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Re: Gyn: Positive margins on a LEEP From: Garry E. Siegel, M.D. (garrys@mindspring.com) Tue Oct 30 11:42:07 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Richard Chudacoff: "Re: Gyn: Positive margins on a LEEP" Previous message: Garry E. Siegel, M.D.: "Re: Gyn: When to stop the pill" In reply to: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Gyn: Positive margins on a LEEP" Next in thread: Richard Chudacoff: "Re: Gyn: Positive margins on a LEEP" Reply: Richard Chudacoff: "Re: Gyn: Positive margins on a LEEP" Reply: Larry Glazerman: "Re: Gyn: Positive margins on a LEEP" Reply: Efrain Ramirez: "Re: Gyn: Positive margins on a LEEP" Dear all: For some reason (the chart is not with me today), I had told the patient that I wanted to do another LEEP, probably because I seem to remember that the original biopsy said invasion could not be ruled out--which is different than what I posted below. I also discussed this with the gyn onc. So. . .if I posted wrong, I'm sorry, but this has generated good discussion. She is scheduled for a LEEP this week, and likely a hyst later. How to hyst? Since she is having pain, I feel that a laparoscope must be involved, so I'll likely do an LAVH since I'll need to go vaginally to look at the cervix and remove it fully. Thanks to all, Garry At Tue, 30 Oct 2007, Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. wrote: > >At Mon, 29 Oct 2007, Garry E. Siegel, M.D. wrote: >> >>33 YO P2002 S/P TL, originally came in for dysmenorrhea and dyspareunia. >> >>Her intial exam was normal, but her pap was HGSIL. Directed biopsies at >>satisfactory colposcopy showed moderate dysplasia. >> >>LEEP in the OR--CIS with positive endo and ectocervical margins, and >>extensive glandular involvement. >> >>What's next? >> >>Garry >> >>-- >>Garry E. Siegel, M.D. >>Private Practice >>Roswell, GA >> >- repeat pap in 3-6 months, new wet prep brushs are just as good as ECC. >- Hyst, sure if that's what pt. wants, usually if pt. has other >pathology,adenomyosis, endometriosis , they don't need much convincing. > >Very common problem, have had over a dozen in the last ten years, only >had one actual reccurence or incomplete excision show up on follow up >PaP, just repeated leep and patient has been -ve for five years, some >women just don't want a hyst. >Quite a few had low grade lesion on follow up PAP's which eventually >turned normal. > >-- > Take care, John > -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: Richard Chudacoff: "Re: Gyn: Positive margins on a LEEP" Previous message: Garry E. Siegel, M.D.: "Re: Gyn: When to stop the pill" In reply to: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Gyn: Positive margins on a LEEP" Next in thread: Richard Chudacoff: "Re: Gyn: Positive margins on a LEEP" Reply: Richard Chudacoff: "Re: Gyn: Positive margins on a LEEP" Reply: Larry Glazerman: "Re: Gyn: Positive margins on a LEEP" Reply: Efrain Ramirez: "Re: Gyn: Positive margins on a LEEP"

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