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Re: Endometrial Implant From: Joanne Bulley, MD (islesannie@yahoo.com) Wed Jul 12 14:57:05 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Joanne Bulley, MD: "Re: Gyn: Rendering someone amenorrheic" Previous message: Joanne Bulley, MD: "Re: LSH PowerPoint" In reply to: Gordon Goldman: "Re: Endometrial Implant" Next in thread: Raymond Stephen: "Re: Endometrial Implant" I have a case similar to Gordon. First excision done under local. Second - went to main OR with general anesthesia. Before the anestheisa we outlined the area of complaint with one of those permanent markers. I did not have to do as extensive and excision as Gordon describes but I did include fascia with a very wide margin around the lesion. I was able to pull things back together without using mesh and she has been fine for 3-5 years now. So - both of us suggest a very wide local excision. I am not sure Lupron would have the best effect. But if she wants to try it, there would be nothing wrong with a 6 month course. Joanne At Tue, 11 Jul 2006, Gordon Goldman wrote: > >Similar case, but perhaps to lesser degree. 47 y/o 8yrs s/p TAH had sudden >appearance of 3cm tender nodule just right of infraumbilical M/L incision, >but nodule was above navel. Records indicated TAH for endometriosis, but >one 'uninvolved' ovary left behind. > >At surgery, wide excision of endometriotic implant of fascia and muscle, >primary repair of defect, and left S&O. Pt. did well for 10 months, then >sudden exacerbation in same site. Surgical consult preop and present in OR >for very wide excision with extension across midline to opposite rectus >sheath. Mesh repair. Pt now 18 months p/op w/o complaint, and very >grateful. > >You may wish to consider this approach. > >-- >Gordon M. Goldman, M.D., FACOG >Private Practice, St. Louis, Missouri > >-----Original Message----- >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Diana >Saari MD >Sent: Tuesday, July 11, 2006 10:51 PM >To: Multiple recipients of list OB-GYN-L >Subject: Endometrial Implant > >35 yo Korean multip who presented with LLQ pain following C-Section x2 >SNIP... > >She was delighted with the outcome and had pain relief for >many months post. > >She then returned with renewed discomfort in the same local. The mass >is 'back'. > >SNIP... > >Any other thoughts? > >-- >Diana Saari MD FACOG >guto0002@tc.umn.edu >University Specialists in Women's Health >Minneapolis, MN > -- Joanne Bulley, MD Keene, NH, USA Next message: Joanne Bulley, MD: "Re: Gyn: Rendering someone amenorrheic" Previous message: Joanne Bulley, MD: "Re: LSH PowerPoint" In reply to: Gordon Goldman: "Re: Endometrial Implant" Next in thread: Raymond Stephen: "Re: Endometrial Implant"

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