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Re: Gyn: Positive margins on a LEEPFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Tue Oct 30 08:59:01 2007
At Mon, 29 Oct 2007, Garry E. Siegel, M.D. wrote: > >33 YO P2002 S/P TL, originally came in for dysmenorrhea and dyspareunia. > >Her intial exam was normal, but her pap was HGSIL. Directed biopsies at >satisfactory colposcopy showed moderate dysplasia. > >LEEP in the OR--CIS with positive endo and ectocervical margins, and >extensive glandular involvement. > >What's next? > >Garry > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > - repeat pap in 3-6 months, new wet prep brushs are just as good as ECC. - Hyst, sure if that's what pt. wants, usually if pt. has other pathology,adenomyosis, endometriosis , they don't need much convincing. Very common problem, have had over a dozen in the last ten years, only had one actual reccurence or incomplete excision show up on follow up PaP, just repeated leep and patient has been -ve for five years, some women just don't want a hyst. Quite a few had low grade lesion on follow up PAP's which eventually turned normal.
--
Take care, John
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