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Ehlers-Danlos & HysterectomyFrom: Mark Perloe (mperloe@ivf.com)Wed Jul 24 21:10:21 2002
>I have a 32yo woman with Ehlers-Danlos who underwent laparoscopy in April >2002 for pelvic pain. She had a past history of endometriosis. Disease was >found and her pain was relieved after surgical excision. She has recently >developed dyspareunia. Exam now shows the uterus to be posterior, where >previously it had been anterior! The uterosacral ligaments are not tender, >but the fundus has one 1.5 cm area of point tenderness with the US probe >which correlates with an area of adenomyosis and reproduces her >dysparenia. In a woman without her history who desired fertility >preservation, I would likely do a suspension procedure. But with ED, I >wonder if a suspension would hold. As far as hysterectomy, I wonder if >there is an issue regarding the integrity of the vaginal cuff. My thought >was to preserve the cervix as the culdesac was endo free and do a >supracervical hysterectomy. Anyone have any experience regarding the use >of various sorts of energy to deal with pedicles?
-- Mark Perloe, M.D. <http://www.ivf.com/>Georgia Reproductive Specialists 5445 Meridian Mark Rd, Suite 270, Atlanta, GA 30342 404-843-2229
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