(Disclaimer: This article is for scientific use only, and the information in the following content has been processed to protect patient privacy)
Abstract: After having sex with her boyfriend, a 23-year-old girl developed a small amount of vaginal bleeding, which was not taken seriously. On the second morning, she went to the toilet and found that her vaginal bleeding had increased, such as the amount of menstruation, especially after activity, and the bleeding would increase significantly, even with the discharge of blood clots, so she came to the hospital. After surgery and medication, her vaginal bleeding stopped and her condition was controlled and she was discharged successfully.
Basic information】Female, 23 years old
Type of disease】Vaginal laceration
Hospital】Jiangbin Hospital of Guangxi Zhuang Autonomous Region
Date of consultation】May 2022
Treatment plan】Surgical treatment (vaginal laceration suture) + medication (cefuroxime tablets, Zikang capsule)
Treatment period】3 days of hospitalization, followed by outpatient consultation in 1 week
Results】Vaginal bleeding has stopped, the condition has been controlled, and the treatment is effective.
I. Initial consultation
The patient reported that she had sex with her boyfriend for the first time on the night of May 29, and felt pain in the vagina and a small amount of vaginal bleeding during the process, which she thought was caused by hymen rupture and did not pay attention to it. The patient’s last menstrual period was on May 16, and the flow cleared in 5 days. The current bleeding ruled out the possibility of menstruation, and the patient went to the hospital in order to clarify the cause of the bleeding because of the high cumulative bleeding volume.
The outpatient gynecological examination revealed a hymenal laceration with no obvious bleeding, blood and blood clots in the vagina, and a 3 cm long circumferential laceration on the right posterior vaginal wall near the cervix with active bleeding, which was diagnosed as “vaginal laceration”.
II. Treatment history
We explained to the patient that the vaginal wall is rich in venous plexus and bleeding can easily occur after the laceration, and that the vaginal tissue itself is not strong in contraction and the posterior vaginal vault is empty, so it is difficult to stop bleeding on its own when there is a lot of bleeding.
After admission, routine blood tests, coagulation function, electrocardiogram and ultrasound were completed. The hemoglobin was only 101g/L, which was considered to be mild anemia due to blood loss. The posterior lateral vaginal wall fissure was closed with absorbable sutures and gauze was given to compress the wound after suturing, and the bleeding stopped immediately. Postoperative antibiotic drug cefuroxime tablets were given to prevent infection and Zicam capsules to stop bleeding.
III. Treatment effect
The patient’s general condition was good after standardized treatment, with no discomfort such as fever, abdominal pain and vaginal bleeding. Subsequently, the vaginal gauze was removed and the vaginal laceration was examined without bleeding, indicating that the treatment was effective. On the morning of the third day of hospitalization, the patient was discharged with good recovery and no complaints of discomfort. 1 week later, the vaginal laceration was basically healed and no infection occurred.
IV. Precautions
I am very glad that the patient’s condition has recovered, and I would like to pay attention to the following points after discharge.
1. Forbid sex for 1 month after surgery, avoid strenuous exercise and take more rest to promote vaginal wound healing.
2. It is recommended to relax, understand the knowledge about sex life and overcome psychological fear.
3. Pay attention to strengthening nutrition and correcting anemia. It is recommended to eat light and nutritious food, including fresh vegetables and fruits, eggs, lean meat, etc.
4, pay attention to personal hygiene, continue to take oral cefuroxime tablets to prevent infection.
V. Personal insight
For this case a small amount of vaginal bleeding occurs in women who have sex for the first time is relatively common, mostly because of hymen rupture, this damage is not serious and the bleeding will soon stop on its own, but in the case of prolonged vaginal bleeding and more cumulative bleeding, it is mostly seen as bleeding caused by vaginal laceration, so it is important to seek medical attention and treatment in time to avoid aggravation of the bleeding and to give some psychological care and sexual knowledge It is important to seek medical attention and treatment to avoid aggravation of the bleeding, and to provide psychological care and sexual guidance.
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