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What Causes Bleeding When Diagnosed With Severe Dysplasia HPV

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Posted on Fri, 6 Feb 2015
Question: Hello Doctor I have a cone biposy for moderate to severe Dysplacia HPV on Nove 13th. As of today and this month I have been bleeding on a off, today Im bleeding not too much. I went to the doctor yesterday and he said the blood maybe is coming out of the kidney that they took out, But Im scare because I should not have blood by now Also when I bleed after intercourse too. Please advice me on what to do and if these is normal?
doctor
Answered by Dr. Aarti Abraham (6 minutes later)
Brief Answer:
Can you clarify about the kidney, and upload the biopsy report please ?

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
What I understand is that you had a cone biopsy on November 13th.
However you mention that the doctor said that the blood is coming out of the kidney that they took out ?????
Could you please clarify ?
And before commenting further, I would really like to look at the report of the cone biopsy .
It is not routine to bleed almost 2 months after the procedure.
Looking forward to hearing from you with the report and some clarifications.
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (10 minutes later)
When he did the ultrasound yesterday he said that he see a little whole from were he did the cone biopsy, also he said that my cervix was healed! That is why Im confused because if it is healed why Im still bleeding :(..... He told me that if the bleeding is there for another month to go back to see him because then he would have to do a cauterization. I had my period on Dec 26th, I believe it was a period but it was not a lot of blood it lasted 5 days. then the bleeding stopped. then I had intercourse with my husband and the bleeding came back again until today, its not alot of blood but I go to the bathroom to pee and change and there's bleeding! Im uploading my paps results from 2010 and the pathology resutls after the cone biopsy
doctor
Answered by Dr. Aarti Abraham (11 minutes later)
Brief Answer:
Yes, if bleeding persists, cauterization or excision is needed.

Detailed Answer:
Hi .
Thank you for the update.
I have gone through your reports.
The options for CIN 2 / CIN 3 seen on biopsy are excision or cauterization.
If the surface has externally healed, that means that the abnormal cells are still active and causing the bleeding.
And yes, if that persists even further, you need a cauterization / excision.
I still am very confused about the kidney that you mentioned.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (9 minutes later)
Im a little confused, does the pathology results means that I still have the infection? He talked about the kidney that they took out Maybe the cone, or maybe he is referrring to the dysplacia that they took out. So what would you recommend me to do? Will the cauterization damage anything in reference to being fertil?
doctor
Answered by Dr. Aarti Abraham (3 minutes later)
Brief Answer:
Explained.

Detailed Answer:
The pathology reports mean that there was CIN 2 / 3 - changes of severe abnormal cells, inside the part that was removed.
All of it is removed because the margins of the specimen are clear.
However, since you are still having the cervical bleeding, it is possible that the cellular changes are progressing in the remaining tissue, which might require cauterization.
Cauterization would not impact your fertility.
The kidney still puzzles me !
You need to ask him how does a kidney come into all of this.
A cone is something entirely different, and relevant to what we are talking about, but not a kidney !
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (4 minutes later)
Do you see any where on the pathology results a part that says that the inside margin are clear but I still have little changes on the exterior side?
Also can you please look at my first paps when I was 18 that came abnormal does that means that I had Hpv at that age?
Thanks for your explination

could the bleeding be a my cervix has not healed completely?
doctor
Answered by Dr. Aarti Abraham (8 minutes later)
Brief Answer:
Clarified.

Detailed Answer:
I see that the inside margins are clear, but the exterior had changes, however the margins of the exterior part are also clear.
In these cases, some cells might always remain on the cervix which were not picked up by the biopsy, that is possible.
Yes, the most common reason would be HPV infection, though HPV testing has not been done in your case back then.
The cervix generally heals after a cone biopsy within 6 weeks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (4 minutes later)
thanks for clarifying
When you say exterior had changes that means that I still have the problem in the exterior? how can the margins be clear if so??!! Should I avoid intercourse for a month to see if the bleeding had stopped by then? Do you think that having this problem I will be able to conceived? I stpped my birth control peel on Nov 12th which was the last day I took it
doctor
Answered by Dr. Aarti Abraham (27 minutes later)
Brief Answer:
Explained in more detail.

Detailed Answer:
Well let me try a bit more.
The cervix is in the shape of a tube, the tube has two ends - one goes inside the uterus, the outside part is in the vagina.
Please go through this link while reading my answer, it will help, particularly the part on cone biopsy of the cervix.
http://www.centerforwomen.com/disorders.html
Now a cone is taken which includes exterior and interior of the cervix ( exterior is what is outside, interior is the part that is going inside the uterus ).
Both the exterior and interior have margins ( the margins of the cone ).
These margins are clear in your case, the exterior part had the dysplastic changes, and the interior ( that goes inside the uterus ) was clear.
I am saying that the cells OUTSIDE the cone margin too might have developed dysplastic changes, leading to bleeding.
The margins can be clear, because the changes might be too subtle to pick up 2 months back, and the changes might have occured now.
IS this a better attempt on my part now ?
If you avoided intercourse for 6 weeks, then the tissue would have completely healed.
You can try and avoid intercourse for a month more, and then if the problem still persists, then further action is warranted.
This would not impede your fertility unless substantial amount of cervical tissue has been removed , only your doctor could tell you how extensive was the conization and how badly the cervix has been scarred.
Take care.
You can write in to me directly anytime using the following link -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (23 minutes later)
I had intercourse at 4 weeks the doctor told me 3 weeks. Thanks for your answer hopefully I get better and not need a cauterization

Hi Doctor,
On my pathology results doctor has the amount of cervix that was taken out during conization. Do you think with that amount I will be able to get pregnant ?
doctor
Answered by Dr. Aarti Abraham (20 hours later)
Brief Answer:
Type of healing matters.

Detailed Answer:
It is not just the amount , but the type of healing ( scarred tissue versus viable healed tissue ) that decides future fertility.
That is why your doctor would be the best judge.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Aarti Abraham

OBGYN

Practicing since :1998

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What Causes Bleeding When Diagnosed With Severe Dysplasia HPV

Brief Answer: Can you clarify about the kidney, and upload the biopsy report please ? Detailed Answer: Hello Thanks for writing to us with your health concern. What I understand is that you had a cone biopsy on November 13th. However you mention that the doctor said that the blood is coming out of the kidney that they took out ????? Could you please clarify ? And before commenting further, I would really like to look at the report of the cone biopsy . It is not routine to bleed almost 2 months after the procedure. Looking forward to hearing from you with the report and some clarifications. Take care.