WOMENS-HEALTH Messages for February, 2001: Re: stenosis of the cervix or synechia

Re: stenosis of the cervix or synechia

From: M. Kelly Shanahan, MD (anonymous@obgyn.net)
Sat, 24 Feb 2001 00:08:09 -0600 (CST)

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In reply to: Susan: "stenosis of the cervix or synechia"

At Fri, 23 Feb 2001, Susan wrote: >
>I was scheduled for a pap smear with my GP, although usually I have a nurse
>practitioner do it at planned parenthood, my HMO requested that I get one
>through a network provider. I have always paid cash before to PPH but for
>some reason I did not question the HMO request and scheduled my pap with my
>primary physician. I have not had a period for abut 20 years which does
>not bother me in the slightest, but when my physician found out he said he
>could think of only two reasons, why that would be despite my stating I
>believed it was due to my birth control pills ( now taking orthonovum 777).
> He said I probably had either stenosis of the cervix or synechia and he
>wanted to due a procedure to check my endometrium tissue. He put the
>speculum in and then inserted a small tube saying that I would feel some
>discomfort. He then did "three passes" of I am not sure what, inside my
>uterus scraping out tissue and bringing out a fair amount of blood with it.
> Discomfort is not an apt description, I thought I would passout with the
>pain. I nearly vomited afterwards. There was no sedation or numbing done,
>no description of the procedure in any realistic terms. I was so nauseated
>and sore with intense cramping that I could not even ask any pertinant
>questions. Am I describing a procedure that you can tell me about?

sounds like an endometrial biopsy

If you >recognize the procedure is it standard to not administer any anesthesia of
>some sort?

anesthesia is not usually given, although I do premedicate my paitients with ibuprofen

I am under the impression that it is not uncommon for birth >control pills to stop the flow for many women. Is that an erroneous
>impression?

no this is true, although if the doc got a lot of blood back, his assumption of a stenotic cervix may have been correct. However, I would have expected some significant cyclic cramping in htat case - and I probably would have done/ordered an ultrasound to assess hte uterine lining before doing an immediate endometrial biopsy in this situation.

I would appreciate any information you could give me on this >matter.
>
>Thank you, sincerely,
>Susan
>
>Susan
>anonymous@obgyn.net

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

**this is for educational purposes only and does not supplant the need for you to consult your personal physician. *** Private e-mails WILL NOT be answered!!!!

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In reply to: Susan: "stenosis of the cervix or synechia"

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