello Thanks for writing to us with your health concern. To answer your questions - 1. No, the course of recovery is not normal. If just a polyp was removed, then the post operative course is not normal. 2. The cause for your bleeding may be one of many. Firstly, in the post menopause, the cervix gets stenosed ( tightened and closed ). If there is some reason for bleeding inside the uterus, the blood gets pent up ( hematometra ) and then comes out in spurts. The reasons for post menopausal bleeding are - endometrial hyperplasia ( thickening of the lining of the uterus ), fibroid, polyp or malignancy of the uterus. It could also be a similar lesion inside the cervix itself. 3. What you should do is this - If possible, please upload the ultrasound report and send it across to me, it will provide me more information. Next, please let me know the report of the biopsy of the polyp - that will also pinpoint the cause. Next please have a formal internal evaluation - per vaginum and per speculum, alongwith an endometrial and cervical biopsy if required. For the stenosed cervix, a plastic tube ( stent ) might be left in situ to let the collected and fresh blood drain through it. Do not neglect or wait over it - such amount and type of post menopausal bleeding is ominous. All the best. PLease feel free to discuss further. Will be awaiting your reports. Take care.
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Follow-up: Why am i bleeding after the removal of polyp from the uterus? 48 hours later
Dear Dr. Abraham: 1. Could you send me your e-mail address so I can forward you my ultrasound report? (I cannot find a way to upload the report on the dashboard) 2. The biopsy of the polyp showed no malignancy. 3. I had an internal vaginal exam on 1/16/14 and it was normal (but the ultrasound on 1/23/14 showed distended endometrial cavity with hematometrium.) 4. I had a genital culture on 1/23/14 with normal genital flora with no pathogens isolated after 24 hours. I had the fluid drained on 1/30/14, should I have it done again?
Answered by Dr. Aarti Abraham 5 minutes later
Brief Answer: EXPLAINED BELOW Detailed Answer: Hello XXXXXXX Good to hear from you again. 1. You can email the report ( s ) at - YYYY@YYYY . It will reach me. 2. If the polyp was non malignant, there is no reason for you to bleed like this. It must have shown some hyperplasia atleast. Can you please upload the biopsy report too, not that I doubt your interpretation, just that I MIGHT find more meaning there. 3. I would appreciate the ultrasound report being uploaded too. 4. The hematometrium was drained, of course this time around too it should be done, but the cause for the bleeding should be ascertained. At this age, with the polyp removed , if it was the only pathology, there should be no re bleeding, of the nature and amount described by you. Something is being missed here Please do get back.
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Follow-up: Why am i bleeding after the removal of polyp from the uterus? 29 minutes later
Dr. Abraham: 1. I just e-mailed you the ultrasound report. 2. I don't have the polyp biopsy report and will have to get it either from the hospital or the doctor's office. As soon as I get them, I will e-mail you. 3. I did not have an endometrial and cervical biopsy. 4. I don't have much blood discharging, but I have a dull and constant abdominal pain and feeling of bloated. 5. a very small piece of blood discharged Friday evening and that gave some relief of pain for about one day.
Follow-up: Why am i bleeding after the removal of polyp from the uterus? 1 minute later
Also, could my doctor cut away too much when he removed the polyp? He commented that it was a challenging operation and the polyp was larger than originally thought (although the measurement of the polyp was in the pre-op ultrasound report, so the size was known.)
Answered by Dr. Aarti Abraham 12 hours later
Brief Answer: EXPLAINED BELOW Detailed Answer: Hello 1. I received the email. The uterine fibroids are quite small, not big enough to warrant the heavy bleeding. 2. Will await the biopsy report. 3. You should have an endometrial biopsy and cervical evaluation. 4. The pain could be again due to retained blood, have a repeat evaluation and drainage as required. 5. Maybe because of the tight cervix, blood leftover due to the difficult polyp surgery got accumulated. Twice over is rare, but apart from the drainage and the evaluation that is left over, there is nothing much to be done, without looking at the biopsy report. All the best. Please feel free to discuss further.
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