Re: Patent cervical stump post laparoscopic supracervical hyst

From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com)
Fri Jun 1 09:43:20 2007


Interesting. Had one similar case but it turned out to be endocervicitis...treated with antibiotics. I would probably do a trachealectomy and suture the vaginal cuff rather than a cerclage

--
Richard Chudacoff, MD, FACOG
-sent from my Treo 650

-----Original Message-----

From: guto0002@tc.umn.edu (Diana Saari MD) Subj: Patent cervical stump post laparoscopic supracervical hyst Date: Thu May 31, 2007 8:34 pm Size: 958 bytes To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>

Painful Scope supracervical hyst for 1.2 pound uterus.

All fine BUT continues to have port-wine color vaginal flow. Did a cystourethrogram, and no insult to renal system, so now think peritoneal fluid is in free-flow out of the cervix. I could tell that after amputation of the uterus the cervix was gaping, and even cautery didn't help.

Have considered cautery, direct stitch to the cervical stroma in a kind of purse-string, or a really Shrodkar-like stitch, but I don't know if the latter would be enough to prevent fluid from flowing through. Funny enough, the patient's asked me to talk to her sister's doctor before considering suture, as her sister had a 'reaction' to suture post C-Section (yes, my patient's own incisions are closed with 4.0 vicryl and no complaint yet!).

Much obliged if any one has ideas or has had a similar experience.

--
Diana Saari MD FACOG
guto0002@tc.umn.edu
University Specialists in Women's Health
Minneapolis, MN




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