Vaginal Hematoma Removal After Surgery: Questions for Dr. Rappaport

Question
Dear Dr, Rappaport,

I rec'd your reply in regards to my vaginal hematomas after surgery BUT I heard there not always able to be aspirated...if this is this case, then how are they removed (surgery, again)
If they are able to be aspirated (Im crossing my toes and fingers) would this be done in his office or an out-patient hospital setting?  
I cant imagine him sticking a needle into my vaginal area & draining hematomas while Im awake, Id probably pass out.

One last question, I have a very little rectal skin tag thats small but large enough you can move it with a q-tip from left to right. I dont know if its due to the delivery of my baby...my OBGYN said he can refer me to a colo-rectal doc to have it removed.
Its not very big but definetely noticeable, would this require surgery or some type of snip and stitch in office?

Your advice is greatly appreciated.
Melissa Petty*

Answer
A hematoma can be removed by aspiration if it has not "organized" yet. If it is a full blown blood clot, it may not be able to be aspirated with a needle and may need to be evacuated with other instruments.  Depending on the position and the extent of the hematoma, it may or may not be able to be evacuated in the office. I'm sure that your doctor would give you some local anesthesia if there is a possibility of discomfort during the procedure. The problem with rectal skin tags is that they may have some blood vessel within the tag. I would also suggest a colorectal surgeon, who knows how to remove it safely. It may merely require a "snip" or may require surgery.I wold suggest that you get a consult.