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Keloid scar of the episiotomy and its treatment - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Infections
Answered by

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
User :   I am 39, have had 3 babies since 2006 and one epesiotomy. I noticed this about 3 months ago.. and have never had this problem before. I had the epesiotomy with my 1st son in march2006. I notice pain swelling and frequent bleeding in the scar area.. but i let it go as irritation maybe from wiping so much or the way i sat on toilet. Then i notied a knot as i was washing in the shower to the right a few inches.. so i got worried.. a day or so later i decided to look because it felt like it could pop when i had a bowel movent and there were two pustules and i popped them and puss and infection and water came out. I waited to see if itwould go away, but the knot was still there but where one of the pustules were, there is a tiny hole directly above the anus and on the scar of the epesiotomy. When i press on the knot, puss, water, blood and airbubbles come out and its been doing this for over 2 months now, and i've also noticed thickening in the skin above the knot on that goes up the side of my outer labia.. i am very scared that this is spreading whatever it may be.. i have no insurance and would like to pleeeeease ask your advice as to what this could be.                                                                  
Doctor :   Hi
Doctor :   I am Dr. XXXXX
User :   good morning!
User :   hello
Doctor :   Let me read your query
Doctor :   Give me a couple of minutes
User :   ok thx
Doctor :   Do you see blood in your stool?
User :   no
Doctor :   Do you have pain while stooling?
User :   it is also not painful as long as i press on the knot and keep itdrained thru the tiny hole that is there.. it's so strange!
Doctor :   Ok, did you have a problem during your second and third deliveries
Doctor :   Were they vaginal?
User :   no none at all, they were all vaginal. my first, though i had to push for several hours
User :   had the episiotomy with my 1st
Doctor :   Ok
Doctor :   How large is the hole?
Doctor :   and does it discharge pus and blood?
User :   tiny prbabably about the size of a very small pinhead
User :   the knot is to the right and stays about the size of a nickel or quarter ifi keep it drained
Doctor :   Ok from what I understood by your explanation, I could think of few possibilities
User :   yes puss and blood and sometimes air bubbles
Doctor :   There can be keloid scar of the episiotomy
Doctor :   which is infected from coiuple of months
Doctor :   The second possibility is a Fistula
Doctor :   which is also infected
User :   ok, could that could that cause the thickening just above on theouter labia?
Doctor :   The next step you have to do is to visit a surgeon who can perform a simple procedure and try to drain the knot
Doctor :   and put you on a course of antibiotic for extended time
Doctor :   Atleast you should not wait before it gets more problematic
User :   hmm ok. so would i need to see a gynocologist or a regular doctor?
Doctor :   If you have a primary doctor who charges less for consultation like a family physician / general surgeon you can see them
User :   how common is this?
User :   ok
Doctor :   It is common
Doctor :   and can be cured easily if acted early
User :   so not likely a cancer then..
User :   i have no other symptoms
Doctor :   Since the location is prone for more bacterial and other infection early
Doctor :   treatment is the key
User :   ok
Doctor :   Do you have a family history of Crohn's or colitis?
User :   no
Doctor :   Ok
Doctor :   Do not worry
User :   lol ok
Doctor :   Just go get the right treatment who ever gives at negotiable rates
User :   ok then thank you
Doctor :   Is there anything else I can answer you?
User :   no,thankfully! i appreciate it!
Doctor :   Thank you for consulting me.
Doctor :   Bye for now
User :   g bye
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