Re: Gyn: menorrhaghia, bicornuate uterus, endometrial polyps

From: Joe (forcep@intercom.net)
Thu Apr 17 06:03:19 2008


3. Joe C

Garry E. Siegel, M.D. wrote: > 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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