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Re: Postmenopausal bleeding--**update** From: rbraun@indyunix.iupui.edu Sat Mar 29 14:28:30 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Betsy Hyde: "Re: HRT dosing variations" Previous message: rbraun@indyunix.iupui.edu: "Re: Bought the ureter......" In reply to: Garry E. Siegel, M.D.: "Re: Postmenopausal bleeding--**update**" Next in thread: Garry E. Siegel, M.D.: "Re: Postmenopausal bleeding--**update**" Reply: Garry E. Siegel, M.D.: "Re: Postmenopausal bleeding--**update**" I don't understand the problem. You have sampled the endometrium adequately by doing a biopsy and getting back proliferative endometrium. I think to do anything further would needlessly put this lady at risk surgical and anesthetic complications. -- @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ R. Daniel Braun, MD FACOG "Money will buy you a fine dog Clinical Professor OB/GYN but only love will make it Indiana University School of Medicine wag its tail" Indianapolis, IN Richard "Kinky" OBGYN.net, International Rep. U.S. Friedman Kinky Friedman for President @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ On Fri, 28 Mar 1997, Garry E. Siegel, M.D. wrote: > 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: Betsy Hyde: "Re: HRT dosing variations" Previous message: rbraun@indyunix.iupui.edu: "Re: Bought the ureter......" In reply to: Garry E. Siegel, M.D.: "Re: Postmenopausal bleeding--**update**" Next in thread: Garry E. Siegel, M.D.: "Re: Postmenopausal bleeding--**update**" Reply: Garry E. Siegel, M.D.: "Re: Postmenopausal bleeding--**update**"

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