What Is RPOC Removal?
Retained products of conception (RPOC) removal clears the pregnancy tissue that stayed behind inside your uterus. RPOC refers to thee tissue from your placenta or fetus that remained inside your uterus no matter how your pregnancy ended.
Felix Cohen, MD, FACOG treats this condition at Hysteroscopy Center of New York. He handles retained tissue removal in your uterus with a slim scope that has a camera and precise instruments, instead of scraping blind. That delivers a better experience and more precise results.
Seeing the problem clearly is the heart of an in-office hysteroscopy. It’s the reason Dr. Cohen built his practice around hysteroscopy care. His primary office is in Midtown Manhattan, but he also has an office in Columbus Circle and Queens. He holds hospital affiliations with Mount Sinai, NYU Langone and Lenox Hill.
“Most women pass everything on their own after a pregnancy,” says Dr. Cohen. “When some piece holds on, RPOC removal brings your body back to baseline. You need RPOC removal when that tissue stays past the point your body should have cleared it.”
What Causes Retained Tissue That Needs Removal?
Retained tissue often comes from the placenta. It attaches to your uterine wall during pregnancy. When the pregnancy ends, it doesn’t always detach completely. The piece that stays behind is what your body can’t clear on its own.
Another cause is placenta accrete, when the placenta grows too deep into your uterine wall and doesn’t detach when it should. Scar tissue from past surgery is a factor too, as it interferes with how your uterus contracts and that makes clearing the tissue naturally more difficult.
Dr. Cohen figures out why the tissue remained before recommending a procedure. The answer drives your treatment plan. According to the American College of Obstetricians and Gynecologists, retained tissue occurs in roughly one in 100 full-term births. “I review your medical history before I touch anything,” says Dr. Cohen. “The cause tells me how the tissue remained and how careful I need to be.”
What Symptoms Point to a Retained Tissue Removal Uterus?
The first clue is often bleeding that doesn’t taper off the way it should after a pregnancy ends. It keeps going for weeks, which is your signal to get checked for retained tissue. The symptoms that bring most women to Dr. Cohen for retained tissue removal include:
- Cramping or pelvic pain that’s still there weeks after your pregnancy ended
- A fever or discharge with a bad smell. Both are signs of infection and need attention fast.
- A pregnancy test just weeks later that comes back positive
These symptoms sometimes overlap with abnormal uterine bleeding from other causes. The American College of Obstetricians and Gynecologists reports that heavy or drawn-out bleeding after a pregnancy is a clear signal to get checked. Dr. Cohen confirms the source before he treats it.
How Does Dr. Cohen Confirm the Need for Retained Tissue Removal?
Retained tissue removal starts with a close look inside your uterus. Your NYC gynecologist begins with a transvaginal ultrasound to spot and measure the retained tissue. He checks your blood flow next, since a rich blood supply changes how he works.
If the ultrasound raises doubts, he uses a diagnostic hysteroscope to look for himself. He finds the tissue, checks its size and pinpoints exactly where it sits. He can then explain the abnormal uterine ultrasound results.
“An ultrasound tells me something is there,” says Dr. Cohen. “The camera tells me what it really is. And then I can plan the safest way to remove the tissue. That’s the difference between them.”
Why Is Hysteroscopic Retained Tissue Removal Safer Than a D&C?
Hysteroscopic retained tissue removal lets Dr. Cohen see the tissue while he removes it. During a traditional dilation and curettage (D&C), the uterus is scraped blind with no camera. That presents a risk of taking out good tissue along with the target. The live view from a hysteroscope makes all the difference. The advantages of hysteroscopic retained tissue removal over a blind D&C include:
- Dr. Cohen removes the retained tissue, leaving your healthy uterine lining untouched.
- A blind procedure puts you at risk of intrauterine adhesions. Direct-vision removal gives him full control, reducing that risk significantly.
- Dr. Cohen checks your uterine cavity before finishing. You leave with the knowledge that the retained tissue is completely removed.
- Less goes wrong during removal when your doctor sees exactly what he’s doing. Your short recovery reflects that.
Research backs up these advantages. Studies show direct-vision removal clears the uterine cavity more completely and causes fewer adhesions than a blind procedure. Dr. Cohen reviews with you what separates a D&C from hysteroscopy. By the end of that conversation, you know exactly why he chose that procedure.
What Happens During Retained Products of Conception Removal?
Retained products of conception removal happens in the office in less than an hour. Dr. Cohen slides a thin hysteroscope through your cervix with no surgical dilation needed. He uses anesthesia and pain management built around your needs, so all you feel is a little pressure. Your retained tissue removal moves through a few straightforward steps, including:
- Dr. Cohen guides the scope through your cervix into your uterus.
- You both see the retained tissue on the screen. He checks its size and exact position.
- He extracts it with small instruments, with the live camera feed guiding every move.
- Afterward, he checks the cavity again so he misses no other abnormalities.
Your diagnosis and removal happen together in one visit due to Dr. Cohen’s see-and-treat approach. You skip general anesthesia entirely, but the bigger win is that this procedure provides fertility preservation.
What Does My Recovery After RPOC Removal Look Like?
RPOC removal allows you to go home the same day. With several light restrictions, you should feel close to normal within a day or two. Plan your recovery after retained tissue removal with tips such as:
- Take it easy your first day. No heavy lifting or strenuous activity.
- You may experience some light spotting for a few days after your retained tissue removal. It clears up on its own.
- Keep over-the-counter pain relievers nearby if cramping bothers you.
- Attend a follow-up appointment for Dr. Cohen to check your healing progress.
Your cycle returns within four to six weeks. Skip tampons and sex until Dr. Cohen clears you. If heavy bleeding or a fever hit before then, call the office, following their emergency and after-hours instructions.
Where Do I Get Expert RPOC Removal in NYC?
The procedure takes place at any of the three Hysteroscopy Center of New York locations. RPOC removal returns your body to normal and keeps your plans to conceive on track. Retained tissue removal in the uterus restores what your body could not finish on its own.
New patients begin with simple new patient information before the first visit. Online consultations are available for Canadian and international women. The Center provides everything you need. Schedule your retained tissue removal consultation in New York City today.