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Re: Ehlers-Danlos & HysterectomyFrom: viv souter (vsouter@yahoo.com)Thu Jul 25 18:19:27 2002
Hi Mark Do you know what type of EDS she has? I think it is pretty important to clarify how, why and by whom the diagnosis was made. The common type of EDS is Classical EDS (formerly type I or II) but there are numerous other types, some with important surgical implications (notably EDS 4 or vascular type). My genetics program directror is an expert on EDS and I would be happy to put you in touch. He is probably going to want the answers to the above questions first. Viv UW Seattle Mark Perloe <mperloe@ivf.com> wrote: 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. Georgia Reproductive Specialists 5445 Meridian Mark Rd, Suite 270, Atlanta, GA 30342 404-843-2229 Live Chat Monday evenings 8:00-9:00 p.m. ET Yahoo! Health - Feel better, live better
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