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Period after Myomectomy
rainyapple posted:
I am wondering if this is anything to be worried about. I had a myomectomy and hysterocopy in mid-September. My symptoms were fairly heavy periods and midcycle bleeding for about a week around ovulation. My first cycle after the surgery was good. It was a bit heavier than normal but I knew this was to be expected. I went through the whole month without midcycle bleeding! That was great and what I had hoped for. This second cycle started 7 days ago and is extremely heavy. I can't even just use tampons. I have to use pads because there are so many clots. I am changing them hourly for sure. I am still bleeding through them on day 7! It is mostly clots and then bright red blood or watery pink blood. I do not have any pain with it. I know my first cycle after the surgery would likely be heavier than normal (which they are already heavy) but 2 months after? I can not find anything about this and my doctor just said the first month would be bad. Any thoughts?
Jane Harrison Hohner, RN, RNP responded:
Dear rainyapple: So sorry I didn't see your post sooner. Soaking though a maxipad every hour mandates contacting the GYN who did your surgery. It may be, since you have not been having any other bleeding during the prior weeks, that you have had a non-ovulatory cycle. These often result in heavy and prolonged bleeding. Certainly the stress of a surgery is enough to temporarily interfere with ovulation.

Also likely would be a continuation of the post-procedure heavier than usual flows. A literature search at the National Library of Medicine site yielded this long term study of a large number of women with hysteroscopic myomectomies. From this you can see that size/number of fibroids influenced outcome:

Ann Chir. 2001 Feb;126(1):58-64.
[Hysteroscopic resection of submucous myomas: long term results>.
[Article in French>
Fernandez H, Kadoch O, Capella-Allouc S, Gervaise A, Taylor S, Frydman R.

Service de gyn?cologie-obst?trique, h?pital Antoine-B?cl?re, 157, rue de la Porte-de-Trivaux, 92141 Clamart, France.

To evaluate the follow-up after operative hysteroscopic resection of submucous leiomyomas.

Between January 1990 and December 1996, 200 patients underwent operative hysteroscopic resection of 289 uterine leiomyomas. Indications were: menometrorrhagia (n = 159), postmenopausal metrorrhagia (n = 22), infertility (n = 19) as sole etiology. Sixteen patients had infertility and menometrorrhagia.

The mean follow-up was 33.4 /- 19.2 months. Twenty-three patients were lost to follow-up. Due to the large size of the leiomyomas, 35 patients had 2 or 3 resections and a total of 241 hysteroscopic resections were performed. Twelve complications (5%) occurred without death or need for intensive care. An improvement of clinical symptoms was observed in 74% of patients. The predictive factors of failure were: size (> 5 cm), number of intracavitary leiomyomas (> 3), hysterometry (> 12 cm), intramural myoma class 2 and association of leiomyomas. Eight of the 35 infertile patients subsequently became pregnant, but with only two live births (5.8%).

Hysteroscopic myomectomy appears to be safe, effective and reproducible for the treatment of menstrual disorders. Intramural class 2 and larger leiomyomas constitute the limits of the endoscopic technique.

Bottom line rainyapple, please contact your GYN about this heavy flow. Hopefully the ensuring months will be linked with lighter flows.

rainyapple replied to Jane Harrison Hohner, RN, RNP's response:
Thanks so much for your reply. I did not contact my surgeon but when to my obgyn and will have a ultrasound once the bleeding stops. She put me on progesterone to stop the bleeding. I am taking it easy and have been home from work since the bleeding is still heavy. Taking MVI with iron and just trying to rest.

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