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Re: Cervical erosionFrom: Garry Siegel (garrys@mindspring.com)Thu Apr 20 21:45:53 2000
Zach: I usually decide at the colposcopy whether I think the patient could handle an office LEEP or not. I usually tell them that an office LEEP (if necessary pending pathology) is a bit worse than the colpo, so if that was bad, then let's go to the OR. In general: 1. Nullips to the OR, especially if younger. 2. Multips in the office, but if they've not delivered vaginally, sometimes the OR is necessary. 3. CIS, positive ECC--OR to get a high endocervical "top hat" piece 4. Any difficulty in exposure due to discomfort, hypoestrogenism, obesity--OR 5. Poor vibes--OR When we all first started LEEPing, I, for one, did a couple in the office that I wished I had in the OR. With apologies to El, life is too short to sweat bullets in the office. Garry
-- Garry E. Siegel, M.D., F.A.C.O.G. Roswell, GA Private Practice
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