Consation and FL
April 7, 2011 | 30,00 EUR | answered by Dr. med. Ralf Berg
Had a cone biopsy on October 12, 2010, the result was positive according to the doctor. Everything was removed. Four weeks later, had bleeding again during intercourse, similar to before. Doctor diagnosed an infection and prescribed Beatisadona suppositories. Bleeding after intercourse continued, next step was cauterization. Condition improved temporarily. Became pregnant in the meantime, had an abortion on January 13, 2011. Started taking Cerazette pill a month after the first normal bleeding. Still experiencing occasional bleeding after intercourse. Could it be that the cone biopsy was not successful, since bleeding during intercourse was already present before? Or could it be related to the abortion?
Dear patient,
A conization primarily serves to prevent the development of uterine cancer. If there are too many precursors of "degenerate" mucosal cells in the smears, or if this proliferating tissue is already visible during the gynecological exam, conization will be performed if there is no other option. (= A partial removal of tissue from the cervix with a cone-shaped incision (tip of the imaginary cone lies in the cervix). The success of this procedure is measured by whether there are no problematic cells in the follow-up smear, which could potentially develop into tumors.
The fact that you had bleeding during intercourse before the conization could be attributed to the altered mucosal cells, but it is also possible that your cervix mucosa is "vulnerable" = very sensitive, and therefore tends to bleed even with mild mechanical irritation. This is not a cause for concern. Another (rarer) cause could be that in cases of a very short vagina and a very long penis, there may be too vigorous contact between the cervix and the glans during intercourse, leading to excessive mechanical irritation and subsequent bleeding. Since the maximum penetration depth of the penis also depends on the chosen position, there may be a starting point for addressing this issue.
However, there is one point you should not worry or blame yourself about: the conization has nothing to do with the pregnancy termination. Address your two questions at your next check-up with your gynecologist: 1. Was the conization successful, 2. Could a second cauterization help prevent the bleeding. Follow-up examinations and smears are still important and necessary after conization.
If your gynecologist assures you that there is no suspicious tissue and the smears are negative, the conization was successful. Further solutions need to be explored for the issue of bleeding during intercourse. Simply discuss my suggestions with your gynecologist.
Best regards,
Dr. R. Berg
