Re: Gyn: Cervical Dysplasia
From: westsidebirthservice@juno.com ("westsidebirthservice@juno.com")
Sat Mar 15 09:12:13 2008
Because it's hers, because it's a pelvic "place holder", because why take out an organ just because it's "paused", because it is the seat of, for many women, what it is to be a woman, because it's part of her and she has an identification with it, and because if it's not diseased why risk surgery. Really, for the men out there, would you be as eager to have your testicles removed because you weren't producing sperm anymore and there was a cyst on one--especially if a female doctor said to you--"Well, they're not useful anymore, so let's just chop them off" ?
Roar :)
Louana
-- Dr Eberhard W Lisse <el@lisse.na> wrote:
Can someone explain to me what she needs her uterus for?
el
On Mar 14, 2008, at 23:40, Andrew Folley wrote:
>
> Joanne
> It has been 6 months since the leep with CIN 2-3 and margins clear
> and ECC negative.
> I suggest that it is quite reasonable to simply repeat the
> colposcopy, pap and ecc now or in 3 months.
> If she is asking for a hysterectomy that is one thing, but this lady =
> wants and expects conservative management.
> A plausible expanation is that the leep excised the majority of the
> CIN. However there may have been one or more focal areas in the
> outer transformation zone outside the cone that were missed on
> leep. In addition I would like to know her HPV status before I
> became overly aggressive with talk of hysterectomy. Besides she
> probably will sustain hep fracture in the stirrups in light of her t- =
> scores. agf
>
> Date: Fri, 14 Mar 2008 15:05:40 -0500From: ainsron@sbcglobal.netTo: ob-gyn-l@mail.obgyn.netSubject
> : RE: Gyn: Cervical Dysplasia
>
> It’s not adequate treatment if the F/U pap showed HGSIL. Cone
> biopsy if she wants conservative Rx, but I would try to convince her =
> to go with a hysterectomy. It doesn’t sound like you think a TVH is
> possible, but I would probably try a LAVH. I don’t do Total
> laparoscopic hysterectomies.
>
> Ronald E. Ainsworth, MD, FACOG
>
> -----Original Message-----From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net
> ] On Behalf Of R. Daniel BraunSent: Friday, March 14, 2008 12:13
> PMTo: Multiple recipients of list OB-GYN-LSubject: Re: Gyn: Cervical =
> Dysplasia
>
> Repeat pap in 6 months.You have already provided adequate treatment
> with the LEEP.Dan
>
> On Fri, Mar 14, 2008 at 3:03 PM, Joanne Bulley, MD <islesannie@gmail.com
> > wrote:
> What would you do next?53yo G4P3013 S/P SVD x 3 (but very narrow
> pelvis) LMP 7/02Pap 12/06 LSIL "possible CIN 1"Colpo 1/07 no lesion, =
> ECC scantPap 7/07 LSIL "possible CIN 2"Colpo 7/07 no lesion, can't
> visualize SCJRecommend LEEP (surgery rescheduled due to the death
> of her mom)9/07 LEEP: CIN 2-3, resection margins clear ECC:
> superfical atypical cells, no definitive dysplasiaEndometrial
> curettage: (vigorous curettage) : detached glands & bstroma,no
> intact endometrium; one fragment squamous epithelium with
> mildlyatypical parakeratosisPap 3/2008 HSIL c/w CIN 2Patient very
> into the "complementary and alternative" therapy - optingfor
> homeopathic treatment of hypothyroidism (with elevated TSH
> andpositive thyroid antibodies) and of osteoporosis (BMD T scores
> startedout at -4.0 for spine and -3.2 for hip and are now -4.5 and
> -3.1)--Joanne Bulley, MD, FACOGSolo gynKeene, NH USA
> -- R. Daniel Braun, MD FACOG(L) ABMP CMThProfessor EmeritusDept. of
> Obstetrics and GynecologyIndiana U. School of MedicineR. Daniel
> Braun"Science without Religion is LAME; Religion without Science is
> BLIND"Einstein 1941
> _________________________________________________________________
> Climb to the top of the charts! Play the word scramble challenge =
> _________________________________________________________________
> with star power.
> http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan
Because it's hers, because it's a pelvic "place holder", because why take out an organ just because it's "paused", because it is the seat of, for many women, what it is to be a woman, because it's part of her and she has an identification with it, and because if it's not diseased why risk surgery. Really, for the men out there, would you be as eager to have your testicles removed because you weren't producing sperm anymore and there was a cyst on one--especially if a female doctor said to you--"Well, they're not useful anymore, so let's just chop them off" ?
Roar :)
Louana
-- Dr Eberhard W Lisse <el@lisse.na> wrote:
Can someone explain to me what she needs her uterus for?
el
On Mar 14, 2008, at 23:40, Andrew Folley wrote:
>
> Joanne
> It has been 6 months since the leep with CIN 2-3 and margins clear
> and ECC negative.
> I suggest that it is quite reasonable to simply repeat the
> colposcopy, pap and ecc now or in 3 months.
> If she is asking for a hysterectomy that is one thing, but this lady
> wants and expects conservative management.
> A plausible expanation is that the leep excised the majority of the
> CIN. However there may have been one or more focal areas in the
> outer transformation zone outside the cone that were missed on
> leep. In addition I would like to know her HPV status before I
> became overly aggressive with talk of hysterectomy. Besides she
> probably will sustain hep fracture in the stirrups in light of her t-
> scores. agf
>
>
> Date: Fri, 14 Mar 2008 15:05:40 -0500From: ainsron@sbcglobal.netTo: ob-gyn-l@mail.obgyn.netSubject
> : RE: Gyn: Cervical Dysplasia
>
>
>
>
> It’s not adequate treatment if the F/U pap showed HGSIL. Cone
> biopsy if she wants conservative Rx, but I would try to convince her
> to go with a hysterectomy. It doesn’t sound like you think a TVH is
> possible, but I would probably try a LAVH. I don’t do Total
> laparoscopic hysterectomies.
>
>
> Ronald E. Ainsworth, MD, FACOG
>
> -----Original Message-----From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net
> ] On Behalf Of R. Daniel BraunSent: Friday, March 14, 2008 12:13
> PMTo: Multiple recipients of list OB-GYN-LSubject: Re: Gyn: Cervical
> Dysplasia
>
> Repeat pap in 6 months.You have already provided adequate treatment
> with the LEEP.Dan
>
> On Fri, Mar 14, 2008 at 3:03 PM, Joanne Bulley, MD <islesannie@gmail.com
> > wrote:
> What would you do next?53yo G4P3013 S/P SVD x 3 (but very narrow
> pelvis) LMP 7/02Pap 12/06 LSIL "possible CIN 1"Colpo 1/07 no lesion,
> ECC scantPap 7/07 LSIL "possible CIN 2"Colpo 7/07 no lesion, can't
> visualize SCJRecommend LEEP (surgery rescheduled due to the death
> of her mom)9/07 LEEP: CIN 2-3, resection margins clear ECC:
> superfical atypical cells, no definitive dysplasiaEndometrial
> curettage: (vigorous curettage) : detached glands & bstroma,no
> intact endometrium; one fragment squamous epithelium with
> mildlyatypical parakeratosisPap 3/2008 HSIL c/w CIN 2Patient very
> into the "complementary and alternative" therapy - optingfor
> homeopathic treatment of hypothyroidism (with elevated TSH
> andpositive thyroid antibodies) and of osteoporosis (BMD T scores
> startedout at -4.0 for spine and -3.2 for hip and are now -4.5 and
> -3.1)--Joanne Bulley, MD, FACOGSolo gynKeene, NH USA
> -- R. Daniel Braun, MD FACOG(L) ABMP CMThProfessor EmeritusDept. of
> Obstetrics and GynecologyIndiana U. School of MedicineR. Daniel
> Braun"Science without Religion is LAME; Religion without Science is
> BLIND"Einstein 1941
> _______________________________________the word scramble challenge
> with star power.
> http=
gt; BLIND"Einstein 1941
> _______________________________________://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan
