WOMENS-HEALTH Messages for March, 2000: Re: Hopefully Last Questions

Re: Hopefully Last Questions - Agus

From: Kelly Shanahan, MD (anonymous@obgyn.net)
Fri, 31 Mar 2000 23:46:09 -0600 (CST)

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In reply to: jwang, M.D.: "Re: Hopefully Last Questions - Agus"

At Fri, 31 Mar 2000, jwang, M.D. wrote: >
>The work-up you've had is what most docs would do. For DES daughters,
>the evaluation recommended is a baseline colposcopy to evaluate the
>vagina and cervix, then provided that the evaluation is normal, yearly
>cervical and vaginal PAP smears.
>If the work-ups continue to be negative, despite abnormal PAP smears, a
>cone biopsy can be performed for another attempt at diagnosis.
>Another option, if not already done is a consultation with a gynecologic
>oncologist for another opinion.
>
>At Fri, 31 Mar 2000, Ruth wrote:
>>
>>Sorry to ask so many questions but this has been very stressful to me.
>>As I said, last year I had AGUS and simple hyperplasia (prolonged
>>estrogen effect) was the diagnosis of the workup. This year, I still
>>show AGUS on the pap although the endocervical curretage and endometrial
>>biopsy are benign. I am going back in 6 months for the colpo, the
>>office endometrial biopsy, the pap/vaginal slides, the endometrial
>>curretage, the whole works. Now, if they all are benign (that will be
>>Sept)and I still have the AGUS on the pap should I consider the
>>hystectomy at that time or do I wait 6 more months and test again? Is
>>there any other alternative to a hysterectomy that wouldn't be too much
>>of a gamble with my health?
>>
>>Since my recent workup was benign, how much of a risk am I taking
>>waiting 6 months to retest? And if they do find the abnormal cells,
>>let's say in the vagina (because of the DES in utero exposure) what is
>>done about that? I don't want to worry the whole 6 months til I retest
>>feeling like I am a walking time bomb. Am I? : ) Thank you for your
>>concern and understanding. These should be my last questions. Bless
>>the doctors on this forum for your kindness and your knowledge. I know
>>I asked a lot, but I'd feel a lot better with a gameplan. Ruthie

In addition to what Dr Wang has said, I would suggest a hysteroscopy/D&C if AGUS continues to show up -- and endometrial biopsy may miss a small, focal abnormality.

-- M. Kelly Shanahan, MD, FACOG S. Lake Tahoe, CA

Replies are for educational purposes only and do not construe a doctor-patient relationship; they do not take the place of a face-to-face consultation with your own doctor.

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