WOMENS-HEALTH Messages for April, 2000: Re: surgery is scheduled......hope I am doing the right thing (Dr. Hill) Or whoever would like to comment

Re: surgery is scheduled......hope I am doing the right thing (Dr. Hill) Or whoever would like to comment

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Sun, 16 Apr 2000 14:19:58 -0500 (CDT)

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At Sun, 16 Apr 2000, Peggy wrote: >
>At Fri, 14 Apr 2000, D. Ashley Hill, MD wrote:
>
>>I have questioned through out
>
>>....he is going to
>>>try to "burn" the pelvic walls to see if he can get rid of the ORS.
>
>one would not "burn" the pelvic walls to remove ORS.
>>Rather, one might "fulgurate" or cauterize areas of endometriosis.
>>Sounds like a miscommunication.
>
>I have been having CPP in The LLQ for over 2 years.I have had 4
>surgeries 1.LAVH and LSO 2. Laporoscopy for lysis of severe adhesions
>3. Laporoscopy for severe adhesions (intercede applied) 4. Laporsoscopy
>(no adhesions were found at this time) diagnosed with endometriosis and
>had RSO he did not remove the endo.due to it being to close to involving
>the bowel and so he was withholding HRT for 3 months to allow the endo.
>to "DIE" off ,pain still persists,had FSH and Estadiol levels checked,
>both are elevated.Dr. feels that there may be ovarian fragments that
>are producing estrogen.Started Lupron 2 weeks ago and have had an
>increase in pain.So my Dr. is more certain now that it could be ORS .
>>
>>He
>>>said that he can't tell what is ORS, endo, or adhesions.....does that
>>>sound right?
>>
>>Sure does. Until he goes in and looks there is no diagnostic test that
>>will give the answer. Could be all three (let's hope not).
>
>What is the difference in appearence between endo and ORS ?

Endo looks like endo (sorry) and ORS may or may not be visible whichis why some recommend Clomid to stimulate the tissue.

>>
>IF the Lupron doesn't help the pain
>Both my primary care physician and Gyn mentioned the possibility of
>doing radiation treatment.Is this something that you have ever
>recommended for any of your patients for endo. or ORS ?

Haven't recommended it personally but RT has been used for various disease entities and the ovaries have been "knocked out". The theory is sound, the practical application is another item. A consult with a radiation therapist may be helpful.

>Seems a little radical to me. Why not go in and try to excise the endo
>or remove the ovarian remnant ?

If possible (multiple surgeries and possible adhesions leading to increased surgical risks), it does, theoretically, sound better.

HSM

>Thanks for any responce! Peggy
>
>>--
>>David Ashley Hill, MD
>>Associate Director
>>Department of Obstetrics and Gynecology
>>Florida Hospital Family Practice Residency
>>http://home.mpinet.net/dahmd
>>
>>My apologies, but due to time constraints I am unable to answer private e-mails.
>>

--
Harvey S. Marchbein, M.D. FACOG, FACS
Great Neck, New York

**Note:  Opinions expressed here are for educational purposes only
and, as such, do not constitute a physician-patient relationship.
This information is not intended to supplant the need for you to
consult with your physician prior to choosing therapeutic options
and/or interventions.

**Private emails cannot be entertained due to time constraints,
consequently no private emails will receive a response.

**Thank you for your understanding ;-)

Next message: Harvey S. Marchbein, M.D.: "Re: Fempatch"
Previous message: Charles: "Re: Tampons"
In reply to: Peggy: "Re: surgery is scheduled......hope I am doing the right thing (Dr. Hill) Or whoever would like to comment"
Next in thread: D.N.: "Re: surgery is scheduled......hope I am doing the right thing"

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