Re: sidual dysplasia
From: Joanne Bulley, MD (islesannie@yahoo.com)
Wed Dec 31 12:54:04 2003
I agree - #3
I had a patient with CIS and positive margins that the gyn onc
recommended this approach.
But as has been said - you have to somehow contract with her about
follow up - and the pursue her when/if she no-shows!
Joanne
At Wed, 31 Dec 2003, Lynn D. Montgomery, M.D. wrote:
>
>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
>************************************************************************
>
>************************************************************************
>
--
Joanne Bulley, MD
Keene, NH, USA
-----
Work to create peace everywhere you go and with everything you do.
-----
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-George Sand
