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Re: Granulation tissue From: Joanne Bulley, MD (islesannie@yahoo.com) Wed Sep 22 21:55:07 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: D. Ashley Hill: "Re: TIC - US OB's beware!" Previous message: Betsy Hyde: "Re: Stem Cells" In reply to: Rafael Haciski: "Granulation tissue" Next in thread: Braun, R. Daniel: "Re: Granulation tissue" In ones like these - I found that taking it out and leaving it out - while applying estrogen cream to the vaginal mucosa - results in a fairly quick healing - then return to a different pessary - sometime chage size - sometimes change type. Also - you can put in an Estring with a pessary and have the local estrogen effect. Even for a LeFort - if she is that atrophic - you would want the estrogen so you could stitch without it falling apart as you stitch. Joanne At Wed, 22 Sep 2004, Rafael Haciski wrote: > >Question for the listers: > >I have an elderly pt. with post hysterectomy (many years ago) vaginal >prolapse, who until now was satisfied with ring pessary. >Over the course of last year she has developed sporadic vaginal >bleeding - granulation tissue by appearance and biopsy. Initially >cauterized with silver nitrate, but today a much greater area is seen >(on both sides of vaginal walls, an at top of vault). > >The question concerns both treating the granulation tissue and vaginal >prolapse. >... it seems too great an area for silver nitrate cauterization (prob. >~6 square cm) >... my concern in this frail pt. in using cautery (or cryo) is >collateral injury to adjacent organs (rectum, bowel) and indeed poor >healing leading to fistula formation. >... due to atrophy, her introitus is getting too painful for pessary >removal and cleaning (lacerates each time, and she is using Premarin >cream on the introitus 2-3 times weekly) >... LeFort procedure may be acceptable to her - she is thinking about >this > >Any thoughts? > >-- >Rafael C. Haciski MD FACOG >Bradenton FL > -- Joanne Bulley, MD Keene, NH, USA "Every gun that is made, every warship launched, every rocket fired, signifies in the final sense a theft from those who hunger and are not fed, those who are cold and are not clothed." President Dwight D. Eisenhower April 16, 1953 Next message: D. Ashley Hill: "Re: TIC - US OB's beware!" Previous message: Betsy Hyde: "Re: Stem Cells" In reply to: Rafael Haciski: "Granulation tissue" Next in thread: Braun, R. Daniel: "Re: Granulation tissue"

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