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Re: chronic pelvic pain patient From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com) Mon Feb 23 08:46:24 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Robert Radnich: "Re: chronic pelvic pain patient" Previous message: Richard Chudacoff, MD: "Re: chronic pelvic pain patient" In reply to: Steve & Eryl Raymond: "Re: chronic pelvic pain patient" Next in thread: Steve Raymond: "Re: chronic pelvic pain patient" Reply: Steve Raymond: "Re: chronic pelvic pain patient" She is on Depo-Provera and the Nuvaring. She actually had a menstrual cycle this last month (first in about a year) and the pain was worse, suggesting adenomyosis as well. I don't believe she has pelvic atrophy. The vaginal is pink, moist and Pap smear doesn't show basal cells -- Richard Chudacoff, MD A government that robs Peter to pay Paul can always depend on the support of Paul. George Bernard Shaw Democracy is a device that insures we shall be governed no better than we deserve. George Bernard Shaw -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Steve & Eryl Raymond Sent: Saturday, February 21, 2004 1:12 PM To: Multiple recipients of list OB-GYN-L Subject: Re: chronic pelvic pain patient The reason she is getting pain is all the progestagen that she has on board. She has what I call, for want of a better term, "pelvic atrophy". Stop her progestagens or give her a bit of oestrogen, or both and I'll be willing to bet she will be pain free. I am also willing to bet that if you remove her right adnexa she will still have pain. Steve Richard Chudacoff, MD wrote: > I have a 22 year old, gravida zero, chronic pelvic pain patient who has > had a left salpingoophorectomy for a dermoid cyst at the age of 14. > Subsequently she has persistent pain which has required three > laparoscopies for lysis of adhesions. Her right ovary on laparoscopy > appears to be normal, as is her right fallopian tube. She has also > undergone a laparoscopic presacral neurectomy. Currently she is on > Depo-Provera and Nuvaring continuously which has decreased dysmenorrhea, > but has not removed for chronic pelvic pain. She is amenorrheic. She > would like her right ovary removed, because her pain is constantly right > lower quadrant/pelvic in nature. For workup has included evaluation by > psychiatry, neurology, pain medicine and gastroenterology. > > The only thing that I could think of would be to super ovulate her, > capture her ova, and then performed a right salpingo oophorectomy, with > the understanding that she could use her captured ova for future fertility. > > Richard Chudacoff, MD, FACOG > Next message: Robert Radnich: "Re: chronic pelvic pain patient" Previous message: Richard Chudacoff, MD: "Re: chronic pelvic pain patient" In reply to: Steve & Eryl Raymond: "Re: chronic pelvic pain patient" Next in thread: Steve Raymond: "Re: chronic pelvic pain patient" Reply: Steve Raymond: "Re: chronic pelvic pain patient"

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