1. If you had a supracervical hysterectomy (cervix left in place), there is still enough glandular tissue (same as uterine lining) lining the cervix to respond to estrogen from HRT, or ovaries left in place.
2. If you have known endometriosis, there are case reports in the literature of endo growing into the scar at the back of the vagina where the cervix was removed.
3. If your ovaries are gone and you are using no estrogen, the vaginal tissues can become so thin and fragile that they can bleed. In this same scenario, a prolapsed urethra can cause spotting when the delicate tissues are rubbed by under wear.
4. If your surgery was for cancer there is a VERY remote chance that the bleeding is from a return of the cancer
5. Two years post-surgery is probably too long a time for there to be granulation tissue at the site of the scar in the back of the vagina. This is a more common problem sooner after surgery.
Yes, I would recommend that you see your GYN to see if there is an obvious source of the spotting.Having examined patients with concerns similar to yours I would have to say that sometimes we are never able to find out what prompted an isolated bleeding incident. amount Yet given the amount of 50 cc you definitely need to be checked out.
Yours,
Jane
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