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Re: Wha' do I do now?From: Kelly Shanahan (mks@sierra.net)Fri Aug 29 16:48:17 1997
>69 yr old woman started on Premarin/Provera 3 months ago by FP. >The cervix was stenotic (os completely epithelialized...not even a >dimple) > >She presented to me with pevic pain, an enlarged central pelvic mass and >and the ultrasound showed distended fluid filled uterine cavity. > >Today on Exam under anestrhesia, no os could be located or probed. > >What to do next? This reminds me of the very first time I asked for help on this list (cervical stenosis post cone). The suggestion that worked for me may work for you: shave away the ectocervix via LEEP until you can identify the os, then do a D&C. If it works and the path is benign, keep her on oral HRT plus some extra vaginal estrogen for a while to, maybe, help keep the os patent. If this doesn't work, or if she really wants her uterus out, do a hyst. Kelly -- Kelly Shanahan, MD S. Lake Tahoe, CA
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