11-17-2007, 02:06 PM
Six months after the delivery of her fourth
child, a 37-year-old
woman undergoes laparoscopic tubal ligation. Menses
occur at regular
28-day intervals. During the operation, she is found
to have a small
dark lesion in the cul-de-sac and filmy adhesions
surrounding the
ovaries. A biopsy specimen of a cul-de-sac lesion
confirms the diagnosis of
endometriosis. Which of the following is the most
appropriate next step
in management?
A
) Danazol therapy
B
) Gonadotropin-releasing hormone agonist therapy
C
) Oral contraceptive therapy
D
) Total abdominal hysterectomy and bilateral
salpingo-oophorectomy
E
) No further treatment indicated
child, a 37-year-old
woman undergoes laparoscopic tubal ligation. Menses
occur at regular
28-day intervals. During the operation, she is found
to have a small
dark lesion in the cul-de-sac and filmy adhesions
surrounding the
ovaries. A biopsy specimen of a cul-de-sac lesion
confirms the diagnosis of
endometriosis. Which of the following is the most
appropriate next step
in management?
A
) Danazol therapy
B
) Gonadotropin-releasing hormone agonist therapy
C
) Oral contraceptive therapy
D
) Total abdominal hysterectomy and bilateral
salpingo-oophorectomy
E
) No further treatment indicated