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Re: Colpo management questionFrom: Anil Singhal, MD (singhalmd@yahoo.com)Wed Aug 1 20:01:45 2007
Interesting case. You don't mention the HPV Typing, though. Assuming it was NOT high risk HPV, I recommend Paps only. If it were high high risk HPV, I would culpo (and biopsy PRN) q6mo. Anil Singhal, MD Director, Women's Services RotaCare Clinic Mountain View, CA
----- Original Message ---- From: Marilyn Ringstaff <marilyn.ringstaff@obgyn.net> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> Sent: Wednesday, August 1, 2007 2:00:17 PM Subject: Colpo management question
25 year old with a 10+ year history of abnormal paps, she had a cryo in 1997 [after her first baby she had at age 14] had a cone in 2002 for CIN II, Since the cone she has had four more abnormals we’ve just been following with colpo-she had vaginal wall condyloma –we thought- biopsy was VAIN I. Last paps was ASC-US w/ (+) HPV-then she had two normals in a row [first in her lifetime!] – now I just got another ASC-US /(+) HPV back on her. Now she’s a G 2 P 2002, may want one more baby, how would you manage this uninsured patient? My back-up gyn asked me to get an opinion. Last colpo was adequte, but with two prior procedures, we are unsure about continuing pap/colpo conservative mgmt in this patient. [yes, I’ve given her Gardasil] TIA, Marilyn
-- Marilyn Ringstaff, CNM, JD Rome, Georgia
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