Re: residual dysplasia

From: Larry Glazerman (l.glazerman@rcn.com)
Wed Dec 31 10:56:13 2003


>From apgar10@montanadsl.net Wed Dec 31 11:56:08 2003
Received: from mb-vopmail.montanadsl.net (mail.montanadsl.net [216.166.176.17]) by dns.obgyn.net (8.11.6/8.11.6/dsb-1.1) with ESMTP id hBVHtx213258 for <ob-gyn-l@obgyn.net>; Wed, 31 Dec 2003 11:56:06 -0600 Received: from rocky45y4biiof (unverified [64.25.141.31]) by mb-vopmail.montanadsl.net (Vircom SMTPRS 2.1.258) with ESMTP id <B0009933623@mb-vopmail.montanadsl.net> for <ob-gyn-l@obgyn.net>; Wed, 31 Dec 2003 10:54:59 -0700 From: "Lynn D. Montgomery, M.D." <apgar10@montanadsl.net> To: <ob-gyn-l@obgyn.net> Subject: Re: residual dysplasia Date: Wed, 31 Dec 2003 10:55:50 -0700 Message-ID: <000501c3cfc7$57179270$3403640a@rocky45y4biiof> MIME-Version: 1.0 Content-Type: text/plain; charset="US-ASCII" Content-Transfer-Encoding: 7bit X-Priority: 3 (Normal) X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook, Build 10.0.2627 Importance: Normal In-Reply-To: <000201c3cfc3$9c6e6a00$85021eac@lvh.com> X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2727.1300

I agree with Larry, often times you get a resolution of the margins just because of the adjacent treatment. Given her desire to retain fertility, I would elect to follow - now the issue is her previous lack of follow-up and if you are suspicious of her doing the same thing again, then I might be more aggressive... Lynn

P.S. Happy New Year Everyone.

--
Lynn D. Montgomery, M.D.
Rocky Mountain Women's Health
2835 Fort Missoula Rd., Suite 303
Missoula, Montana, 59804
406-549-0978
fax 406-549-0987
e-mail: apgar10@montanadsl.net

-----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Larry Glazerman Sent: Wednesday, December 31, 2003 10:28 AM To: Multiple recipients of list OB-GYN-L Subject: Re: residual dysplasia

I'd choose #3. Often, removing the bulk of disease will let the immune system resolve the rest.

Larry R. Glazerman, MD Ob-Gyn at Trexlertown, PC larry.glazerman@lvh.com

-----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Charlie Chambers Sent: Wednesday, December 31, 2003 11:17 AM To: Multiple recipients of list OB-GYN-L Subject: residual dysplasia

Suggestions on F/U regarding this patient sent to me today.

Multiparous patient with HGSIL several years ago, and was lost to F/U. Had LEEP done last month at another office with multiple margins (endo and ecto) that are positive. She wants to keep her uterus in order to have more chldren. What would others do?

1. another LEEP 2. cold knife cone 3. recolpo and ECC at 6-8 weeks

BTW, I examined her yesterday because of bleeding. The prior LEEP was huge. Looks like one of those "cowboy hat" excisions with a wide loop then a narrow deep loop done.

************************************************************************

*

--
Charlie Chambers
Hood River, OR
cchamber@alumni.rice.edu

"No matter where you go... there you are." Dr. Buckaroo Banzai ************************************************************************





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