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Re: Gyn: CIS From: Joanne Bulley, MD (islesannie@gmail.com) Tue Sep 25 22:03:23 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Larry Glazerman: "Re: Board Recertification -- Is It A Scam?" Previous message: Joanne Bulley, MD: "Re: Board Recertification -- Is It A Scam?" In reply to: Garry E. Siegel, M.D.: "Gyn: CIS" Next in thread: Raymond Stephen: "Re: CIS" At Tue, 25 Sep 2007, Garry E. Siegel, M.D. wrote: > >Two cases: > >23 YO P0 with HGSIL pap, office biopsy CIN II or III (can't remember). > >OR LEEP: CIN III, no invasion, positive endocervical margin. A nice >specimen was obtained with a 20 X 15 mm loop. > >Would you: > >1. Re-LEEP after 6 weeks? >2. Reassess in the future (3 months)? If so, how, i.e. > a. Pap and colpo > b. Pap and colpo and ECC regardless of findings > c. Other > The LEEP procedure and cauterizing the base with the ball kills another fe mm of tisseu - and ther emay be nothign left. I would Pap (and colpo because it is so easy) at either 4 or 6 months. >33 YO P2002, S/P TL, with HGSIL pap, office biopsy CIN III/can't rule >out invasion. > >OR LEEP--large transition zone, two passes, one central and one superior >with 20 X 15 loop to encompass entire non-staining zone. > >Pathology: postive endocervical and ectocervical margins, no invasion, >glandular involvement. > >What would you do here? > >1. Re-LEEP after 6 weeks >2. Reassess in the future (3 months)? If so, how, i.e. > a. Pap and colpo > b. Pap and colpo and ECC regardless of findings > c. Other >3. TVH? Probably pap / colpo / ECC at 4 or 5 months - but if she wanted to be done with it a TVH is an option. Joanne > >Garry > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > -- Joanne Bulley, MD, FACOG Solo gyn Keene, NH USA Next message: Larry Glazerman: "Re: Board Recertification -- Is It A Scam?" Previous message: Joanne Bulley, MD: "Re: Board Recertification -- Is It A Scam?" In reply to: Garry E. Siegel, M.D.: "Gyn: CIS" Next in thread: Raymond Stephen: "Re: CIS"

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