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Re: Postmenopausal bleeding--**update**From: Garry E. Siegel, M.D. (garrys@mindspring.com)Sat Mar 29 21:14:43 1997
At Sat, 29 Mar 1997, rbraun@indyunix.iupui.edu wrote: > >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 Dan: I certainly do not have much excitement about taking her to the OR, even for something as minor as a D&C/hysteroscopy. However, she has unexplained post menopausal bleeding, and multiple risk factors for endometrial cancer. Furthermore, she had proliferative, not inactive endometrium. She also is worried and did not accept the option of saline sonography (to rule out a polyp and lend further support to not operating). Lastly, there are examples, however few, of finding lesions such as complex hyperplasia in the absence of a thickened endometrium. We all know the biopsy is reasonably representative of the endometrium, but that exceptions occur. Thus, I was willing, and offered/suggested to her to not go to the OR, but she wanted as much certainty as available. Thanks for your thoughts. Garry
-- Garry E. Siegel, M.D., FACOG Private Practice Roswell, Ga.
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