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Re: Ascus management questionFrom: Andrew Folley (agfolley@hotmail.com)Thu Jul 31 12:58:57 2008
Essentially the colposcopic exam is "unsatisfactory" in light of inablity to visualize the endocervical border of the Transformation Zone. Leep would seem a logical solution for both diagnositic and theraputic purposes. If she develops cervical ca, the present course of management would be difficult to justify and defend. Date: Thu, 31 Jul 2008 09:58:11 -0500From: ENDODOK@aol.comTo: ob-gyn-l@mail.obgyn.netSubject: Ascus management question Have a 50 yr old postmenopausal clinic pt that I inherited when I took over as managing gynecologist in March. Over the last 4 years she has had recurrent Ascus smears, with positive high risk HPV screen. A couple of years ago she did have a single Bx of CIN 1. Subsequent smears done every 4-6 months remain Ascus/ HRHPV pos. Colposcopy repeatedly neg for exocervical lesions. ECC not possible because of total cervical stenosis. No atypical glandular cells ever encountered. Clinic NP's and OB/GYN Director concerned that cervical canal not adequately assessed . They are inclined to proceed with LEEP/ cone bx. Apppreciate your comments. J. Glenn Bradley MD Get fantasy football with free live scoring. Sign up for FanHouse Fantasy Football today. family_safety_072008
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