Unexpected Results on a D and C: CIN on a D and C Path Report

A reader asked several great questions regarding the findings of CIN, in her case I/II or mild to moderate dysplasia, on the pathology report of a D and C and then NovaSure done. NovaSure endometrial ablations are to treat heavy menstrual cycle bleeding which is the result of the shedding of the endometrium, or the lining of the uterus. CIN stands for Cervical Intraepithelial Neoplasia. This is a term for precancerous changes of the cervix itself. It is not likely the cause of any heavy menstrual bleeding. It is not likely the cause of any actual symptoms at all (spotting and discharge are sometimes associated, but not often). It is the result of an HPV infection, and it can lead to cancer. The chance that a woman will have cervical cancer after a CIN I diagnosis is probably about 1/100...after a more high grade diagnosis ...CIN II or CIN III....more like 10/100. Other tests are useful, like an HPV 16/18 test, or the actual pap smear. But bottom line, CIN cannot come from the lining of the uterus, it comes from the cervix. So if it was an unexpected result from your D and C, then you need to have your gyno investigate further. Some gynos may choose to have a colposcopy done for you right away (look with the microscope). Just ignoring unexpected findings may not be the best strategy for all, perhaps a gab with another gyno. And for those of you readers just reading who didn't just have an unexpected test: HPV is literally becoming a preventable disease. Vaccinate your girls and your boys and maybe we won't ever have to have this part of THE GAB again!

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Passing Your Uterine Lining, Menstrual Period Norms

Decidual Cast Periods can be fairly easy, passing some tissue at a time, or off can come the whole lining in one piece called a decidual cast. Generally the lining of the uterus is only 6-8 mm thick at the time of the menstrual period, and it is shed gradually, a few cells at a time. The decidual cast is when the entire lining passes spontaneously. It's not uncommon, but it usually both uncomfortable, and alarming to some. But us women are designed to have some sort of periods Or Not? We have to pass tissue each month. Or Not? Are they good for us? Or Not? Do we want them? Or Not? Is this something that is individual? Or Not? It's a complex topic that I will be discussing a lot over my time in this blog. So lets start with basics: How much do we bleed and what are we loosing, and just what was this that the patient passed? And another basic: track your periods, and the Women's Health Practice site http://www.womenshealthpractice.com/media/pdf/menstrual_chart.pdf you...

Post-Endometrial Ablation Syndrome

If you have had an endometrial ablation and have developed symptoms of pelvic pain you might have post endometrial ablation syndrome. What is post-endometrial ablation syndrome? It is a constellation of symptoms due to entrapped blood or tissue within a uterus that has previously undergone an endometrial ablation. We are able to diagnose this at Women's Health Practic e but occasionally other conditions are causing similar symptoms. Other complications of endometrial ablation include pregnancy, risks from pre-existing conditions such as a polyp or fibroid, an infection of the uterus, or a pregnancy. If you have had a tubal ligation then it is possible that the condition could be post-ablation tubal sterilization syndrome. The ablation procedure is designed to destroy all lining tissue, but in fact there is no way to confirm the completeness of the ablation. It is thought that either residual or regrowth of the tissue is producing the symptoms of post-endometrial ablation syndrom...

You Have an IUD: But a Positive Pregnancy Test

Fortunately IUD pregnancy failures are rare. But if you have an IUD for contraception, and you get a positive pregnancy test, you probably ask yourself, what next? Well, make your gyno appointment promptly, this is a condition that is not typically an emergency, but it can be and it’s not handled over the phone or on a blog, or through self diagnosis! That being said, some researchers from University of Texas Southwestern Medical Center in Dallas decided to look back at over 4100 women who had IUDs and of those 42 cases who became pregnant in their institution, over about a year period of time, to help understand what these women could expect when they got to their gyno and what actually happened to their pregnancies. Accurate pregnancy diagnosis, pelvic examination, and pelvic ultrasound were the cornerstones of the evaluations. They had very specific ways they looked at their ultrasound to prove there was no pregnancy in the fallopian tube, or partially in the fallopian tube...

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