WOMENS-HEALTH Messages for May, 2000: Re: **Negative Pelvic CT & Pelvic sonogram** Endo in tissue??

Re: Negative Pelvic CT & Pelvic sonogram Endo in tissue??

From: D. Ashley Hill, MD (anonymous@obgyn.net)
Wed, 10 May 2000 06:30:26 -0500 (CDT)

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In reply to: Connie: "**Negative Pelvic CT & Pelvic sonogram** Endo in tissue??"

At Tue, 9 May 2000, Connie wrote: She >has had severe endometriosis & adhesions resulting in TAH/BSO. Now years later she is still having pain. He
>told her that since her CT & Sono was normal, he wouldn't do another
>scope.

There are many potential causes of pelvic pain, including endometriosis. Pelvic pain is one of the most difficult gynecologic problems to diagnose and treat, not only because there are many potential causes, but because treatment must be carefully adjusted for each patient. Also, many patients have their own idea about which treatment is best, or they have heard from family members that such and such a treatment is the only way to treat the problem. (For example, I commonly hear "I have painful periods so I want a hysterectomy") when many times a less radical form of treatment will work fine. Thus, this condition requires a lot of detective work, time, and compassion on the doctor's part, and patience on the patient's part.

Endometriosis and adhesions are uncommonly seen on either a CT scan or ultrasound, so the fact your friend has had normal pelvic imaging does not mean much. What she needs is a thorough history and careful, head-to-toe exam. If an obvious source is not found, then either medical therapy (one or more medications) or surgical therapy (ie laparoscopy) might be indicated. It sounds like she should see another gynecologist. I hope everything works out well for her.

--
David Ashley Hill, MD
Associate Director
Department of Obstetrics and Gynecology
Florida Hospital Family Practice Residency
http://home.mpinet.net/dahmd

My apologies, but due to time constraints I am unable to answer private e-mails.

Next message: D. Ashley Hill, MD: "Re: Skin Tag in Vagina?"
Previous message: Robin: "Re: **Negative Pelvic CT & Pelvic sonogram** Endo in tissue??"
In reply to: Connie: "**Negative Pelvic CT & Pelvic sonogram** Endo in tissue??"

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