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Dr. Pfeiffer
Dr. Pfeiffer, Doctor
Category: OB GYN
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Experience:  Ob/Gyn Doctor
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I am 40 years old and I got a laser conization in March 2012.

Resolved Question:

I am 40 years old and I got a laser conization in March 2012. The doctor checked me after 3 months and said that all the bad cells were removed. However, I am experiencing bleeding after sex. It is mild and does not happen after every intercourse. Is it normal to bleed after sex after laser conization or should I check with the doctor again? I will take another PAP smear in 3 months.
Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr. Pfeiffer replied 1 year ago.

Dr. Pfeiffer :

hello

Dr. Pfeiffer :

usually when a woman has an abnormal pap test she will have pap tests every 6 months (following the procedure) until there are 2 normal tests...and then go back to annual screening.

Dr. Pfeiffer :

Between March and now....you should not be bleeding from the cone procedure.

Customer:

I took one Pap test two weeks ago, so I am awaiting for the results

Customer:

I bleed only after sex and not every time

Dr. Pfeiffer :

ok...

Dr. Pfeiffer :

so that's good.

Dr. Pfeiffer :

if there are still some abnormal cells that could be the cause.

Customer:

It is mild. The period is normal but sometimes I get some tissue

Dr. Pfeiffer :

the pap results will help, but there are 10-15% of pap results that are false negative.

Dr. Pfeiffer :

So...even if the test is negative I would have this evaluated...and to rule out infection.

Customer:

3 months after conization the doctor took a biopsy and sent it to analysis and it was normal

Dr. Pfeiffer :

yes...bleeding from the cervix is usually bright red and clots...

Dr. Pfeiffer :

different that menstrual blood.

Dr. Pfeiffer :

the clots can look like tissue.

Customer:

but they are dark

Dr. Pfeiffer :

that's good regarding a negative biopsy.

Dr. Pfeiffer :

yes...that's a blood clot

Customer:

what type of infection could it be. I do not experience any pain

Dr. Pfeiffer :

bacterial can cause cervical irritation resulting in bleeding after sex

Customer:

would it be a difference if my husband is very deep vs not so deep?

Dr. Pfeiffer :

it could only because of the contact with the cervix....but, the cervix doesn't normally bleed with contact...

Dr. Pfeiffer :

so finding out why it's bleeding is the key part to this.

Dr. Pfeiffer :

and again...assuming it is from the cervix and not the vagina.

Customer:

Ok, can I have a bacterial infection for this long period without "feeling" anything?

Dr. Pfeiffer :

if the pap test is negative again you might ask your doctor to do an ultrasound and may even a hysteroscopy to look for a polyp in the cervix.

Dr. Pfeiffer :

yes...with regards XXXXX XXXXX infection and no pain.

Dr. Pfeiffer :

usually there is an odor that is noticied though.

Customer:

In the last pap smear, they ob gyn did do an ultrasound and said everything looked normal.


she also said that if the results are normal my next pap smear will be in one year.

Dr. Pfeiffer :

ok..I would certainly bring up the fact that you are still bleeding after sex.

Dr. Pfeiffer :

I think I would to a hysteroscopy and fractional D&C if the pap tests were normal..

Dr. Pfeiffer :

before I said 1 year.

Dr. Pfeiffer :

that's me personally

Customer:

I have told her, and she has said that some people do have this after a laser conization, due to changes to my body because of age,.

Customer:

with this I mean the bleeding

Dr. Pfeiffer :

Yes...I understood what you meant.

Dr. Pfeiffer :

That has not been my experience.

Customer:

what is fractional D&C?

Customer:

ok to not your experience

Dr. Pfeiffer :

She see that, but I would have to feel very comfortable that I have excluded all bad things before saying 'that happens to some people.'

Customer:

how can I be tested for an infection?

Dr. Pfeiffer :

Fractional D&C is when we scrap the endocervical canal...that which is not typically evaluated by a pap test and then the endometrial cavity (inside the uterus)

Dr. Pfeiffer :

you doctor can do simple cultures.

Customer:

Ok

Dr. Pfeiffer :

so really..if the pap test is normal I would proceed with the hysteroscopy and fractional D&C

Dr. Pfeiffer :

and cultures for infection.

Dr. Pfeiffer :

If that all returned normal I would repeat screening in 1 year providing the 2 normals had be established.

Customer:

I will follow up with this and thank you for your time Dr. Pfeiffer. It has been very helpful.

Dr. Pfeiffer :

Ok...you're welcome.

Customer:

one last question:

Dr. Pfeiffer :

ok.

Customer:

what is the time-fram for results for the hysteroscopy and fractional D&C?

Dr. Pfeiffer :

hysteroscopy is immediate - we use a camera and look ourselves.

Customer:

ok

Dr. Pfeiffer :

the D&C depends on your pathology department...and you can expect it to take about the same lenght of time it takes to get your pap results back.

Customer:

my doctor did look with a microscope and vinegar (I think) as well in my visit in december. So, just awaiting results for pap smear now.

Dr. Pfeiffer :

yes..that is called a colposcopy. they are different

Customer:

ok.

Customer:

thank you again - is it possible to ask follow ups to this chat later on?

Dr. Pfeiffer :

yes of course.

Dr. Pfeiffer :

just come back to this or post a new question and ask for me.

Customer:

ok, will do. Thanks again!

Dr. Pfeiffer :

sure...you're welcome

Dr. Pfeiffer :

please take the time to rate my service good/excellent.

Dr. Pfeiffer :

thank you

Dr. Pfeiffer :

Dr. Pfeiffer

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