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Dr. Pfeiffer
Dr. Pfeiffer, Doctor
Category: OB GYN
Satisfied Customers: 5986
Experience:  Ob/Gyn Doctor
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Today I went to the bathroom and when I wiped after urination

Customer Question

Today I went to the bathroom and when I wiped after urination I found a small amount of bright red blood on the toilet paper. I have had a complete hysterectomy and last year I had brain surgery to remove a benign tumor and have been taking dilantin ever since. I just had an MRI and my scan showed no change in my brain since the surgery. I have no pain.

I just went to the bathroom again and there was fresh red blood on the toilet paper again. There doesn't appear to be any blood in the urine.

I have been under a great deal of stress lately, since I haven't been able to work in over a year (I've just begun rehabilitation training) so finances are extremely tight. In addition, on 8/23 we had an arson car fire at 2 a.m. Fortunately our neighbors saw the fire and woke us up. All of us got out safely and the home was not severely damaged. We are, however, currently limited to one vehicle. I'm in the process of getting a second vehicle.

Do I need to worry about this blood?
Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr. Pfeiffer replied 1 year ago.

Dr. Pfeiffer :

hello

Dr. Pfeiffer :

are you on any hormones at all?

Customer:

no


 

Dr. Pfeiffer :

ok.


when did you have your hysterectomy? did you have the ovaries removed too?

Customer:

I had a complete hysterectomy in 1995 ad the ovaries were also removed

Dr. Pfeiffer :

ok

Dr. Pfeiffer :

was there intercourse recently?

Customer:

I had the ovaries, uterus, cervix and fallopian tubes all removed because there was a percancerous sitaution and since I was past the childbearing years my doctor and I dcided it was time to remove them.


 


There hasn't been any intercourse in many years due to sleep problems (sleep apnea) on my part.


 

Dr. Pfeiffer :

ok

Dr. Pfeiffer :

when was your last pelvic exam done?

Customer:

I am currently under a great deal of stress -- I'm working with a church group to complete 1500 little girls dresses to be sent to a mission in Haiti on 3/2/13. We're having our first sewing overnighter tonight (9/28). We'll sew from 8 p.m. to about 7 a.m. Saturday morning. I've been working with the founder of the group and it has taken a lot of my time.


 


I'm also starting school again to be able to work from home and re-enter the workforce to help my husband with the financial responsibilities he faces now that my only income is my social security disability


 

Customer:

I haven't had one in about 5 years because I haven't had any reason (I didn't think) to have one done since I no longer have periods, or a uterus and other "female" parts.


 

Dr. Pfeiffer :

ok..

Dr. Pfeiffer :

stress in your situation (post hysterectomy) really should cause this type of bleeding.

Dr. Pfeiffer :

should not...sorry.

Dr. Pfeiffer :

so we have to look at things that could

Customer:

If I relieve the stress, will the bleeding stop?


 

Dr. Pfeiffer :

no, I don't believe so

Customer:

ok


 

Dr. Pfeiffer :

urinary infection is something that needs to be considered.

Customer:

what kinds of things can bring this on all of a sudden?

Dr. Pfeiffer :

vaginal infection

Dr. Pfeiffer :

vaginal dysplasia

Dr. Pfeiffer :

vaginal cancer

Customer:

I am susceptible to those -- but there is no burning this time, like usual


 

Dr. Pfeiffer :

those are the 4 things that we need to exclude.

Dr. Pfeiffer :

hopefully that's all it is.

Dr. Pfeiffer :

but, I would recommend having the source investigated.

Dr. Pfeiffer :

I would hate for someone to tell you not to worry about it and it turns out to be a vaginal or vulvar cancer.

Customer:

can these things wait until January to be checked out when I have insurance? Our financial situation is so tight and without insurance I can't afford to pay any more medical bills. I currently have over $200,000 in medical bills I can't pay now from the brain surgery. Is there anything I can do in the meantime to do some diagnostics onmy own?

Dr. Pfeiffer :

place a tampon in the vagina and see if that's where the blood is coming from.

Customer:

ok -- if it is, then what?

Dr. Pfeiffer :

you need an exam

Customer:

if it isn't coming from the vagina, then what?

Dr. Pfeiffer :

it may be simple atrophy (shrinking), but the others would need a biopsy to diagnose.

Customer:

Is there some way I can tell if it's just shrinking? If it is just shrinking, what happens next?


 

Dr. Pfeiffer :

then it's either the urethra or rectum (ie hemorrhoid, GI)

Dr. Pfeiffer :

usually it isn't bleeding...it's usually a foul green/yellow discharge

Dr. Pfeiffer :

bleeding with the shrinking is usually due to intercourse.

Customer:

I have had some hard stools lately (constipation) and there has been blood on the stool when it finaly is discharged

Dr. Pfeiffer :

could be a hemorrhoid.

Customer:

do they require surgery to remove?

Dr. Pfeiffer :

no..not unless the symptoms continue to bother you.

Dr. Pfeiffer :

so...


 

Dr. Pfeiffer :

tampon in the vagina for a day

Dr. Pfeiffer :

you may try miralax (OTC) for a week to see if this is due to constipation (hemorrhoid)

Customer:

if the vagina is where the blood is coming from, what next?

Dr. Pfeiffer :

I would contact your local health department for a low cost or free gynecology clinic...and mention to them post-menopausal bleeding

Customer:

ok, I'll give them a call

Dr. Pfeiffer :

I think that's a very good plan

Dr. Pfeiffer :

If you have additional questions please ask…I want you to be satisfied with this service.


If you do not have additional question please take the time to rate my service.


We only receive credit for answering your question with a positive rating.


Thank you.
Dr. Pfeiffer

Customer:

I think everything has been answered. I'm concerned that it might be cancer. I'm hopeful that it isn't but with my family's history of various forms of cancer, I know I'm probably a great risk for it. How does that affect my health?

Dr. Pfeiffer :

Well...usually vaginal and vulvar cancer are due to the HPV virus and not genetic..so I don't think that's a big concern.


And the reason I recommended what I did is you had a hysterectomy because of precancerous cells...which is caused by the same virus

Customer:

My history includes my mother who died of brain cancer in 1978, my grandmother (on my mother's side) who had a form of blood cancer and died in 1991, my aunt (my dad's sister) who died of a form of lymphoma and my grandmohr (on my dad's side) who had a form of bone cancer.


 


In addition, with my own pre-cancerous cells, I'm sure the rate is higher for me.

Customer:

What is the treatment for vaginal and vulvar cancer?


 

Dr. Pfeiffer :

the good thing though..is even if it were a cancer, vaginal and vulvar cancers are slow growing and are usually early stages when diagnosed.

Dr. Pfeiffer :

excision

Dr. Pfeiffer :

plus/minus lymph nodes depending on how extensive

Customer:

excision though surgery or through radiation/chemotherapy? What is the success rate for removal and cure? What is the recovery time after surgery (if surgery is required)?

Customer:

Can this wait until January for diagnosis if the bleeding continues? Also, how can I stop the bleeding in the meantime? I've also been anemic before and have taken iron pills. Should I take them aga

Customer:

again?

Dr. Pfeiffer :

usually excision. radiation and chemo would be for advanced cases.


success rates are high because they are slow growing and usually in early stages when diagnosed.

Dr. Pfeiffer :

given your history I would strongly suggest against waiting.


there really isn't anything you can do to stop the bleeding until you know where it's coming from.


 

Dr. Pfeiffer :

Iron is probably fine...but, it can make you constipated.

Customer:

well, I guess I'll have to have the exam and find out where we go from here -- even though my financial situation is extremely tight. I was hoping this could wait until January -- especially since the cancers are slow growing.

Dr. Pfeiffer :

I understand...I really do

Dr. Pfeiffer :

and I really wish I could tell you it's safe to wait, but I simply don't know if it is or not because I haven't examined you and don't know exactly what's going on.

Customer:

what if the blood flow increases in quatity -- what then?

Customer:

also in frequency -- to where it appears to have periods resumed?

Dr. Pfeiffer :

that suggests a bigger problem and that you need to be seen by a gynecologist even more important.

Customer:

after I had my daughter, I had to take depo provera shots to get my periods to stop. I ended up in th hospital due to blood clots. That was just before the hysterectomy.

Dr. Pfeiffer :

yes, but those days are gone now..

Customer:

So that wouldn't be a concern now to stop the blood flow if needed?

Dr. Pfeiffer :

no...because that works on the uterus.

Customer:

ok

Dr. Pfeiffer :

alright...


if there's nothing else I can do for you please take the time to rate my service.


 


thank you


 

Dr. Pfeiffer :

Dr. Pfeiffer

Customer:

Thank you.

Dr. Pfeiffer, Doctor
Category: OB GYN
Satisfied Customers: 5986
Experience: Ob/Gyn Doctor
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