Post-Myomectomy Bleeding: When to Seek Medical Attention?

Postoperative bleeding after uterine fibroid surgery?

Hello Doctor, I underwent a traditional subtotal hysterectomy at National Taiwan University Hospital on February 25.
After a five-day hospital stay, my vaginal bleeding nearly stopped, but yesterday, March 22, after mopping the floor at home, I started bleeding again.
The amount of bleeding is not significant; I notice pinkish blood on the toilet paper after wiping, and it has been ongoing for two days.
Should I return to the hospital for a consultation, or can I wait a few more days to observe? Kelly

Kelly, 40~49 year old female. Ask Date: 2021/03/23

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, please monitor your condition.
If you experience any discomfort, it is advisable to return for a follow-up consultation.
Wishing you good health.

Reply Date: 2021/03/23

More Info

Hello Kelly,
Thank you for reaching out regarding your post-myomectomy bleeding. It’s understandable to be concerned about any bleeding following a surgical procedure, especially one as significant as a myomectomy.
After a myomectomy, it is not uncommon for patients to experience some vaginal bleeding as part of the healing process. However, the nature and amount of bleeding can vary significantly from person to person. In your case, since you had a traditional myomectomy on February 25 and experienced a significant reduction in bleeding during your hospital stay, the re-emergence of bleeding after physical activity, such as mopping, raises a few considerations.

Firstly, light spotting or a small amount of pink discharge can be normal, especially after engaging in physical activity. The uterus is still healing, and any strain or exertion can sometimes lead to minor bleeding. However, it is crucial to monitor the situation closely. Here are some guidelines to help you determine whether you should seek medical attention:
1. Amount of Bleeding: If the bleeding remains light and only appears as pink on toilet paper, it may not be a cause for immediate concern. However, if you notice a significant increase in the amount of blood, such as soaking through a pad or tampon in an hour, this warrants immediate medical attention.

2. Duration of Bleeding: If the bleeding persists for more than a few days or shows no signs of improvement, it is advisable to consult your healthcare provider. Continuous bleeding could indicate a complication that needs to be addressed.

3. Associated Symptoms: Pay attention to any other symptoms that may accompany the bleeding. If you experience severe abdominal pain, fever, chills, or any signs of infection (such as foul-smelling discharge), you should seek medical care promptly.

4. Physical Activity: Since you mentioned that the bleeding started after mopping, it might be beneficial to limit physical activity for a few days and observe if the bleeding decreases. Strenuous activities can sometimes exacerbate bleeding.

5. Follow-Up Care: If you have a follow-up appointment scheduled with your surgeon or gynecologist, it may be worth waiting until that appointment to discuss your symptoms. However, if you feel uneasy or if the bleeding worsens, do not hesitate to reach out to your healthcare provider sooner.

In summary, while light spotting can be normal after a myomectomy, it is essential to monitor the situation closely. If you have any doubts or if the bleeding changes in character or intensity, it is always better to err on the side of caution and consult your healthcare provider. They can provide you with the most accurate advice based on your specific situation and medical history.

Take care, and I hope you find relief soon!
Best regards,
Doctor Q&A Teams

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