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Granulation tissueFrom: Rafael Haciski (haciski@earthlink.net)Wed Sep 22 15:11:24 2004
Question for the listers: I have an elderly pt. with post hysterectomy (many years ago) vaginal prolapse, who until now was satisfied with ring pessary. Over the course of last year she has developed sporadic vaginal bleeding - granulation tissue by appearance and biopsy. Initially cauterized with silver nitrate, but today a much greater area is seen (on both sides of vaginal walls, an at top of vault). The question concerns both treating the granulation tissue and vaginal prolapse. ... it seems too great an area for silver nitrate cauterization (prob. ~6 square cm) ... my concern in this frail pt. in using cautery (or cryo) is collateral injury to adjacent organs (rectum, bowel) and indeed poor healing leading to fistula formation. ... due to atrophy, her introitus is getting too painful for pessary removal and cleaning (lacerates each time, and she is using Premarin cream on the introitus 2-3 times weekly) ... LeFort procedure may be acceptable to her - she is thinking about this Any thoughts?
-- Rafael C. Haciski MD FACOG Bradenton FL
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