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Re: Postmenopausal bleeding--**update** From: Garry E. Siegel, M.D. (garrys@mindspring.com) Fri Mar 28 19:48:15 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: maria luiza: "Re: Roberta's dinner" Previous message: ILBarnes@aol.com: "Re: I am lactating" Next in thread: rbraun@indyunix.iupui.edu: "Re: Postmenopausal bleeding--**update**" Reply: rbraun@indyunix.iupui.edu: "Re: Postmenopausal bleeding--**update**" Reply: Michael J. Wolpmann, M.D.: "Re: Postmenopausal bleeding--**update**" Thanks to all for your opinions. After talking with this woman today, and going over saline sonography (my choice) versus Hysteroscopy/D and C, she wants the certainty of the latter. Given her risk factors--nullip, Obese, IDDM, Hypertension--I have a hard time not doing a D and C/Hysterscopy, which remains the standard of care. Garry At Mon, 24 Mar 1997, Garry E. Siegel, M.D. wrote: > >Opinions please, ladies and gentlemen; what would ya'll do? > >66 YO Obese, IDDM, Hypertensive referred from her internist for >postmenopausal bleeding. At age 36 had 1.5 ovaries removed (according >to the patient), and had an early menopause thereafter. She has never >been on hormones. > >On exam, her uterus is not palpable, nor are here ovaries (whatever >might remain). I first did an endo biopsy with a pipelle, and got no >tissue. She came back in, and I did a pipelle and a 4 quadrant Novak >biopsy, and got proliferative endometrium. I then had her have a >vaginal sonogram and the endometrium is 3.1 mm thick. > >I am debating among the following options; her bleeding is not heavy, >and intermittent. > >1. Saline sonography; if normal, do nothing more. If abnormal, >reassess. > >2. Doing nothing more. > >3. D and C/Hysteroscopy in the OR (she's too big, old, and "sick" to >attempt in my office). > >Thanks in advance for your opinions. > >Garry :) > >-- >Garry E. Siegel, M.D., FACOG >Private Practice >Roswell, Ga. > -- Garry E. Siegel, M.D., FACOG Private Practice Roswell, Ga. Next message: maria luiza: "Re: Roberta's dinner" Previous message: ILBarnes@aol.com: "Re: I am lactating" Next in thread: rbraun@indyunix.iupui.edu: "Re: Postmenopausal bleeding--**update**" Reply: rbraun@indyunix.iupui.edu: "Re: Postmenopausal bleeding--**update**" Reply: Michael J. Wolpmann, M.D.: "Re: Postmenopausal bleeding--**update**"

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