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Re: Ruptured endometrioma From: Bernard Cristalli (bcrist@club-internet.fr) Thu May 14 00:20:41 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Robert J. Woolley: "Re: Ultrasound certification" Previous message: jay kulkin: "Re: Ruptured endometrioma" RModugno wrote: > > Recently did laparoscopy on a patient who had a ruptured endometrioma. > Chocolate stuff throughout her abdomen. She actually had bilateral endotriomas and the > one ovary was stuck to the pelvic side walls. Both endomtriomas were resected and > adhesiolysis was performed.I intend to follow this with a course of lupron.She > is very keen to get pregnant soon. Questions for the cybergyns: > 1) Would it be reasonable to do a second - look laparoscopy with the view to > doing adhesiolysis if further adhesions are found? -- if this first operation is satisfactory (no cyst or adhesions left) a second operation would be redundant. If you left severe adhesions or endometriomas a second operation after three months of GnRH analog will be necessary. > 2) If yes, when should the second look laparoscopy be performed? -- 3 mo. The remaining adhesiolysis is much easier > > 3) For those of us who have performed second-look laparoscopy - how easy is it > to convince third-party payors that this is a reasonable thing to do? ( If, in > fact, it is a reasonable thing to do!) -- There are some publications supporting this attitude. Here are some: -- Bernard Cristalli MD CNGOF AIHP - ACCA Paris - France http://www.obgyn.net/corresp/cristalli.htm Next message: Robert J. Woolley: "Re: Ultrasound certification" Previous message: jay kulkin: "Re: Ruptured endometrioma"

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