Abnormal Bleeding After Laparoscopic Myomectomy - Obstetrics and Gynecology

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After undergoing laparoscopic myomectomy, it is not uncommon to experience some abnormal bleeding, especially in the days and weeks following the procedure. Your situation, where you had a sudden onset of bright red bleeding after a period of dark brown discharge, raises several important considerations.

Firstly, it is essential to understand that after any surgical procedure, particularly one involving the uterus, there can be a variety of factors that contribute to bleeding. In your case, the bright red bleeding could be attributed to several potential causes:
1. Surgical Trauma: The procedure itself can cause trauma to the uterine lining and surrounding tissues. This trauma can lead to bleeding as the body heals. The fact that you had a significant fibroid (11 cm) removed means that there was considerable manipulation of the tissue, which can result in some bleeding post-operatively.

2. Hormonal Influence: You mentioned receiving a long-acting hormonal injection to suppress menstruation. Hormonal treatments can sometimes lead to irregular bleeding patterns as your body adjusts to the changes in hormone levels. The injection may have initially suppressed your menstrual cycle, but as the effects begin to wear off, it can lead to unexpected bleeding.

3. Infection or Complications: While less common, it is crucial to rule out any signs of infection or complications such as hematoma (a localized collection of blood outside of blood vessels) or even issues related to the surgical site. If the bleeding is accompanied by fever, severe pain, or foul-smelling discharge, it would be advisable to seek medical attention promptly.

4. Menstrual Cycle Variability: It is also possible that the timing of your bleeding is related to your menstrual cycle. After surgery, your cycle may take some time to normalize, and the bleeding you are experiencing could be a variation of your menstrual cycle rather than a complication.

Given your description, it is essential to monitor the situation closely. Here are some recommendations on what to watch for and when to seek further medical advice:
- Volume and Duration: Keep track of the amount of bleeding. If it becomes heavy (soaking through a pad in an hour or less), or if it lasts longer than a typical menstrual period, you should contact your healthcare provider.

- Associated Symptoms: Pay attention to any additional symptoms such as severe abdominal pain, fever, chills, or unusual discharge. These could indicate complications that require immediate medical evaluation.

- Follow-Up Appointments: Ensure you attend any scheduled follow-up appointments with your healthcare provider. They can assess your healing process and address any concerns regarding your bleeding.

- Rest and Recovery: Allow your body time to heal. Engage in light activities and avoid strenuous exercise until cleared by your doctor.

In conclusion, while some abnormal bleeding can be expected after laparoscopic myomectomy, it is essential to differentiate between normal post-operative changes and signs of potential complications. If you have any concerns or if the bleeding persists or worsens, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. Your health and safety are paramount, and it is always better to err on the side of caution when it comes to post-operative symptoms.