Re: DUB treatment (2)
From: Efrain Ramirez (eramirezt@coqui.net)
Tue Jan 27 19:29:59 2004
Of course - if the path report comes out just proliferative endometrium
I would order a hysterosonogram or go directly to hysteroscopy - a 3 cm
endometrium deserves a bit of attention .. I think.
At Tue, 27 Jan 2004, art fougner, md wrote:
>
>one caveat before progestin therapy or biopsy - polyps are often missed
>by biopsy and don't respond to progestin rx. would again suggest ruling
>out a focal lesion before assuming global pathology.
>
>art
>
>At Tue, 27 Jan 2004, Efrain Ramirez wrote:
>>
>>Ron - why not an office EMB first? you can start her right on OC's that
>>same day - but you have a tissue diagnosis - >
>>
>>>At Mon, 26 Jan 2004, Dr. Ainsworth wrote:
>>>
>>>No! Cycle with progestogen of your choice or BCPs.
>>>
>>>>More info: Menarche 15 yo. Usually irregular period, obviously related
>>>>to stress. Spotting every day for last 3 mo.
>>>>
>>>>TSH 1.8, FSH 5.9, PRL 8, CHL neg, GL neg
>>>>
>>>>Let me put the question this way. Does D&C indicate in this case?
>>>>
>>>>Thanks, Surasak
>>>>
>>>>At Wed, 21 Jan 2004, Surasak wrote:
>>>>>
>>>>>33 yo married women with 3 months of DUB and no medical therapy. Plan
>>>>>to conceive.
>>>>>
>>>>>Pelvic U/S Findings:
>>>>>The uterus is not enlarged measuring 8.7 cm in lenght. There is a 2.5 cm
>>>>>fibroid in the anterior aspect of the uterine body. The endometrium was
>>>>>very thickened measruing 3 cm.
>>>>>
>>>>>Both ovaries were normal with no adnexal masses. There is a small
>>>>>amount of fluid in the cul-de-sac, probably physiologic in nature.
>>>>>
>>>>>Impression:
>>>>>1) Thickened endometrial echo complex. Differential diagonosis includes
>>>>>endometrial hyperplasia, endometrial polyp/polyps, submucosal fibroid
>>>>>and endometrial carcinoma.
>>>>>2) 2.5 cm fibroid.
>>>>>
>>>>>What is an appropriate treatment of choice, D&C plus hysterscope, or
>>>>>hormonal therapy plus follow-up?
>>>>>
>>>>>How to keep her fertility without bleeding?
>>
>>--
>>"The opposite of a correct statement is a false statement.
>>But the opposite of a profound truth may well be another profound truth."
>>
>>Niels Bohr (1885 - 1962)
>>
>--
>art fougner, md
>ich bin ein New Yorker
>
--
"The opposite of a correct statement is a false statement.
But the opposite of a profound truth may well be another profound truth."
Niels Bohr (1885 - 1962)
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