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Cancer

Question
Posted by: Erica | 2017/12/05

Q.

Pain after cervical biopsy

I had a endometrial ablation and cervical cone biopsy this year early September. My pap smear results was CIN 2. After this operation I am riddled with pains and vaginal bleeding every two weeks. I had a CT scan done and nothing abnormal showed up. Gynie said nothing she can do. I was supposed to go back 01.12.17 for my 2nd pap smear.Do I need a 2nd opinion? What can the cause be besides "complications from operation"

Expert's Reply

A.

Cancer expert
- 2017/12/07

Dear Erica

A cone biopsy may be done after a Pap test shows moderate to severe cell changes and:

  • The abnormal tissue cannot be seen with colposcopy but was found in cells collected from a biopsy of the cervical canal, or the abnormal tissue seen with colposcopy extends high into the cervical canal. A cone biopsy is done to remove and examine the abnormal tissue.
  • The abnormal cells found on a Pap test cannot be seen with colposcopy or found in cells collected from a cervical biopsy. The cone biopsy may be used to diagnose the cause of the abnormal cell changes and remove the abnormal tissue at the same time.
  • Cervical cancer is suspected based on Pap test results, colposcopy, and cervical biopsy. A cone biopsy can determine the extent, depth, and severity of the cancerous tissue and can guide treatment decisions.

A cone biopsy is an extensive form of a cervical biopsy. It is called a cone biopsy because a cone-shaped wedge of tissue is removed from the cervix and examined under a microscope. A cone biopsy removes abnormal tissue that is high in the cervical canal. A small amount of normal tissue around the cone-shaped wedge of abnormal tissue is also removed so that a margin free of abnormal cells is left in the cervix.

The cervix should heal completely within four to six weeks, but some women make a full recovery as early as three weeks. A vaginal discharge and / or bleeding are usual for some weeks following treatment and are part of the healing process. This should stop or return to 'normal' as soon as the cervix is healed.

After a cone biopsy

  • Some vaginal bleeding is normal for up to 1 week.
  • Some vaginal spotting or discharge (bloody or dark brown) may occur for about 3 weeks.
  • Pads should be used instead of tampons for about 3 weeks.
  • Sexual intercourse should be avoided for about 3 weeks.
  • Douching should not be done.

 

Endometrial ablation is a procedure that removes the inner lining of the uterus (the endometrium). This procedure, which is usually done for women who have heavy menstrual periods that are not able to be controlled with medication, is a preferred option to the complete removal of the uterus. Endometrial ablation carries several risks, including infertility and the chance of damage to the uterus or bowel. Some gynaecologists report that several common, mild side effects may be experienced after the procedure as well.

Abdominal cramping is common after endometrial ablation, which is similar to menstrual cramps. During endometrial ablation, the cervix is dilated and the inner lining of the uterus is disturbed, which can cause uterine muscle spasms and cramps. Cramping is generally mild and can be controlled with over-the-counter pain medications.

Severe abdominal pain or cramping, or pain that radiates into the lower back after the procedure may indicate a more serious side effect, however, and should be checked by a gynaecologist – often a second opinion may be warranted.

Some women experience vaginal discharge after endometrial ablation. Discharge may be thin, watery and may contain blood. Discharge can also be heavy up to three days following the procedure and resemble a menstrual period. However, excessive or heavy bleeding beyond two days, the passing of blood clots, or foul-smelling vaginal discharge, are abnormal side effects and warrant urgent medical attention.

Disruption of the uterus during endometrial ablation can irritate the bladder and cause the urge to urinate more frequently. Some women may feel bladder spasms or have the sensation of being unable to empty the bladder completely. A woman should watch for signs of a urinary tract infection after having endometrial ablation, which include painful urination, bloody urine and lower back pain.

Some women continue to experience bleeding after ablation because areas of the endometrium are treated unevenly, allowing some of the endometrial tissue to grow. But because of the scarring, there is no way of knowing if the bleeding is caused by the ablation or by endometrial hyperplasia, particularly if hyperplasia was diagnosed prior to the ablation. At this point women are likely to be told that the only remedy is a hysterectomy.

I would suggest that you request a second opinion.

The signs and symptoms described by you is not normal after 2 months from having had an endometrial ablation. (MCH).

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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