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Re: Gyn: Elongated cervix From: Joe (forcep@intercom.net) Sat Jul 29 14:20:31 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: R. Daniel Braun: "Re: staples at C/S" Previous message: LCLEMOS@aol.com: "Re: Ob:  staples at C/S" In reply to: Garry E. Siegel, M.D.: "Gyn: Elongated cervix" Next in thread: Garry E. Siegel, M.D.: "Re: Gyn: Elongated cervix" Reply: Garry E. Siegel, M.D.: "Re: Gyn: Elongated cervix" Garry: Had a patient like this. No relaxation but a long cervix. I just excised it: didn't do hyst. I've followed her over the years: problem was solved. Just be sure you are not dealing with relaxation or prolapse. Joe C Garry E. Siegel, M.D. wrote: > 62 YO P2002, many years menopausal, has a very elongated cervix, i.e. 5+ > cm., that is present at the introitus. On exam, she has a small uterus, > and is hypoestrogenic, and really doesn't have an appreciable cystocele > or rectocele, and I don't sense any vaginal vault descensus per se. She > had two children vaginally, 6-ish pounds, and is a bit heavy, and has a > narrow arch. > > She is a non-insulin requiring diabetic on 3 oral meds, and is now ready > for a hysterectomy for this protrusion, which she has tolerated for > years. She has no SUI or incontinence whatsover, no trouble with > defecation, etc. > > My concerns: > > 1. I don't think this is such an easy vaginal hysterectomy. > 2. Am I missing vault prolape? > 3. Should I suspend the cuff anyway--Ashley kindly has taught me a > pretty easy way to do a vaginal suspension to the uterosacrals at TVH. > > I'm kind of thinking about going to the OR and putting her up for a > vaginal hyst, and seeing if her uterus is accesible vaginally by using a > tenaculum as a test. Failing that, I could see if I thought starting > laparoscopically (i.e. LAVH) would help, or simply do a TAH. > > If I can do this vaginally, ovaries would come out if accesible; if LAVH > or TAH, then a BSO is added. > > Thoughts welcome. > > Garry > > -- > Garry E. Siegel, M.D. > Private Practice > Roswell, GA > Next message: R. Daniel Braun: "Re: staples at C/S" Previous message: LCLEMOS@aol.com: "Re: Ob:  staples at C/S" In reply to: Garry E. Siegel, M.D.: "Gyn: Elongated cervix" Next in thread: Garry E. Siegel, M.D.: "Re: Gyn: Elongated cervix" Reply: Garry E. Siegel, M.D.: "Re: Gyn: Elongated cervix"

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