-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: chronic pelvic pain patient From: Rafael Haciski (haciski@earthlink.net) Mon Feb 23 19:39:01 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Richard Chudacoff, MD: "Re: chronic pelvic pain patient" Previous message: RModugno@aol.com: "Re: chronic pelvic pain patient" In reply to: Steve Raymond: "Re: chronic pelvic pain patient" Next in thread: Richard Chudacoff, MD: "Re: chronic pelvic pain patient" Reply: Richard Chudacoff, MD: "Re: chronic pelvic pain patient" I definitely do not think that just because no endometriosis was seen on laparoscopy that the patient does not have endometriosis - it may be beneath serosal surface, it may be adenomyosis, etc. The fact that Depo lupron resolved the pain actually strongly suggests that endometriosis (interna or externa) may be involved. Why not give her 6 months of lupron, then put her on continuous OCP? -- Rafael Haciski, MD FACOG Gynecology & Infertility Associates On Feb 23, 2004, at 2:52 PM, Steve Raymond wrote: > I didn't say vaginal atrophy. This is not the same thing. This is > progestagen induced "pelvic peritoneal atrophy" which results in > pelvic pain and goes away when you reverse the progestagen or withdraw > it. I am suggesting you try it first before doing something > irreversible. Endometriosis and adenomyosis are usually improved by > progestagens. Endometriosis has been excluded on laparoscopy. I > repeat, I'll be willing to bet she has no improvement after > adnexectomy! > Steve > > Richard Chudacoff, MD wrote: > >> She is on Depo-Provera and the Nuvaring. She actually had a menstrual >> cycle >> this last month (first in about a year) and the pain was worse, >> suggesting >> adenomyosis as well. I don't believe she has pelvic atrophy. The >> vaginal is >> pink, moist and Pap smear doesn't show basal cells >> >> Richard Chudacoff, MD >> >> -----Original Message----- >> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of >> Steve & >> Eryl Raymond >> Sent: Saturday, February 21, 2004 1:12 PM >> To: Multiple recipients of list OB-GYN-L >> Subject: Re: chronic pelvic pain patient >> >> The reason she is getting pain is all the progestagen that she has on >> board. >> She has what I call, for want of a better term, "pelvic atrophy". >> Stop her >> progestagens or give her a bit of oestrogen, or both and I'll be >> willing to >> bet she will be pain free. I am also willing to bet that if you >> remove her >> right adnexa she will still have pain. >> Steve >> > Next message: Richard Chudacoff, MD: "Re: chronic pelvic pain patient" Previous message: RModugno@aol.com: "Re: chronic pelvic pain patient" In reply to: Steve Raymond: "Re: chronic pelvic pain patient" Next in thread: Richard Chudacoff, MD: "Re: chronic pelvic pain patient" Reply: Richard Chudacoff, MD: "Re: chronic pelvic pain patient"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Sun Nov 2 04:48:29 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.