Who Is Getting the LAST Word on Your Cervix?

HPV disease and what to do after a positive HPV test, or after an abnormal pap smear, or after prior treatment for precancerous changes of the cervix has been the subject of a lot of controversy. In the US, almost every strategy we use prevents cervical cancer reliably as long as you are following gyno advice. Ultimately we fail when we don't get the patient in for testing or follow up. But, we are still in search of a way to more reliably go after patients that are likely to progress to cervical cancer, and be able to be patient and wait for HPV disease to resolve if it is likely to not progress to cervical cancer. The newest meeting of the minds that follow this subject closely was in March of 2012, specifically looking at how the cervical biopsies are interpreted. This meeting was called CAP Pathology and Laboratory Quality Center and the ASCCP Consensus Conference: The Lower Anogenital Squamous Terminology Standardization Project (The LAST Project) . Their object is to further refine the way tissue biopsies done after an abnormal pap test are interpreted. They are advocating changes in how those samples are processed to more accurately know the results. There is a new test that laboratories will use called a p16. You may not even know that this p16 test has been used, but if it has been, it's possible there is a more accurate way to interpret what the pathologist reads when they are called upon for a diagnosis. Your gyno may have not yet seen these results, and their laboratories may not yet have adopted these changes, but very likely these changes will be adoped soon, as these experts do have the LAST Word on the biology of your cervix!

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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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