Patient's question:
The doctor said my endometrium is fifteen centimeters and I need to have a D&C (dilation and curettage) to check the pathology. She mentioned that this D&C is like a menstrual period has passed, so I should rest at home and wait for the report. I had the D&C on September 30th. That night, I didn't have any bleeding, but starting from the 3rd, there was a little bit of blood, and it's still there today. I feel like I'm back to the situation before I had the D&C. What could be the reason for this? Please ask.Doctor's answer:
Abnormal uterine bleeding is often caused by gynecological diseases such as tumors and inflammation.Suggestions: The factors or causes of uterine bleeding include:
1. Vaginal tumors: When tumors occur on the vaginal wall, such as vaginal cancer, the tumor surface may become necrotic or ulcerated due to infection, leading to irregular vaginal bleeding. The bleeding volume is usually small.
2. Vaginal injury: Foreign objects in the vagina can damage the vaginal wall, causing bleeding. Postmenopausal women, whose vaginal walls are thin, may also sustain injuries during sexual activity, leading to vaginal bleeding. These cases typically have a clear medical history.
3. Vaginal inflammation: For example, in severe candidal vaginitis, the vaginal mucosa may be covered with a white membranous substance. After removing it, superficial ulcers or erosions on the vaginal wall may be visible, with bleeding on the ulcer surface. Patients often experience itching and pain in the external genitalia, along with cottage cheese-like vaginal discharge. In cases of atrophic vaginitis, the vaginal wall may have small bleeding points or ulcers that cause bleeding. The bleeding volume is usually small, often appearing as blood in vaginal discharge, accompanied by itching and pain in the external genitalia.
Suggestions:
4. Cervical tumors: When cervical cancer occurs, the tumor invading the stromal blood vessels can cause uterine bleeding. Initially, it may be contact bleeding, then develops into small, irregular vaginal bleeding. In advanced stages, the bleeding volume increases, even leading to heavy bleeding.
5. Cervical inflammation: Conditions like cervical polyps or cervical erosion may also cause uterine bleeding, often appearing as blood streaks in vaginal discharge and typically contact bleeding. In cervical tuberculosis, the diseased tissue may form ulcers, which rupture and cause uterine bleeding. At times, the diseased tissue appears nodular or papillary, and due to its fragile nature, it is prone to bleeding.