WOMENS-HEALTH Messages for December, 1999: Re: Uncertain about treatment for AGUS?

Re: Uncertain about treatment for AGUS?

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Thu, 30 Dec 1999 13:35:39 -0600 (CST)

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In reply to: terry: "Uncertain about treatment for AGUS?"
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At Thu, 30 Dec 1999, terry wrote: >
>Please help me. My pap test came back at the end of August as AGUS. I
>went for a colposcopy on November 1 (the first opening my obgyn had). He
>was unable to do the colposcopy because he said that my cervix was too
>tight. Now I am scheduled for a D&C (to rule out cancer he says) and
>another colposcopy in the hospital. I have read from past posts that a
>D&C is not the best way to determine what is causing this AGUS. I went
>for a second opinion and this doctor told me that she would also add the
>LEEP to the colposcopy and the D&C. Now I am really confused. Also,
>what kind of a cancer might I have, cervical or endometrial or both? I
>am trying to talk to my obgyn about doing a LEEP while I am surgury. Is
>this a good idea? And I sure hope that I haven't waited too long for all
>of this. My obgyn seems to think not.Any help that you could give me
>would be much appreciated.

Some general info. When AGUS is noted on a pap, it's showing glandular cells. The outside of the cervix has squamous cells (skin-like). The lining of the cervix and the lining of the vagina have glandular (gland-like) cells. With AGUS, it's usually endocervical (inside the lining of the cervix) abnormalities but the possibility of endometrial (glands from the lining of the uterus) abnormalities is possible. Although ideas and techniques vary, most gyns feel that the initial investigation of an AGUS should include colposcopy, endocervical curretage (scraping of the lining of the cervix), endometrial biosy (sampling of the lining of the uterus) and some believe in LEEP as part of a first step although many do not. Those that don't reserve LEEP for recurrent AGUS (noted on paps 3-6 months apart, depending upon the situation). As far as a D&C, if getting a sample is impossible because of cervical stenosis (tight or scarred cervix), D&C may be appropriate.

--
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 ;-)

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In reply to: terry: "Uncertain about treatment for AGUS?"
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