Renal cell carcinoma presenting as vaginal bleeding

A case is presented of a patient who manifested vaginal bleeding due to metastatic renal cell carcinoma. Although the lungs are the primary focus of metastatic renal cell carcinoma, nearly any organ system can be a site for metastases giving bizarre symptoms. The mechanism of dissemination of tumor emboli is discussed.     

Abnormal vaginal bleeding from endometrial polyps in a woman receiving tamoxifen therapy for breast cancer: Report of a case

We report herein the case of a woman receiving tamoxifen therapy for breast cancer who developed vaginal bleeding, subsequently found to be caused by unusual endometrial polyps. Upon presentation, ultrasonography and magnetic resonance imaging (MRI) demonstrated a tumor within the uterus. A hysterectomy was perfomed, and macroscopic examination showed polyp-like lesions of the uterus. Histologically, these polyps demonstrated cystically dilated glands and stromal proliferation, and were diagnosed as endometrial polyps. Although tamoxifen has few side effects, any signs or symptoms of gynecological abnormalities should be carefully evaluated in patients on long-term tamoxifen therapy.     

绝经后阴道流血宫腔镜检查结局分析

目的：探讨绝经后阴道流血的病因及宫腔镜检查的临床应用价值。方法：回顾分析为188例绝经后阴道流血妇女行宫腔镜检查的临床资料,术后均送病理检查。结果：官腔镜检查后经病理确诊,引起绝经后阴道流血的病因中子宫内膜良性病变占92．02％,子宫内膜不典型增生占1．60％,子宫内膜癌占6．38％。子宫内膜癌与绝经年限有关。结论：宫腔镜技术是诊断绝经后阴道流血病因较好的方法,可及时发现可疑病变,提高子宫内膜癌及癌前病变的诊出率,操作简单,创伤较小,术后康复快,是诊疗绝经后阴道流血的可靠方法。     

Laparoscopic management of bleeding after laparoscopic or vaginal hysterectomy.

OBJECTIVE: To assess the results and contributions of laparoscopy in the management of postoperative bleeding following laparoscopic (LH) or vaginal hysterectomy (VH). METHODS: A retrospective study of a 5-year period was carried out on 1167 women who underwent laparoscopic or vaginal hysterectomy. Ten women with postoperative bleeding following laparoscopic or vaginal hysterectomy were identified. RESULTS: The overall incidence of bleeding after laparoscopic or vaginal hysterectomy was 0.85% (10 of 1167). Over the 5-year study period, the incidence fluctuated between 1.1% and 0.4%. Surgical revision was primarily vaginal in 1 woman, followed by laparoscopic control. In 6 patients, laparoscopy was performed immediately. The patients profited from the prompt laparoscopic treatment, because intraabdominal hemorrhage was found and stopped. Of 6 cases of intraperitoneal bleeding, 1 resulted from a blood disorder. The collagen-fibrin agent TachoComb was applied locally, and the patient was postoperatively treated with blood products and coagulation factors. Only bipolar coagulation, TachoComb, and Foley catheter were used to achieve local hemostasis during laparoscopy. The remaining 3 cases where the vaginal cuff was bleeding were managed by vaginal repair and packing without laparoscopy. CONCLUSION: The laparoscopic approach to postoperative bleeding following laparoscopic or vaginal hysterectomy is an attractive alternative to the abdominal surgical approach. Bleeding following laparoscopic or vaginal hysterectomy can be managed by laparoscopy in the majority of patients. Because the abdominal incision is avoided, the recovery time is reduced.     

A rare cause of vaginal bleeding in a 7-month-old female infant

Ovarian sex cord stromal tumor (OSCST), sclerosing type, is an extremely rare ovarian tumor. Sex hormone production by OSCST can result in isosexual or heterosexual precocious puberty in younger patients. We present a case of a 7-month-old female infant found to have a sclerosing-type OSCST that presented with vaginal bleeding and very prominent vellus hair at the mons pubis. This represents the youngest patient reported in the literature with this subset of OSCST.     

Transvaginal suture placement for bleeding control with the tension-free vaginal tape procedure

Tension-free vaginal tape (TVT) is a well-established surgical procedure for the treatment of female urinary stress incontinence. The operation, described by Ulmsten in 1995, is based on a midurethral Prolene tape support. TVT is accepted as an easy-to-learn and safe minimally invasive surgical technique. Intraoperative bleeding was described as complicating former surgical methods for correction of female urinary stress incontinence as well as TVT. The aim of this paper was to describe a simple transvaginal hemostatic suture placement to control accidental intraoperative hemorrhage. Of 566 patients undergoing TVT and followed for up to 68 months, 9 (1.6%) had intraoperative bleeding of 200–800 ml, all of which were diagnosed and corrected among the first 466 procedures. The last 100 patients had a transvaginal hemostatic suture placed whenever more than minimal bleeding occurred and hemostasis was achieved immediately with all. The benefit of this minimal, fast, and simple surgical step is assessed and discussed.This revised version was published online in March 2005 with corrections to the authors name.     

Cavernous hemangioma of the cervix: a rare cause of vaginal bleeding

Cavernous hemangiomas of the cervix are extremely rare, benign lesions. To date, fewer than 50 cases have been reported. Here reported is a case of cavernous hemangioma of the cervix in a 53-year-old patient with the complaint of postcoital spotting. Most of these lesions are asymptomatic incidental findings, but sometimes, they may cause abnormal vaginal bleeding in the form of menometrorrhagia and postcoital spotting. They should be included in the differential diagnosis of patients with vaginal bleeding.     

Severe bleeding from internal obturator muscle following tension-free vaginal tape Secur hammock approach procedure

Various perioperative and postoperative complications have been reported after the use of pubo-vaginal tension-free vaginal tapes. The transobturator approach was introduced to minimize the potential complications connected with entering the retropubic space, but different types of complications have also been described. The next generation of recently introduced minitapes such as TVT-Secur is intended to minimize the incidence of complications. This report concerns a patient who underwent a tension-free vaginal tape procedure—TVT-Secur hammock approach—and developed severe bleeding from the internal obturator muscle, which required surgical intervention.     

穴位贴敷应用于人工流产术后阴道流血的效果观察

目的 减少人工流产术所致的阴道流血.方法 将600例在妇科门诊人流室行人工流产术后的患者,随机分成对照组与观察组各300例,术后提供安静、舒适、整洁的休息环境,嘱患者在观察室休息2 h,对照组按照人工流产术后常规护理;观察组在此基础上予以中药当归、三七、川芎、炮姜、吴莱萸膏药贴敷神阙,气海、关元、中极、子宫穴位,以达到活血暖宫之功效.结果 两组人工流产术后1 h、2 h阴道流血量比较,差异有统计学意义(均P＜0.01);观察组治疗效果显著优于对照组(P＜0.01).结论 人工流产术后使用中药贴敷穴位能有效减少患者阴道流血,提高治疗安全性.     

Capillary hemangioma of the uterine cervix: an unusual cause of vaginal bleeding in a child.

Only a few scattered reports of hemangiomas of the female genital tract are found in the literature. Most of them are in adults, very few of which are located in the uterus, and none in the cervix. We present a very unusual case of profuse vaginal bleeding from a benign hemangioma in a 6-yr-old girl. Its location in the uterine cervix required complete surgical excision.     

Total pelvic arterial embolization in a case of massive vesical and vaginal bleeding by pelvis carcinomatosis.

A case of massive vesical and vaginal bleeding due to a primitive uterine cancer that relapsed hemorragically after bilateral hypogastric embolization and required an additional embolization of all arterial sources supplying the tumor is reported.