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Re: Postmenopausal Bleeding From: ainsron@msn.com Fri Sep 22 19:46:48 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: ND84MD@aol.com: "Re: The 'Infamous' Ina May Gaskin" Previous message: ainsron@msn.com: "Re: Postmenopausal Bleeding" In reply to: Joanne Bulley: "Re: Postmenopausal Bleeding" Next in thread: Anna Meenan, MD: "Re: The 'Infamous' Ina May Gaskin" Reply: Anna Meenan, MD: "Re: The 'Infamous' Ina May Gaskin" Reply: Anna Meenan, MD: "Re: The 'Infamous' Ina May Gaskin" I agree with Malcolm. How many Gyns don't have an ultrasound in their office now and do a quick and usually uncharged for TVUS when a patient presents with postmenopausal bleeding. The only ones I send for an "expensive" ultrasound at the hospital are the ones I can't visualize well or when questionable findings are present and I want a higher resolution ultrasound or color flow. Its not at all unusual for me to do a TVUS followed by an endometrial biopsy in the office when the findings warrant it and the only charges are for the office visit and the biopsy, not for the ultrasound. Quite a bargain if I don't say so myself! >Excuse me? Ultrasounds are not inexpensive - compare the hospital charge >followed by the radiologists charge - the ease and scant time of doing a >Pipelle while she is there and the pathologist's report is MUCH less >expensive than the time between the office visit and ultrasound, the >bladder filling and 1-2 hours of the patient's day away from her >scheduled responsibilities PLUS the hospital charge AND the radiologists >charge.... How can US the Pipelle be less expensive? > >Sorry - my dander flew at the suggestion of Us first! > >Joanne > >At Fri, 22 Sep 2000, Griffiths Malcolm wrote: >> >>Agreed and maybe throw in a Pipelle biopsy according to results. In my own >>practice I tend to do Pipelle and only arrange scan if I can't get Pipelle. >>I am aware though that there was a US paper last year which showed US first >>then Pipelle if indicated (rather than other way round) is more clinically >>and cost-effective approach. >> >>-----Original Message----- >>From: Vivienne Souter [mailto:viv@seaultrasound.com] >>Sent: 21 September 2000 17:13 >>To: Multiple recipients of list OB-GYN-L >>Subject: Re: Postmenopausal Bleeding >> >>I would do a pelvic ultrasound scan. I think it is as good if not better >>than hysteroscopy >>Viv >> >>ainsron@msn.com wrote: >> >>> 75 yo. on combined/continuous HRT for over 10 years, no bleeding before >>> December, no changes in HRT at that time. Hgb has been normal, her >>> bleeding is light. >>> >>> >agree... Hyst for abnormal uterine bleeding might be all you need.. >>> > >>> >You have more.. >>> > >>> >How old is she? What is her hgb? >>> > >>> >-- >>> >_______________________ >>> >Geffrey H. Klein, MD >>> >_______________________ >>> >geffrey.klein@obgyn.net >>> >200 Medical Center Blvd Suite 103 >>> >Webster, TX 77598 >>> >(281) 332 6723 >>> > >>> >http://www.geffreyklein.com >>> > >>> >>> -- >>> Ronald E. Ainsworth, MD > >-- >Joanne Bulley, MD, FACOG >Keene, NH, USA > >All decisions are made with insufficient data. > -- Ronald E. Ainsworth, MD Next message: ND84MD@aol.com: "Re: The 'Infamous' Ina May Gaskin" Previous message: ainsron@msn.com: "Re: Postmenopausal Bleeding" In reply to: Joanne Bulley: "Re: Postmenopausal Bleeding" Next in thread: Anna Meenan, MD: "Re: The 'Infamous' Ina May Gaskin" Reply: Anna Meenan, MD: "Re: The 'Infamous' Ina May Gaskin" Reply: Anna Meenan, MD: "Re: The 'Infamous' Ina May Gaskin"

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