Re: Gyn: Submucous fibroid
From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Thu Mar 23 19:06:51 2006
Thanks to all for confirming my gut, i.e. use the resectoscope for all.
Would you prep with Lupron, or something else, or nothing.
I was leaning towards no prep so I could see the fibroid better.
Garry
At Thu, 23 Mar 2006, ainsron wrote:
>
>Agree, but she also needs to be aware that the success may be limited by not
>prepping the uterus first.
>
>Ronald E. Ainsworth, MD, FACOG
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>l.glazerman@rcn.com
>Sent: Thursday, March 23, 2006 2:14 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Gyn: Submucous fibroid
>
>Garry:
>
>I think that as long as you're comfortable using a resectoscope,
>which you obviuosly are, since you're willing to tackle the
>fibroid, there's no reason to break out any of the global ablation
>devices in addition to the resectoscope. Do a myomectomy,
>then either rollerball or endomyometrial resection.
>
>>>---- Original message ----
>>Date: Thu, 23 Mar 2006 14:38:37 -0600
>>From: garrys@mindspring.com (Garry E. Siegel, M.D.)
>>Subject: Gyn: Submucous fibroid
>>To: Multiple recipients of list OB-GYN-L <ob-gyn-
>
>l@dns.obgyn.net>
>>
>>46 YO P3003 seen in 12/05 after an absence with iron
>
>deficiency anemia
>>(Hematocrit around 30 by the Internist) and a complaint of
>
>menorrhagia,
>>and a newer complaint of hypermenorrhea and menorrhagia,
>
>i.e. 2
>>cycles/month.
>>
>>She has a normal examination, and the endometrial biopsy
>
>showed
>>proliferative endometrium with a suggestion of a polyp.
>>
>>The saline sonogram showed a 9 X 6 X 5 mm. area
>
>suspicious for a polyp,
>>and a 3 cm. fibroid that was submucous and protruded into
>
>the
>>endometrial cavity.
>>
>>I am contemplating a hysteroscopy/resection of the fibroid, as
>well as
>>assessing and removing the polyp.
>>
>>Medical management options such as the
>
>Pill/Lupron/DepoProvera are not
>>really her cup of tea, and she is on anti-hypertensives, so I'm
>>reluctant to initiate combination OCPs at age 46.
>>
>>I also am contemplating a concurrent ablation.
>>
>>If you agree with an ablation, how would you accomplish both?
>>--old fashioned way, i.e. resectoscope/rollerball
>>--resect fibroid with resectoscope, then global technique?
>>
>>Garry
>>
>>--
>>Garry E. Siegel, M.D.
>>Private Practice
>>Roswell, GA
--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA
