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Heavy bleeding. Had myomectomy to remove leiomyoma. Endometrial tissue ruptured. Help?

Good Day, Doctor: I am 44 years old, black female - 5ft 6ins tall and weighing app. 210lbs. I usually have irregular menses and in latter years began to experience heavy painful bleeding. I completed a myomectomy in 2008 to remove an 8cm leiomyoma , which on sectioning revealed the typical white whorled cut surface. P/E (2) 1 cap . Ever since the surgery I have experienced itching around the incision area and have been also experiencing severe pain in the incision area; which also has a lump, measuring about 2ins in diameter. The pain is experienced during and after my menses up to about 2 weeks after - the pain gives a sensation of skin being stretched and a heavy soreness. For the next week after that it s just intense itching until my menses start again. My menses are more or less very regular (21 days or less) with the first day in to the second accompanied with very heavy bleeding. Usually after the 3rd day it s very light up to about the 5th or 6th day - when it ends. I have been to an oby-gyn who made me complete a pelvic ultrasound (transabdominal and transvaginal ) which according to the doctor resulted in normal findings. I have recently been to another doctor who informed me that I may require another surgery because he suspects that that the endometrial tissue have ruptured, causing a hernia to develop (maybe because I do a lot of lifting at work - up to about 40lbs). This does not affect my bowel movement , as my doctor had enquired, as I have a regular one every morning. I am afraid of going through another surgery - what is your opinion, Doctor?
Asked On : Wed, 6 Jun 2012
Answers:  1 Views:  101
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General Surgeon 's  Response
Hi ! Post operative scars can develop into a keloid/hypertrophic scar which mybe painful and itchy also. I would suggest you not to scratch it as this will increase your problem if it is a keloid.
You have mentioned that the pain becomes more during every menstrual period, and that means it is regulated by your hormonal status. This can happen if some endometrial tissue got embedded in your scar and responds to the hormonal changes just like normal endometrial tissue in the uterus. This is known as abdominal wall endometriosis though it is not that frequent.
Whether you have got an incisional hernia or not can be known only by clinical exmination and for this you have to visit your surgeon.
In the mean time, as you had an abdominal surgery, please try to avoid lifting of heavy weight , as this may induce an incisional hernia.
Wishing you an early recovery.
Answered: Fri, 31 May 2013
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