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Re: Gyn: AGUS pap**Order of events From: Atkinson, Samuel M (ATKINSONS@ECU.EDU) Tue Apr 25 09:30:07 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Atkinson, Samuel M: "Re: Section on demand" Previous message: Richard Chudacoff, MD: "Re: Subject: Section on demand" Next in thread: Garry E. Siegel, M.D.: "Re: Gyn: AGUS pap**Order of events" Reply: Garry E. Siegel, M.D.: "Re: Gyn: AGUS pap**Order of events" There are wide LEEP's and there are deep LEEP's. If the ectocervix is neg to colpo, then why wide..just do deep to get above the SCJ. "Big LEEP's can be dangerous. Several years ago I had such a pt. Persitent abnormal smear after second, deep cone. Only at hyst did we finally find the invasivew sq cell ca. Rember, the biggest percentage of AGUS smears still have squamous lesions, not glandular. Sam Atkinson,MD Brody School of Medicine. -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. Siegel, M.D. Sent: Friday, April 21, 2006 3:22 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Gyn: AGUS pap**Order of events The patient below had a negative/inadequate colposcopy (well, unable to see SCJ, but nothing at all seen), a negative ECC, and negative endo biopsy. She is terrified and the plan is to go to the OR for a LEEP, ECC, and hysteroscopy/curettage. The 3 gyn oncs I've spoken with (happened to run into them)have 2 opinions--two say TAH now, one says repeat the pap in 4 months, as the AGUS was relative close to the last LEEP. So. . .we're going to the OR. In what order would you do things? Since there is no lesion to see on microscopy of the cervix, I was favoring prepping normally, doing a big LEEP, ECC, then H-scope. Garry At Tue, 4 Apr 2006, Garry E. Siegel, M.D. wrote: > >Posted previously during the missing days: > >38 YO P2002 who has completed her family. > >Cryo--some type of dysplasia--around age 20, no records. > >Intermittently, has had atypical/reactive paps, maybe a colpo here and >there--worst biopsy atypia. > >Due to LGSIL pap/worry, had a LEEP 11/05--mild dysplasia, clear margins. > >Her first postop pap was AGUS. > >Thoughts? > >Garry > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: Atkinson, Samuel M: "Re: Section on demand" Previous message: Richard Chudacoff, MD: "Re: Subject: Section on demand" Next in thread: Garry E. Siegel, M.D.: "Re: Gyn: AGUS pap**Order of events" Reply: Garry E. Siegel, M.D.: "Re: Gyn: AGUS pap**Order of events"

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