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Re: Gyn: Cervical Dysplasia From: ainsron (ainsron@sbcglobal.net) Fri Mar 14 14:03:27 2008 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: Gyn: Cervical Dysplasia" Previous message: Joanne Bulley, MD: "Re: Gyn: Cervical Dysplasia" In reply to: R. Daniel Braun: "Re: Gyn: Cervical Dysplasia" Next in thread: Andrew Folley: "Re: Gyn: Cervical Dysplasia" Reply: Andrew Folley: "Re: Gyn: Cervical Dysplasia" It's not adequate treatment if the F/U pap showed HGSIL. Cone biopsy if she wants conservative Rx, but I would try to convince her to go with a hysterectomy. It doesn't sound like you think a TVH is possible, but I would probably try a LAVH. I don't do Total laparoscopic hysterectomies. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of R. Daniel Braun Sent: Friday, March 14, 2008 12:13 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Gyn: Cervical Dysplasia Repeat pap in 6 months. You have already provided adequate treatment with the LEEP. Dan On Fri, Mar 14, 2008 at 3:03 PM, Joanne Bulley, MD <islesannie@gmail.com> wrote: What would you do next? 53yo G4P3013 S/P SVD x 3 (but very narrow pelvis) LMP 7/02 Pap 12/06 LSIL "possible CIN 1" Colpo 1/07 no lesion, ECC scant Pap 7/07 LSIL "possible CIN 2" Colpo 7/07 no lesion, can't visualize SCJ Recommend LEEP (surgery rescheduled due to the death of her mom) 9/07 LEEP: CIN 2-3, resection margins clear ECC: superfical atypical cells, no definitive dysplasia Endometrial curettage: (vigorous curettage) : detached glands & bstroma, no intact endometrium; one fragment squamous epithelium with mildly atypical parakeratosis Pap 3/2008 HSIL c/w CIN 2 Patient very into the "complementary and alternative" therapy - opting for homeopathic treatment of hypothyroidism (with elevated TSH and positive thyroid antibodies) and of osteoporosis (BMD T scores started out at -4.0 for spine and -3.2 for hip and are now -4.5 and -3.1) -- Joanne Bulley, MD, FACOG Solo gyn Keene, NH USA -- R. Daniel Braun, MD FACOG(L) ABMP CMTh Professor Emeritus Dept. of Obstetrics and Gynecology Indiana U. School of Medicine R. Daniel Braun "Science without Religion is LAME; Religion without Science is BLIND" Einstein 1941 Next message: Efrain Ramirez: "Re: Gyn: Cervical Dysplasia" Previous message: Joanne Bulley, MD: "Re: Gyn: Cervical Dysplasia" In reply to: R. Daniel Braun: "Re: Gyn: Cervical Dysplasia" Next in thread: Andrew Folley: "Re: Gyn: Cervical Dysplasia" Reply: Andrew Folley: "Re: Gyn: Cervical Dysplasia"

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