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Re: dyspareunia From: William Mcintosh, md (wdmcintoshmd@pol.net) Mon Apr 28 20:37:57 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Harvey S. Marchbein, M.D.: "Re: Preimplantation Testing for Kell" Previous message: tstork2: "Re: Mastodynia" Maybe in reply to: David Zimmerman: "dyspareunia" Next in thread: David Zimmerman: "Re: dyspareunia" Reply: David Zimmerman: "Re: dyspareunia" This sounds like the bowel is involved. Has she been worked up by someone from GI? -- William D. McIntosh, MD Clarksville, TN David Zimmerman wrote: > > Several weeks ago I saw a patient with an unusual constellation of Sx and I > obtained her permission to consult the list for input. She is a 28 yo G0 > with a 9 yr h/o cyclic pelvic pain initiated by orgasm, ovulation and often > occurring during the week prior to, but not during, menses. Occasionally > the pain is precipitated by anxiety, defecation, and voiding. It is > described as squeezing, twisting, and jabbing in the LLQ and radiates to > left lower back. After the beginning of the pain, there is a 25' period of > projectile vomitting. During this time, there is no bowel or bladder > control and she is forced to sit on the toilet. She has had two > laparoscopies (the most recent a little over a year ago) which showed only > small serosal fibroids, no adhesions or endometriosis. > > The cyclic nature of her symptoms prompted me to start BCP's and she is, at > least initially, reporting improvement, but not resolution, of Sx. We > discussed the possibility of trying a total suppression of hormonal > function with Lupron (using add-back therapy if the initial response was > encouraging) but this seems radical to me if the BCP's help. > > Any thoughts from the list as to etiology or other therapeutic options? > > Terri Rosenbaum,MD > Kauai, HI Next message: Harvey S. Marchbein, M.D.: "Re: Preimplantation Testing for Kell" Previous message: tstork2: "Re: Mastodynia" Maybe in reply to: David Zimmerman: "dyspareunia" Next in thread: David Zimmerman: "Re: dyspareunia" Reply: David Zimmerman: "Re: dyspareunia"

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