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Gyn: menorrhaghia, bicornuate uterus, endometrial polypsFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Wed Apr 16 21:43:59 2008
44 YO P2012, longstanding patient 1992--after initial pregnancy with missed Ab, found to have uterine duplication on ultrasound. 1992--after D and C, underwent hysteroscopy/laparoscopy with stage I endo and bicornuate uterus Subsequently, had two term pregnancies delivered by sections (breech, repeat). 2002--AUB and/or pain (can't remember) and desire for TL--H-scope with 2 cm. endometrial polyp in one cavity, LTL with stage I endo. Now, has recurrent menorrhagia, and had a 2 cm. endometrial polyp removed transcervically in the office (easily seen through os) and endo biopsy benign. Saline sonogram shows a 2.5 cm. polyp in one cavity (done after biopsy and polyp removal). Now, contemplating another H-scope, probably without lapscope. Also, discussing hysterectomy and ablation for completeness. Her goal is not to have repetitive surgeries (oh, well) and to stop the menorrhagia. Would you: 1. H-scope alone, remove the polyp, and see what happens? 2. Add ablation to #1? If so, hydrothermal seems to be the best option but ACOG says no data exists for ablations in mullerian abnormalities. 3. Go to hysterectomy if desired? 4. Other? Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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