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CHRONICPAIN: Guidance required please.

From: webster (anonymous@obgyn.net)
Wed, 7 Mar 2007 15:56:33 -0600 (CST)

Hi, could anyone offer any information or guidance on the following.

Female aged early fifties, has had a hysterectomy including removal of one ovary, one and a half tubes, womb and cervix. Has one functioning ovary only and part of a tube.

Experiences a cyclic pain over the remaining ovary which culminates in sharp pain of great intensity lasting 36-48hrs every 21 days.Patient also experiences a heavy discharge with dark brown blood staining before the pain lapses

Patient is now reporting unusual post coital bleeding . Bleeding is bright red and lasts for 24-36 hrs after intercourse and is sufficent to require wearing of a panty liner.

What investigations would be necessary and what diagnosis is likely.

IS torsion of remaining tube likely or should ovarian cancer be considered and if so as patient has adhensions would a laparotomy be the wiser investigation.

Any suggestions welcome.





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