Re: Hymenectomy
From: Zachariah Newton (zbnewton@bellsouth.net)
Mon Dec 20 17:26:32 2004
Agree with Gerald.
For low expense, grades dilatation, it is worthy of consideration to
recommend use of graduated candles, covered with a condom with ample K-Y.
Compare this to all other alternatives on a cost/effectiveness basis.
Zach Newton
Z. B. Newton, III, M.D.
Atlanta/Gyn
(retiring and gone 12/31/2004)
--
>----- Original Message -----
From: "Gerald P. Rodríguez" <geraldpr@cybermesa.com>
To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net>
Sent: Monday, December 20, 2004 7:11 PM
Subject: Re: 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
>>
>
