Re: Gyn: Submucous fibroid

From: Efrain Ramirez (eramirezt@coqui.net)
Thu Mar 23 20:09:28 2006


Vag hyst?

Ef

>At Thu, 23 Mar 2006, Garry E. Siegel, M.D. wrote:
>
>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
>

--
“ The greatest obstacle to knowledge is not ignorance,
it is the illusion of knowledge.” Daniel J. Boorstin - Historian




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