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Re: Prolapsing myomaFrom: Robert Brenner (robbrenner@earthlink.net)Thu Jan 30 19:02:34 1997
At >I can feel completely around the fibroid, which is coming through the >cervix, but the stalk is about 1.5-2 cm in diameter and I cannot see it. >It does extend into the cervical canal, which is dilated to about 3 cm. > >My thought is to give Depro-Lupron, shrink the fibroid, and put her on >iron, to increase her blood count, then do a TAH, possible LSO versus >cystectomy, in 3 months. I don't think she has cervical Ca, but cannot >rule this out completely. What would you do? Exam under anesthesia, >with a biopsy of the mass? Straight to the OR? Patient seems reliable, >contrary to the above history. > >Rick > >-- >Rick Chudacoff, MD >Baylor College of Medicine >BaylorMedCare >Houston, TX Rick: I would take her to the OR, give her some sedation, then take a tonsil snare and encircle the fibroid, extend the snare up to the fundus, and cut off the fibroid. Her bleeding should stop and then you can later evaluate the ovarian cyst and do a PAP. I've done this several times with good results.
-- Robert Brenner MD FACOG Baltimore MD Robbrenner@earthlink.net
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