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Re: Postmenopausal bleeding From: ainsron@msn.com Wed Feb 2 08:40:00 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: John Robertson MD: "Re: general anesthesia" Previous message: Gerald P. Rodriguez: "Re: Postmenopausal bleeding" I would also treat with cyclic progestin for 3-6 months and then repeat TVUS, but would not automaticaly do repeat hysteroscopy and D&C in this patient unless thickening noted. If the original biopsy had shown hyperplasia, I would agree with repeat sampling, but an outpatient biopsy with a pippelle would be adequate. >Treat with cyclic progestin therapy for 3 months, then repeat hysteroscopy >and D&C. > >-- >Gerald P. Rodriguez, M.D., FACOG > >+++++++++++++++++++++++++++++++++++++++++++++++ >"Idealism is fine, but as it approaches reality the cost becomes >prohibitive."--Wm. F. Buckley >"¿Qúe es un pedo pa' tanta naríz?"--quien sabe quien lo dijo >+++++++++++++++++++++++++++++++++++++++++++++++ >>----- Original Message ----- >From: Alexandra Borisova <treatment@mtu-net.ru> >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@forum.obgyn.net> >Sent: Wednesday, February 02, 2000 7:04 AM >Subject: Postmenopausal bleeding > >> 54 y.o. patient presented with scanty vaginal bloody discharge for 3 >> days. >> Menopuase for 2 years. Normal weight. No HRT. >> On pelvic exam: cervix - clean, small sized uterus, adnexa - not >> palpated. >> On TVUS - irregular endometrial structure, thickness 3-6 mm. >> Hysteroscopy and D&C were done. On hysteroscopy - atrophic endometrium >> without any focal lesions was seen. However, histology conclusion was >> following: prolifirative endometrium, some fragments with signs of >> secretory phase, in some - patterns of hyperplasia present. >> I`am confused with this histology conclusion. >> Is it possible prolifirative and secretory endometrium are present at >> the same sample? >> What kind of treatment/follow-up would you recommend for this patient? >> In my opinion, as D&C was done and endometrial hyperplasia (if it was >> really present)was removed, patient needs expectant observation and >> repeated TVUS in 3 months. If again endometrial thickness more than 4 >> mm - TVH should be done. >> >> -- >> Alexandra Borisova, MD >> AEA International - SOS Assistance >> International Medical Clinic >> Russia, Moscow. >> -- Ronald E. Ainsworth, MD Next message: John Robertson MD: "Re: general anesthesia" Previous message: Gerald P. Rodriguez: "Re: Postmenopausal bleeding"

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