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Re: Menorrhagia From: Steve & Eryl Raymond (eryl@intekom.co.za) Wed May 30 12:03:17 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dean Huffman: "Re: FRI Does he have a Porche or not?" Previous message: ND84MD@aol.com: "Re: 66% Induction Rate" Maybe in reply to: Joanne Bulley: "Menorrhagia" Seems to me that this patient is a candidate for surgery - after all the various responses to hormone manipulation indicate that the relief is temporary at best. if she has multiple myomata intramurally, then, even if the bleeding responds to some conservative regimen, at some stage in the future it is likely that one or several or all of these fibroids are going to give new trouble. Time to get it out - hysterectomy - by whatever route is your current favourite. And, to use a British expression, stop faffing about! What do you have against topping her up with some packed cells? (prior to surgery, I mean) Joanne Bulley wrote: > 52yo G2P2 woman with DUB sent to me by her PCP - when an US showed some > sort of intrauterine mass. > > H/S - submucus myoma - resected at same time as diagnostic H/S being > done. Pathology - leiomyoma and disordered proliferative endometrium. > > Post op treated initially with cyclic progesterone. Next 3 months she > continued to bleed in various amounts and was placed on continuous > medroxprogesterone. > > Then one day begins a major hemorrhage... Rx with 25 mg Premarin IV, > quit bleeding. U/S shows reduced uterine size bu still show numerous > intramural fibroids.. Pelvic exam shows rather large fibroid > change with fibroid filling posterior cul de sac... > > Quit bleeding immediately. 3 days after completing the above, she had > another BIG bleed - went to covering MD - admitted overnight for IV > premarin and fluids. Sent home on Premarine (CEE) 2.5 mg twice daily > for 5 days. > > Who would do what? > TAH +/- BSO > Lupron > DepoProvera (150mg, 200mg, 400mg?) > different Estrogen/Progestin treatment > Of course iron replacment - how much and which kind? > Other? > > Hyst > > -- > Joanne Bulley, MD, FACOG > Keene, NH, USA -- Dr.S.H. Raymond Head of Department of O & G Empangeni Hospital South Africa 3880 Phone: (+27) 35-7721111 Fax: (+27) 35-7922596 Next message: Dean Huffman: "Re: FRI Does he have a Porche or not?" Previous message: ND84MD@aol.com: "Re: 66% Induction Rate" Maybe in reply to: Joanne Bulley: "Menorrhagia"

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