WOMENS-HEALTH Messages for May, 2000: Re: moval of ovaries

Re: moval of ovaries

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Tue, 16 May 2000 20:14:41 -0500 (CDT)

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At Tue, 16 May 2000, anonymous@obgyn.net wrote: >
>At Fri, 12 May 2000, Harvey S. Marchbein, M.D. wrote:
>>
>>At Fri, 12 May 2000, anonymous@obgyn.net wrote:
>>>
>>>I have endo on the bowels, 1 ovary & back of uterus. Two gynos that I
>>>have seen recommended a complete hyst. I am in an HMO, and am highly
>>>restricted on the docs I can see. Neither of these docs seemed very
>>>educated on endo.
>>>
>>>My reading seems to indicate that removal of uterus without a complete
>>>removal of endo from the bowels, is not advisable, as the uterus
>>>protects the endo on bowels from spreading to the bladder.
>>>
>>>Why not just remove the ovaries & put me on HRT?
>>
>>Even with oophorectomy and HRT, optimum would be to extirpate (love that
>>word and never get enough chances to use it - means "get rid of") all
>>visible endometriosis.
>>
>Dr. Marchbein, thank you very much for your response.
>
>I would love to have all the endo extirpated (glad you provided a
>definition). However, my HMO is very restrictive on the docs I can see
>(I've consulted with 2 so far). I doubt very much if these docs would
>even be willing to attempt to remove the endo from bowels and rectum.
>They didn't even address that problem in my consult. They just said I
>had stage IV endo, that the 1 ovary is endometrial & is almost the size
>of uterus, and the left utero-sacral ligament area is infiltrated with
>endo. Their solution was a hyst. I don't have the horrible pain I used
>to have with the endo, but they didn't like the fact that there was so
>much of it. In addition, even if they were willing to bring in a
>"gastro-whatever they're called doctor" into the surgery to work on the
>bowel, the HMO wouldn't cover it. So, I think it's a given that the
>endo will NOT be removed from bowels & rectum.

A general surgeon or a colon and rectal surgeon. IF they won't approve it, get a supervisior, then get thier supervisor, then the president of the company then your congressman then yuour local TV channel to complain. Do what you need to do to take care of yourself.

>Therefore, I was thinking that preserving the uterus would at least
>lessen the chances of the endo spreading to bladder (See my reply to Dr.
>Braun in this thread if you're interested).

Didn't see your reply but I remember Dr. Braun's and he's right. the uterus won't protect the bladder. Sorry. I've seenit on the bladder even with a uterus there.

>>>Is there a reason why this couldn't be done? Why are gynos adverse to
>>>only removing the ovaries & not the uterus.
>>
>>Usually not enough.
>How does the uterus contribute to the growth and or persistence of the
>endo.

#1 There may be invisible endo onthe uterus (yes, there is invisible endo)

#2 Endo has a tendency to cause dense scarring in the pelvis mainly. Removing the uterus removes an area to get dense scarring, adhesions and pain.

Good luck.

HSM

>I know for many female ailments, the uterus has to go. By how
>would it help with endo?
>
>Thank you, again, for your response.

--
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: moval of ovaries"
Previous message: Tracy: "Re: HRT"
In reply to: anonymous@obgyn.net: "Re: moval of ovaries"
Next in thread: R. Daniel Braun, MD: "Re: moval of ovaries"

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