Is this a Hysterectomy Complication?

I Had A Hysterectomy Many Years Ago. But I Am Bleeding From Vagina Now. Is This A Hysterectomy Complication?

Dear Dr. Mazumdar,

I am a 44 year old who had a hysterectomy in 10/2006. I told my GYN that I had a bad pap smear 10 yrs prior. My left ovary had developed a cyst that had encapsulated it and my uterus forming a benign tumor. He insisted on leaving my cervix even with my concerns. I told him that I wanted the right ovary out as well and my cervix if he found ANYTHING wrong with them. He did the surgery laproscopically, and it took him longer than he expected because the tumor was so fibrous. When I awoke, he told me he left my cervix and left my right ovary even though he had to remove a cyst from it. Over the course of my recovery I told him that I thought he may have nicked a bowel as I had a sharp pain in my lower right abdomen, but he insisted that he hadn”t and that it would go away – it hasn”t. I also have spotting with tissue passage every 4 weeks since the operation. My new GP just had an ultra sound done and found a piece of uterus is still there and my cervix bleeds to the touch. Ur Thoughts

MaryP, Age: 45, SF

Mary,

Spotting, with a cervix bleeding on touch, and a history of a bad pap smear merits an immediate investigation to rule out cervical cancer.

Spotting with tissue passage every 4 weeks means that not only has the cervix been left behind but also quite a bit of the uterus. You are getting menstrual periods from that part of the uterus.

Please consult another obgyn as early as possible for a repeat pap smear. If the pap is normal, you will need a cervical biopsy from the area of the cervix which bleeds on touch.

I am afraid that this combination of symptoms, especially the cervix bleeding on touch after a history of a bad pap smear, does not sound good to me. Please consult an Obgyn as early as possible.

Dr.M.D.Mazumdar

Dear Doctor,

Is it rare to have a hysterectomy complication like this? Why would the GYN have left so much uterus? Could there be other tissue adhered to my intestines and abdominal cavity as well?

I am having intestinal issues as well lately, such as cramping, diarrhea, nausea etc… could this all be related?

Mary.

Mary,

It is not uncommon to have a complication like this if the uterus was not removed completely with the cervix.

It is standard to remove the entire uterus with the cervix if there is a history of a bad pap smear. It is possible that your gyn left so much uterus behind because he was unable to remove the whole uterus by laparoscopy because of fibrosis. The operation could have been converted to an open hysterectomy at the time the problems were encountered.

It is difficult to say if the intestinal symptoms are due to the complications at the time of the operation. I do not think that an intestine was nicked – this would have caused quite acute infection immediately after the operation.

What has happened I suspect, is that there is gross scarring at the site of the operation which could have involved the intestines. The scarring could be due to adhesions after the operation or due to the fibrosis which was present before the operation.

But the intestinal symptoms can also be due to infections in the gut, or due to other conditions like IBS (Irritable Bowel Syndrome) or Crohn’s dsease.

You need to get an MRI scan for the diagnosis of the abdominal adhesions, if any, as well as tests like colonoscopy, barium enema Xray and stool tests for the intestinal symptoms.

I hope this helps.

Please feel free to ask a follow-up question if you wish to know more.

Dr.M.D.Mazumdar

Thank you doctor. I will get back to you after I consult a gyn here and get an MRI done.

You are welcome, Mary.

Let me know if you need more help.

Dr.M D Mazumdar

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