Post-Cervical Conization Surgery: Abnormal Bleeding and Menstrual Changes

Postoperative issues following cervical conization?

Hello, I underwent a cervical conization procedure on April 9.
During the first week, I experienced yellow or pink discharge, with occasional small drops of brown blood on my pad.
I was originally expecting my period to start on April 22, but it came early on April 18, and the flow was heavier than usual, with a brighter red color.
On April 23, I had a follow-up appointment at the hospital, and by that time, I was on the sixth day of my period (previously, it would usually end in about 3 to 4 days).
I informed the doctor about the changes in my menstrual cycle, and after a pelvic examination, the doctor told me that it is normal for there to be bleeding as the wound has not yet healed and the scab is still coming off.
I was advised to avoid heavy lifting and vigorous exercise for a month and to return for a Pap smear in three months.

Today, April 2, marks the tenth day, and I still experience sudden bleeding (especially when squatting to pick something up or when I exert my abdomen).
Most of the bleeding is light, about half of a regular pad, but there was one instance where it was enough to fill a regular flow pad.
The blood is still bright red or dark red, and I have noticed a small blood clot once.
Occasionally, I feel a tight, cramp-like sensation in my lower abdomen, but it is not painful.

Is this still part of my menstrual period? Why is my post-operative period lasting so long? Should I return to the doctor for further examination?

S, 30~39 year old female. Ask Date: 2024/04/27

Dr. Liu Fuping reply Obstetrics and Gynecology

If you have any concerns, it is recommended to follow up with the original surgeon.
I have not seen the condition of your cervix or the results of your ultrasound, so I cannot determine whether the bleeding is from the cervix or the uterus.
Thank you.

Reply Date: 2024/04/27

More Info

Post-cervical conization surgery, also known as cervical conization or cone biopsy, is a procedure that removes a cone-shaped section of the cervix to treat or diagnose cervical dysplasia or early-stage cervical cancer. While this procedure can be effective in managing precancerous conditions, it can also lead to various postoperative symptoms, including abnormal bleeding and changes in menstrual patterns.

Understanding Your Symptoms
1. Abnormal Bleeding: It's common to experience some bleeding or spotting after cervical conization. This can be due to the healing process of the cervix, which may take several weeks. The yellow or pink discharge you mentioned, along with occasional brown blood, is typically a part of this healing process. However, if you are experiencing bright red bleeding, especially if it is heavier than your normal menstrual flow, it is important to monitor this closely.

2. Menstrual Changes: After surgery, some women may notice changes in their menstrual cycle. This can include heavier bleeding, longer duration of periods, or changes in the color of menstrual blood. The changes you are experiencing, such as a longer menstrual period and increased flow, could be attributed to the surgical procedure. The cervix plays a role in regulating menstrual flow, and any alteration to its structure can lead to temporary changes in your cycle.

3. Postoperative Healing: The healing process after cervical conization can vary from person to person. It is not unusual for the cervix to take several weeks to heal completely. During this time, it is essential to avoid heavy lifting and vigorous exercise, as these activities can exacerbate bleeding.

When to Seek Further Medical Attention
Given that you are experiencing ongoing bleeding ten days post-surgery, especially if it is bright red and heavier than usual, it is advisable to consult your healthcare provider. Here are some specific reasons to seek further evaluation:
- Persistent Bleeding: If the bleeding continues beyond what is considered normal for your menstrual cycle or if it becomes heavier, this warrants further investigation.

- Blood Clots: The presence of blood clots can indicate that there may be an issue with the healing process or other complications.

- Pain or Discomfort: While you mentioned that you do not experience pain, any new or worsening symptoms should be discussed with your doctor.

- Signs of Infection: If you develop fever, foul-smelling discharge, or increased pain, these could be signs of an infection that requires immediate attention.

Conclusion
In summary, while some changes in bleeding patterns and menstrual cycles are expected after cervical conization, it is crucial to stay vigilant about your symptoms. If you continue to experience abnormal bleeding or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation. They may recommend additional tests or examinations to ensure that your recovery is on track and to rule out any complications. Regular follow-ups are essential in monitoring your cervical health, especially after undergoing such procedures.

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