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Re: Incisional Endometriosis/underappreciatedFrom: Paul Prior MD (pprior@earthlink.net)Fri Jul 21 23:00:11 2000
On Fri, 21 Jul 2000 17:05:28 -0500, ryantiques@prodigy.net (RareEndo) wrote:
>Well thank goodness for your basic understanding in your residency. I'm If he/she is not aware of incisional endometriosis or thinks it exceedingly rare, I guess I'd have to say I wouldn't be impressed with the diagnostic acumen of that particular physician.
>would any OB/GYN Dx incisional endo with a laparoscopy (the only sure No the diagnosis is made by history and basic exam 90% of the time. A simple thing called listening to the patient and then laying hands on them. I don't claim to be the world's authority on the subject, but in the cases that I've managed I certainly have not needed a microscope, nor have I had to engage my x ray vision (yes, I do actually have x-ray vision, but I try not to use it too much as reimbursement from HMOs is limited) on many occasions. You take them to the OR premenstrually, and do the basic dissection - not a challenge to find the lesion in my experience. Microscopic disease does not cause pain in an incision, IMO.
>As far as "incisional endometriosis" some get it because there is Gee - you have enlightened me. I never in a million years would have thought of that as a possibility. Let me get this straight - 'cause I want to be able to quote you properly when the Nobel prizes are awarded - you're saying "cleaning up" prevents endometriosis? I guess all the research into endometriosis can stop now because little Miss Rare Endo has solved the mystery. Ever wonder why not every c/s gets it then? Ever wonder why although the vast majority of women have retrograde menstruation the majority do not get endometriosis? Ever consider it might be a little more complicated than your simplistic understanding of it? Guess not.
>This is where I got the info on this underappreaciated disease. I'm If all you have is a hammer, the world looks like a bunch of nails. We all tend to think in our specialty. My most recent case of incisional endometriosis actually came properly diagnosed (at least provisional Dx) from a general surgeon, but many will not think about it. You see, unlike you, we are not all-knowing.
...deleted reference to gen surg literature...
>With the proper diagnosis, the growths, which were an average of 3 Note the word "our." Again, I suggest to you that the vast majority of practicing -=gynecologists=- are very aware of this entity and that most of us have cared for patients with it. Is it the easiest diagnosis in the world, no. But despite your seemingly fanatic desire to make it so, it's not terribly rare nor terribly difficult to manage. I don't claim to be an expert on general surgical issues, and they are not experts in ours - that's why we are -specialists-. By the way, I'm tiring of your little tirades. Until you have done this forum the courtesy of posting your credentials and identify yourself, I'll personally not be responding to any more of your posts. It is list policy and if you want to participate you need to follow the rules. Otherwise Guido will be in shortly to escort you out.
-- Paul Prior MD Get rebates on online purchases - up to 25% cash back. Ashland, KY USA Including Disney,Borders,DVDexpress,800.com,Dell, petstore Using Spamkiller iBaby, etoys, JCrew,800-flowers,PlanetRX,Avon & many more. so spam away... try: http://www.ebates.com/index.jhtml?referrer=pprior
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