I'm wondering if somehow a piece of my placenta stayed attached after the birth of my son. My midwife said it was uncertain looking at my placenta whether all of the pieces were there. 2 days after he was born I lost a rather large piece....about the size of a baseball. I bled for 8 weeks after he was born. And at 8 weeks I had a very sore spot on the top of my uterus.
About 3 weeks ago I started my first period postpartum...23 months postpartum. But it started after I started having what first looked like amniotic fluid and now is almost certainly thought to be urine coming out of my vagina. So it seems I may have a fistula.
The problem is no one wants to diagnose a fistula because they say you can't have one if you haven't had pelvic surgery or radiation treatments....of which I have had neither.
I'm still bleeding and now passing long ropy "clots" that look more like placenta. And I'm uncertain if the blood is coming from my urethra or from my vagina...most likely I think both. Docs all swear it's migrating along the outside of my body.
Now I also have that same sore spot on my uterus. And now there's one on the left side too...as well as in my bladder. I'm wondering if it is possible to have a piece of placenta missed, grown into the lining of my uterus, and now causing a fistula....
If it's not weird and complicated....it wouldn't be happening to me.
if there was a piece of placenta retained from the birth, it would have either passed or caused serious issues within a week or so after the birth. It sounds like you're describing mucusy blood - and clots at that.
Pieces of the placenta do not cause fistulas - what causes fistulas are serious tears or trauma (episiotomy) between the rectum and the vagina or the bladder and the vagina.
Are you sure you're not leaking urine from your urethral opening? It's right at the top of your vagina.
I'm almost 100% certain the urine is coming from inside my vagina. I've done several kinds of tests.
One, I held my finger over my urethra and beared down....fluid about 5 oz came out of my vagina, and into a cup. My finger came away totally dry.
Two, I took AZO (it's a red dye that also has some urinary analgesic properties) and inserted a tampon. I took the tampon out before peeing and there was red dye on the side of it. I also put in another tampon and peed with it in (into a cup so the string wouldn't wick) and there was red fluid on the tampon.
Three, I peed with a tampon inserted---into a cup---without taking the AZO---and the tampon filled with fluid.
At first I thought maybe I was pregnant, but I have very pale urine. Then my midwife suggested maybe it was a cyst---but a pint of fluid? Anyway, u/s showed no cyst. Then ER doc (I went when I nearly passed out) said, probably a fistula.
I have had my bladder filled and emptied several times during the last 3 weeks, and every time, when I go into the bathroom, the fluid RUSHES out of my vagina. I've even gone so far as to pee into a cup, so I can tell if other fluid is rushing out.
BUT, my gyn says same thing: fistulas are from trauma or radiation. And 2 urologists said same thing.
I still think a fistual seems most feasible. What concerns me is that it may be in my uterus.... My understanding is, in the wall of the vagina is a nuissance. In the wall of the uterus could be much more serious.
ETA: I have had both my boys at home with relatively hands-off midwives. No tearing, no cutting, nothing.
Have you had cystoscopy (a scope of the bladder?) They should be able to see if there is any fistula with the bladder, no matter where it is.
Another possibility would be a cystogram, where they fill the bladder with a radio-opaque dye and take and x-ray. If the dye is migrating anywhere, it will show on x-ray.
A simple pelvic exam is often not enough to diagnose a fistula, as they are often hard to see.
I've had a VCUG, a CT Scan, a cystoscopy. All showed nothing.
However the urologist who did the cystoscopy did it in the office, and basically inserted it straight away without my permission, as well as examined me in a very rough and careless manner. Though he saw nothing, I don't trust his results. Afterwards, when I went to empty my bladder from the irrigation water, almost all of it came out of my vagina.
The radiologist doing the VCUG indicated that he did not think the VCUG to be the best test for diagnosising a fistula. He thought the blue dye test would be more accurate. Or some sort of test where they fill the vagina with contrast and see if it migrates anywhere else.
I agree with the other posters, doesn't sound like a placental fragment. As far as deciding if it is fistula or something else, sounds like you need to get a second opinion from another urologist. What are they telling you that it is? If not a fistula, then what? Can you pee at their office or give them the tampon soaked with fluid?
I'll have to think about this, but really, not sure what is going on? But no, I don't think it is a placental fragment. That really would have nothing to do with a fistula and would have caused some complications by now. What about a prolapse? Have you had an gyn testing done? Ultrasound?
Keep us updated, I will be interested to see what is finally decided. Sorry you are going through this, it is frustrating when you know something is wrong but no one seems to know what. Sometimes you need to visit many different practitioners to find out!
It is so frustrating. I'm trying to decide if I need to see another gyn altogether. I had an ultrasound but all it showed was fluid at my cervix, an aneverted uterus, and several small cysts on my ovaries.
The next thing my gyn and I discussed doing is the blue dye test...where either you take blue dye orally or have it filled into your bladder, and then insert tampon, and then pee.
Unfortunately, she is very hard to get on the phone.
I do think I need to see another urologist, but I just don't know who to go to. I've seen two. One borderline assaulted me, and the other insulted me---acting like I was just fat and didn't know which hole was which.
i know i'm resurrecting a dead thread here, but i've been told (at 16 months pp) that i probably have a placental fragment left. not yet officially diagnosed, because i have to have more tests, but it was stated on my initial pelvic ultrasound report.
Do you know for sure that it is only urine that comes out when you go to the bathroom, or have you tried to push fluid out when on the toilet and you don't have to go? It sounds like there is fluid retained in your uterus for some reason, and that may be due to unseen trauma to the uterus, especially if there is a sore spot inside. Have you checked yourself for a low-grade fever? I would do this every day while pain remains constant and keep in touch with your OB and midwife. Has anyone suggested that you may have simply torn a hole in your urethra with hard pushing? Have them check this out with a scope or something. And it does sound like you have a piece of placenta in there---I would continue to get it checked out. My placenta had a very thin wall on one side when it came out and shortly afterwards, luckily, a chunk of placenta plopped into the toilet. You may still have one in there preventing full healing. Good luck, mama---I'll be praying.
this happened to me....I had some prelabor on a monday afternoon, i took a couple of blue cohosh and walked to see if it would pick up. it stopped, and we went until the next Thurs morning when he was born.
when the placenta came out, it was obvious that a good portion of it had basically abrupted, and had clotted over. enormous blood clot, the size of a baseball at least.
We didnt really think anything of it, and the mw thought it was all there.
Well, by 2 weeks pp I STUNK. It was awful....I couldnt escape this smell..
I was in throbbing pain in my perineal region, but no fever.
She told me to take Shepherds purse quite often, and I did. The next day, I passed a peice of placenta....this was at least 3 weeks pp...
The smell then cleared up, and the icky discharge went away.
the baseball size piece you lost postpartum is a fairly large piece was did your midwife say- did she see it? it may have been an extra lobe or a large clot around some membranes? but that would be a very large piece to miss when looking at a placenta- unless it was an extra lobe- and I wouldn't imagine you had any more left in there unless you didn't deliver more than a small piece to begin with.
deleted useless spectulation
woops I read further down and saw that you do have it more than just the once with the period-- I am thinking a small bit of bladder prolapse maybe and the direction of your urine is not just straight out- my urethra is an inny and is inside both sets of labia and under my pubic bone so it is a bit inside my vagina - there are times that my urine doesn't have much force behind it and it seems like it is trickeling out my vagina- do some kegels - or super kegels and see what happens- also I find that greater or lesser prolapse because of where my uterus hangs- when my uterus is heavy with blood at my period it hangs lower and changes how often I have to pee( more frequently) and the angle my urine exits...
You can, in some cases, retain a piece of the placenta without acute infection for 2-3 weeks. Usually an infection will develop along with a slow hemorrhage. Mother's can get very sick (think puerperal fever) and can even bleed out.
One symptom of retained placenta is low or non-exsitant milk production... sometimes that can tip you off.