Expert: Lawrence Jay Rappaport <B>M.D.</B> - 2/14/2005
Question I am 30 and I have 1 child.
I've had 3 surgeries for severe pelvic pain and removal of adhesions and then finally I had a TAH hysterectomy in Jan 04 after a diagnosis of adenomyosis & endometriosis. Every since the surgery I've had recurrent granulation tissue at the vaginal apex. The doctor has tried cauterization to get rid of it several times (7) in the office, but it still grew back. I then underwent an outpatient surgery to aggressively remove the granulation tissue. However, the granulation tissue has grown back and now I'm scheduled for outpatient surgery again to cut out the tissue and resew the vaginal apex. Other symptoms I've been having since the hysterectomy are pain with sex, unexplained bleeding (with & without sex), and a funny odor with very small discharge.
Why is this recurring especially after treating it so many times and then so aggressively with the outpatient surgery….and could this be something besides granulation tissue? I'm sick and tired of hospital visits and surgeries with no relief.
Answer Some women develop granulatoin tissue at the site of the vaginal cuff, which continues to form even if you have multiple surgeries to remove it. Eventually, as long as there is no bleeding from thes ite, it will scar over and recede (over many months). I would not suggest more surgery unless the granulation tissue is presenting a severe problem (bleeding, infection, etc). First try treating any infection with antibiotic crams and, perhaps, cautery to control the bleeding. This is a very common occurrence.
