Re: Granulation tissue?
From: Dr. Rupak Ranjan Roy (rupakroy1@dataone.in)
Thu Aug 25 22:02:25 2005
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Thanks.
I took both the ovaries out.
Actually, I was trying to have some idea about the possible diagnosis before doing anything. It was reassuring to know that granulation tissue can indeed develop this late. I cannot think of any other possibilities.
I remember seeing one patient who had a hysterectomy (with BSO) for severe endometriosis (done by a very good gynaecologist) and developed a vault fistula communicating with the sigmoid SEVEN years later. Completely asymptomatic till then.
Funny things do happen.
Dr. Rupak Ranjan Roy
MRCOG
> ----- Original Message -----
From: Ronald Ainsworth
To: Multiple recipients of list OB-GYN-L
Sent: Friday, August 26, 2005 7:01 AM
Subject: Re: Granulation tissue?
I've seen granulation tissue several years after a hysterectomy. Most of the patients I've seen hadn't followed up to be sure that their cuff had healed competely and didn't return until it was symptomatic, i.e, postcoital bleeding, discharge or pain. If she had her tubes and ovaries left, could be tubal prolapse. Like Effrain said, you can easily biopsy it if you are concerned about what it is. If you feel strongly that it is granulation tissue, cauterize it with AgNO3 swab, Monsel's solution, or freeze it. If it goes away you've not only made the diagnosis, you have cured it.
"Dr. Rupak Ranjan Roy" <rupakroy1@dataone.in> wrote:
Thinking about it.
Dr. Rupak Ranjan Roy
MRCOG
> ----- Original Message -----
From: "Efrain Ramirez"
To: "Multiple recipients of list OB-GYN-L"
Sent: Friday, August 26, 2005 6:24 AM
Subject: Re: Granulation tissue?
> Do a biopsy..
>
>>At Thu, 25 Aug 2005, Dr. Rupak Ranjan Roy wrote:
>>
>>Forty six year old woman; I did a straight forward abdominal hysterectomy
>>for symptom producing multiple fibroids, nearly two and half years ago.
>>Perfectly okay till now. Came the other day for vague lower abdominal
>>pain.
>>Could not find anything abdominally. There was a small, area of scarring
>>on
>>the vaginal vault that was tender (not too bad, but a speculum hurts) and
>>bled a tiny bit when touche! d by the speculum blade. Looks like granulation
>>tissue.
>>
>>Can granulation tissue develop this late after a hysterectomy?
>>
>>Dr. Rupak Ranjan Roy
>>MRCOG
>
> --
> "Character may be manifested in the great moments, but it is made in the
> small ones."
>
> - Phillip Brooks
>
> ~walt whitman~
>
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Thanks.
I took both the ovaries out.
Actually, I was trying to have some idea about the
possible diagnosis before doing anything. It was reassuring to know that
granulation tissue can indeed develop this late. I cannot think of any other
possibilities.
I remember seeing one patient who had a
hysterectomy (with BSO) for severe endometriosis (done by a very good
gynaecologist) and developed a vault fistula communicating with the sigmoid
SEVEN years later. Completely asymptomatic till then.
Funny things do happen.
Dr. Rupak Ranjan Roy
MRCOG
> ----- Original Message -----
Sent: Friday, August 26, 2005 7:01
AM
Subject: Re: Granulation tissue?
I've seen granulation tissue several years after a hysterectomy.
Most of the patients I've seen hadn't followed up to be sure that their cuff
had healed competely and didn't return until it was symptomatic, i.e,
postcoital bleeding, discharge or pain. If she had her tubes and ovaries
left, could be tubal prolapse. Like Effrain said, you can easily biopsy
it if you are concerned about what it is. If you feel strongly that it
is granulation tissue, cauterize it with AgNO3 swab, Monsel's solution,
or freeze it. If it goes away you've not only made the diagnosis, you
have cured it.
"Dr. Rupak Ranjan Roy"
<rupakroy1@dataone.in> wrote:
Thinking
about it.
Dr. Rupak Ranjan Roy
MRCOG
----- Original Message
-----
From: "Efrain Ramirez"
To: "Multiple
recipients of list OB-GYN-L"
Sent: Friday,
August 26, 2005 6:24 AM
Subject: Re: Granulation tissue?
>
Do a biopsy..
>
>>At Thu, 25 Aug 2005, Dr. Rupak Ranjan Roy
wrote:
>>
>>Forty six year old woman; I did a straight
forward abdominal hysterectomy
>>for symptom producing multiple
fibroids, nearly two and half years ago.
>>Perfectly okay till now.
Came the other day for vague lower abdominal
>>pain.
>>Could not find anything abdominally. There was
a small, area of scarring
>>on
>>the vaginal vault that
was tender (not too bad, but a speculum hurts) and
>>bled a tiny
bit when touche! d by the speculum blade. Looks like
granulation
>>tissue.
>>
>>Can granulation tissue
develop this late after a hysterectomy?
>>
>>Dr. Rupak
Ranjan Roy
>>MRCOG
>
> --
> "Character may be
manifested in the great moments, but it is made in the
> small
ones."
>
> - Phillip Brooks
>
>
> ~walt
whitman~
>
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