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GYN: Residual uterine tissue after subtotal hysterectomyFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Wed Dec 24 12:53:58 2003
39 YO P3103, old patient years ago, returned for a second opinion. 11/02 underwent subtotal hyst/BSO for fibroids, done with local good gyn onc and regular gyn. Since then, she has had been on Premarin 1.25 mg. daily for menopausal symptoms, but has bleed pretty much continously. Original gyn suggested OCPs; patient didn't try them. Another gyn did exam, ECC (inflammed endocervical tissue), and while I don't have records, the patient said the gyn said she only went in 2.5 somethings--I assume cm. Her internist ordered a pelvic ultrasound, which showed a "long cervix" and residual uterus 5.9 X 3.7 X 3.0 cm. Ideally, I would like to sample her endometrium, or even look at it with a scope, but I'm none too keen on going up her cervix and into her abdominal cavity! Thus, I've proposed to simply cycle her as if she were menopausal with a uterus (she sort of is) with daily Premarin 1.25 mg, and Provera 10 mg. for 12 days/month, and see how she responds. She is pretty much ready to have another surgery, but I've suggested the above first. Any thoughts? Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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