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Re: Hymenectomy From: Gerald P. Rodríguez (geraldpr@cybermesa.com) Mon Dec 20 17:10:38 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Anna Meenan, MD: "Insurance company rant" Previous message: Joanne Bulley, MD: "GYN: Hymenectomy" Whatever you end up doing in terms of incisions/suturing would be secondary to the role of post-op management. IMHO she (they) should use ample estrogen cream for a significant period of time post-op (hx. of breast cancer notwithstanding) AND have them use a dildo-type appliance starting very soon after surgery to maintain the added space you've achieved surgically. Gerald P. Rodríguez, M.D., FACOG Santa Fe >----- Original Message ----- From: "Joanne Bulley, MD" <islesannie@yahoo.com> To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net> Sent: Monday, December 20, 2004 4:17 PM Subject: GYN: Hymenectomy > After being in practice 20 years post residency, hymenectomy is one > thing I haven't happened to have an occasion to do! > > Right now I have a 68yo +/- woman whose deceased husband was an > alcoholic and never penetrated. So ... she is now menopausal and still > a virgin and never took estrogen. She is contemplating hymenectomy. > > Another similar in age patient had a posterior > colporrhaphy/perineorrhaphy - then was diagnosed with breast cancer and > taken off her estrogen and put on tamoxifen (after all the other stuff). > Her perineorrhaphy, without estrogen, became taut as can be. She has > been massaging estrogen cream in faithfully, but it just won't stretch. > > So I am faced with 2 postmenopausal hymenectomies. > > Where would you cut (12, 4 & 8 o'clock?) (someplace else?) > > Would you suture -- cut parallel to the vaginal access and suter 90 > degress from that to make the introitus larger? > > Any suggestions and commentary welcome. > > Joanne > > -- > Joanne Bulley, MD > Keene, NH, USA > > "Every gun that is made, every warship launched, every rocket fired, > signifies in the final sense a theft from those who hunger and are not > fed, > those who are cold and are not clothed." > > President Dwight D. Eisenhower > April 16, 1953 > Next message: Anna Meenan, MD: "Insurance company rant" Previous message: Joanne Bulley, MD: "GYN: Hymenectomy"

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