Elderly hysterectomy for more than 20 years suddenly bleeding to consider with vaginitis, human papilloma virus infection, vaginal stump polyps, vaginal malignant tumors and so on. 1. Vaginitis: if the patient is combined with leukorrhea, vulvar itching and other discomforts, we should be alert to the occurrence of vaginitis, at this time, due to the local tissue congestion and edema obvious, vascular permeability increased, so the patient may also be combined with a small amount of bleeding. 2. Human papillomavirus infection: due to the poor resistance of the elderly, if the vaginal stump, vagina, vulva and other parts of the human papillomavirus infection, some patients will be abnormal bleeding as the main symptom. 3. Vaginal stump polyps: as the vaginal stump is retained locally after hysterectomy, patients with localized polyps may have symptoms such as irregular bleeding. 4. Vaginal malignant tumors: If the elderly are diagnosed with vaginal malignant tumors, due to the rapid growth of the tumor, invading blood vessels will destroy the vascular structure and cause bleeding. Elderly hysterectomy 20 years after the sudden bleeding, it is recommended to the regular hospital gynecology consultation, improve ultrasound, gynecological examination and other tests, clear cause of the disease under the guidance of the doctor active treatment.