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Not exactly a pain in the buttFrom: David Zimmerman (fastedy@aloha.net)Sun Sep 29 02:08:01 1996
I am hoping for some brilliant suggestions by my cyberspace compatriots on the following case. My 51 y.o. patient has incapacitating introital dyspareunia. The pain is localized to the area overlying the marsupilization of a left Bartholin's abscess in 1983. A "revision of the scarring" (her words, not mine) was accomplished in 1986. On exam, there is tenderness immediately outside the introitus, corresponding to the prior op site. The area is totally re-epithelialized but the "new" epithelium is very slightly raised, although there is no mass or underlying induration. We have talked about this problem since I first met her four years ago (when I started her on HRT), and she is very much a "straight shooter", so I don't feel there is any underlying psychopathology. I was contemplating a laser ablation of the affected area. She understands there can be no guarantee of a perfect outcome. Any comments or suggestions will be appreciated. Mahalo. Terri Rosenbaum, M.D. private practice Lihue, HI "Our heads are round so our thinking can change direction" Oliver Wendall Holmes
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