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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Continuous Vaginal Bleeding After A Hysterectomy?

Almost 9 years ago, to be specific, I found I had cervical cancer. I had a complete hysterectomy plus lymph nodes. Had two months of radiation after healing and continued until declared cancer free five years later. Had problems after with a shortened vagina. No problems until July 2013 and doctor said I had a UTI as there was blood in urine. Have been bleeding from vagina ever since. Had bladder check and no problems with UTI or bladder. Was sent to gyn doctor and had ultrasound of area and found calcification at top of cervical cuff. ??? I am seeing another doctor tomorrow but have continued with brownish type light bleeding daily. Also have trouble with leakage from bladder. Thank you for your help
Tue, 21 Apr 2015
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OBGYN,  's  Response
You have indeed given a very nice elaborate history.
From your history, the first three causes of bleeding that came to my mind are:
1. Recurrence of your cancer with some metastasis (secondaries) in the vagina.
2. Granular tissue at the top of vaginal cuff.
3. Urinary fistula (tract) into the vagina.
Since, you had cervical cancer 9 years ago, anybody will first think of recurrence only. However, after 5 years you were declared as cancer free. Recurrence after 5 years is indeed very rare.
The top of vagina is sutured during surgery. The suture line sometimes develops a granular tissue which bleeds off and on. This seems to be the most likely cause of your bleeding.
The urinary fistula is unlikely since the bleeding has now become brown and the doctor has already checked for it.
If it is a granular tissue causing the bleeding, simpler methods like cauterisation (burning the tissue) should help you.
The other gynaecologist will probably guide you properly.
I will be interested in having a update from you.
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What Causes Continuous Vaginal Bleeding After A Hysterectomy?

You have indeed given a very nice elaborate history. From your history, the first three causes of bleeding that came to my mind are: 1. Recurrence of your cancer with some metastasis (secondaries) in the vagina. 2. Granular tissue at the top of vaginal cuff. 3. Urinary fistula (tract) into the vagina. Since, you had cervical cancer 9 years ago, anybody will first think of recurrence only. However, after 5 years you were declared as cancer free. Recurrence after 5 years is indeed very rare. The top of vagina is sutured during surgery. The suture line sometimes develops a granular tissue which bleeds off and on. This seems to be the most likely cause of your bleeding. The urinary fistula is unlikely since the bleeding has now become brown and the doctor has already checked for it. If it is a granular tissue causing the bleeding, simpler methods like cauterisation (burning the tissue) should help you. The other gynaecologist will probably guide you properly. I will be interested in having a update from you.