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Re: current dysplasia From: Atkinson, Samuel M (ATKINSONS@ECU.EDU) Wed Nov 1 12:21:57 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: JD Stewart,MD: "Re: early onset severe IUGR and ambiguous genitalia without any other anomaly" Previous message: Richard Chudacoff: "Re: IMPLANON" If she is happy being followed great! I only suggested cone if she is an overly anxious pt demanding assurances there is nothing there and wishing minimalist approach. She does have CIN I,recurrent. I suggest cone only if an extirpatiave procedure felt necessary and that Leep probably would not get rid of the abnormal PAPS or reach the CIN I. sAm -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. Siegel, M.D. Sent: Tuesday, October 31, 2006 5:30 PM To: Multiple recipients of list OB-GYN-L Subject: Re: current dysplasia Sam: Thanks for the input. Her colpo was easy and adequate, and ECC negative, so I wonder why you think she has a lesion higher in the canal. She has opted for serial follow-up, and I have suggested a colpo, pap and maybe HPV test in 6 months. I realize that is more than the current guidelines suggest, but this woman has had CIS before, and hasn't changed partners, etc. Bikini? She is an exercise fiend, and has zilch body fat and a scaphoid abdomen that would be the envy of us all! Garry At Tue, 31 Oct 2006, Atkinson, Samuel M wrote: > >Dealers' choice! Your workup is adequate and no further workup required, >other than Pap ;in six mos. Cone for CIN one will probably not clear the >lesion which, I suspect, is high in the endo cervix, as a result of the >leep. Assuming the ectocervix shows no abnormality, You could do do a >narrow but deep cone. I do knot believe a leep would go high enough. >This carries the risk of bleeding and a hyst. If her childbearing >desires have matured and no longer are in the equation, then a simple >vag hyst could be presented as curative. I say vag hyst. The world's >published record, I believe is 12 minutes and home in 12 hrs. No >unsightly laparoscope scars to mar her bikini figure, which, I assume, >she still has with, only one child. >In the words pf a bygone professor, hysterectomy is a simple operation. >The less it is indicated the simpler it is. >Thus with only CIN 1 and no other disease entities, it would be an >excellent choice. Sam Atkinson,MD >Brody SOM, Greenville NC > >-----Original Message----- >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry >E. Siegel, M.D. >Sent: Monday, October 30, 2006 1:18 PM >To: Multiple recipients of list OB-GYN-L >Subject: Gyn: Recurrent dysplasia > >44 YO P1001 with CIS excised fully (clear margins)by LEEP 1994. > >Paps normal for years. > >Recently, ACS-US, with positive HR HPV. > >Colposcopy adequate, ECC negative, biopsies CIN I. > >What would you do? > >Garry > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: JD Stewart,MD: "Re: early onset severe IUGR and ambiguous genitalia without any other anomaly" Previous message: Richard Chudacoff: "Re: IMPLANON"

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