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Re: Optimal Treatment of Rectovaginal Endometriosis From: jay kulkin (jkulkin@mindspring.com) Wed Feb 25 17:12:12 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: ATB28@aol.com: "Re: Abnormal triple scree" Previous message: Malcolm Griffiths: "Re: FRI:SAVANAR way off OB/GYN" Maybe in reply to: Dr Ron Jewell: "Optimal Treatment of Rectovaginal Endometriosis" Next in thread: Carlos Alberto Porta: "Re: Optimal Treatment of Rectovaginal Endometriosis" What stage endo did she have at the time of hyst? This is a rather unusual post op finding but wouldn't be as surprised if it was stage 3 or 4. I think vaginal resection is fine but does she have other pelvic pathology? Laparoscopic approach, in very experienced hands, would be a good approach as you may have bowel involvement as well requiring resection. Otherwise, scope poss e lap after bowel prep etc. Jay At 05:00 PM 2/25/98 -0600, you wrote: >Ron, I have had good success in alleviating dyspareunia and other symptoms >by resecting the lesion vaginally and primary closure. Would also recommend >post op suppression with Depo-Provera or Lupron. > >Bob > >-----Original Message----- >From: Dr Ron Jewell <rjewell@medeserv.com.au> >To: Multiple recipients of list <ob-gyn-l@talk.obgyn.net> >Date: Wednesday, February 25, 1998 9:05 AM >Subject: Optimal Treatment of Rectovaginal Endometriosis > >>I have a 44 year old lady who had a hysterectomy for endometriosis >>related symptoms. Since the operation, she has developed rectovaginal >>septum endometriosis with an upper vaginal nodule about 2 cms in >>diameter which has biopsied as endometriosis and causes pain and >>dyspareunia. >> >>The rectal mucosa is not involved. She responded very well to gnrh >>agonists for 6 months. >> >>Should I now - do a bilateral laparoscopic oophorectomy and put her on >>HRT? >> >>Or - Resect the septum? >> >>Or - Continue medical treatment? >> >>-- >>Ron Jewell FRACOG >>PO Box 507 >>Bunbury >>Western Australia >> > Next message: ATB28@aol.com: "Re: Abnormal triple scree" Previous message: Malcolm Griffiths: "Re: FRI:SAVANAR way off OB/GYN" Maybe in reply to: Dr Ron Jewell: "Optimal Treatment of Rectovaginal Endometriosis" Next in thread: Carlos Alberto Porta: "Re: Optimal Treatment of Rectovaginal Endometriosis"

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