Perineoplasty: The Real Deal
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Of all prolapse defects, vaginal laxity, or perineal thinning, is the most bothersome to patients and the least acknowledged by doctors. But that doesn't mean it's normal. Find out the best way to restore the vaginal opening's normal structure.
Transcript: Right after you have a baby, everyone seems eager to offer their best advice for a new mom. But there's...
Right after you have a baby, everyone seems eager to offer their best advice for a new mom. But there's one thing they may not be so willing to discuss. After childbirth, many women feel laxity during sex, air trapping in the vagina during exercise, a terrible 'open all the time' feeling, a bizarre falling-out-the-bottom sensation when walking, or like they simply can't close their vagina no matter how many Kegel exercises they do. The medical term for this problem is perineal atrophy, because it happens when the perineum, the small wedge of cartilage that separates the vagina and the anus, is pulled and stretched by childbearing or aging. Of all types of prolapse defects, perineal thinning is often the most bothersome to the patient and the least acknowledged by doctors. So don't settle for a life sentence of laxity if your doctor tells you it's normal. And don't waste your time with exercises. Even if you Kegel 500 times a day, the connective tissue down there won't grow back together. Perineoplasty is truly the only way to restore the perineum to pre-baby thickness. If your doctor doesn't understand what you are telling him or her, find a urogynocologist-because we do.More »
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Approximately 30% of all women suffer from uterine prolapse at some point in their lives. Get the facts on uterine prolapse and how it's treated in this video.
Transcript: Uterine prolapse affects 30% of ALL women, so theres a good chance that it will touch you or someone...
Uterine prolapse affects 30% of ALL women, so theres a good chance that it will touch you or someone you know. But before you can comprehend uterine prolapse, you need to have a basic understanding of a womans pelvis. The vagina is the foundation of female anatomy, while the cervix sits above the vagina, and the uterus above the cervix. Connective tissue called uterosacral ligaments hold the uterus and cervix in place. As the primary support system for the entire female pelvis, these uterosacral ligaments are extremely important! Uterine prolapse occurs when collagen fibers in these ligaments stretch or weaken, causing the cervix and uterus to drop down into the vaginal canal. If it drops far enough, its actually possible to feel and see the cervix, which looks like a small pink donut. Although this is not usually painful, a woman may experience feelings of heaviness or pulling in the pelvis. Other symptoms of uterine prolapse include painful sex, low backache, frequent urination, or even vaginal bleeding. A number of things can cause uterine prolapse. Women who give birth vaginally are more likely to experience thinning and stretching of the supportive uterosacral ligaments, especially those who experience long labors or deliver big babies. Prolapse is also more likely in women over 50, simply because muscle tone decreases with age. Research also suggests that some women may be genetically predisposed to uterine prolapse. In other words, you cant always PREVENT uterine prolapse, but you CAN-and should-learn about treatment options. One effective treatment choice is a pessary, which is a vaginal support made of rubber, plastic, or silicone. A doctor fits a womans pessary to her body to hold the prolapse comfortably in place. Surgery is another option, which, unlike a pessary, actually REPAIRS the prolapse. One in nine cases of uterine prolapse is severe enough to require surgery. The good news is that uterine prolapse IS fixable! To learn more about this condition and other female concerns, check out other videos on this site.More »
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Apart from surgery, there are other ways to treat uterine prolapse. Take a look at this video on pessaries to find out more.
Transcript: Surgery isnt your only option for treating uterine prolapse. A removable support gadget called a pessary...
Surgery isnt your only option for treating uterine prolapse. A removable support gadget called a pessary can be worn inside the vagina to hold the prolapse in place. Uterine prolapse occurs when the cervix and uterus fall from their correct position above the vagina into the vaginal canal. Should the uterus drop far enough, it may be possible to even SEE the cervix, which looks like a small pink donut. A pessary is sort of like a brace or wrap you would wear for wobbly knee ligaments. It simply boosts your uterus back up and holds it there. Women have used them since biblical times, when they were made of smooth stone and potatoes. Thankfully, todays models are made of comfortable latex, plastic, or silicone. Pessaries are ideal for women with prolapse who are in between babies or when a woman simply doesnt have the time, money, or good health that surgery requires. If your doctor decides a pessary is right for you, shell fit you right in her office. The best model is the one that you can insert and remove on your own, and it doesnt move around during any activity. Ring plate pessaries, the most common option, are 80% effective for treating mild and moderate cases of uterine prolapse. The ring pessary is inserted just like a diaphragm, where it rests on the Kegel muscle walls. If a womans Kegel muscle walls are weak, however, she may have a hard time keeping the pessary in place. Luckily, there are other options, like the Gelhorn, a stemmed device, the balloon, which can be inflated and deflated, and the Colpexin, which looks like a lollypop on a string. Colpexin is a newer model which gently exercises the Kegel muscles WHILE holding the prolapse in place. In fact, 63% of women who used this model had stronger vaginal muscles at the end of a 16-week trial! Whichever pessary you use, remember to clean it per your doctors instructions, and have it replaced if its cracked, pitted, or unpleasant smelling after washing.More »
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Hymenoplasty is a surgical procedure through which the hymen is restored for virginity. Get more hymenoplasty facts in this informative video.
Transcript: Losing your virginity used to be a one-time experience. But using cosmetic surgery called hymen restoration,...
Losing your virginity used to be a one-time experience. But using cosmetic surgery called hymen restoration, or hymenoplasty, todays plastic surgeons may be able to help you relive your first time. Named after the Greek God of marriage, the hymen has been considered a sign of virginity since the Stone Age. Its a thin mucous membrane that partially covers the entrance to a womans vagina and often ruptures the first time she has sex. But the hymen can also tear during normal activity, such as horseback riding, gymnastics, and even inserting a tampon. When the hymen breaks, some women experience mild pain and bleeding, while others feel nothing at all. So why would someone want to restore their virginity? Some cultures and religions value virginity so much that men may request a certificate of purity showing the hymen is intact before they marry. In cases like this, a woman may be humiliated, or even punished for not being a virgin bride. For this reason select plastic surgeons in the United States and Europe offer hymenoplasty. The surgery is performed under local or general anesthesia and it takes about an hour. A surgeon uses a laser or scalpel to bring the fragments of a womans hymen together, and then stitches them back together around the vaginal opening, leaving only the small opening associated with virginity. Hymenoplasty costs from $2,000 to $5,000 and only lasts until the hymen is broken again. Still, women continue asking for the procedure for both religious and nonreligious reasons. Some women cough up the money in the hopes of reviving their sex life, or surprising their partners in bed. Although it DOES appear to effectively give the illusion of virginity, hymenoplasty is not approved by any official plastic surgery or gynecological association. So it isnt covered by insurance, and it can be hard to find a surgeon to do it. To learn more about various forms of vaginal restoration, check out other videos on this hot topic!More »
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In recent years, labiaplasty, a surgical procedure for reshaping the female labia, has become a common plastic surgery. Know more in this video.
Transcript: Women can have cosmetic surgery to change the appearance of their noses, breasts, lips, and thighsso...
Women can have cosmetic surgery to change the appearance of their noses, breasts, lips, and thighsso why not their vaginas? Labiaplasty is surgery to reduce or re-shape a woman's labia. This surgery involves the labia minora, which are the vaginas thin, inner lips. Generally, labiaplasty is done to correct elongated or asymmetrical labia, which may be a result of genetics, dramatic weight fluctuations, childbirth, or age. Whatever the reason for the labias appearance, most women choose labiaplasty for cosmetic purposes. In other words, they want their vaginas to look better.' For some women, labiaplasty is treatment for pain during sex or discomfort during normal everyday activities, both of which may be caused by an oversized or asymmetrical labia. Labiaplasty is an outpatient procedure thats performed under sedation, local or general anesthesia. During surgery, the vaginal lips are cut and remodeled using a scalpel, laser, or specialized scissors. Some women under-go clitoral hood reduction at the same time, which removes the folds of skin that shield the clitoris. Clitoral hood reduction allegedly increases arousal by making the clitoris more pronounced, but this has never been proved, and being close to the clitoris, is highly controversial as it may do more harm than good. The cost of labiaplasty ranges from $3,500 to as much as $10,000, and it is not covered by insurance. Three to five days recovery time is required before going back to work, and AT LEAST four weeks before having sex. The American College of Obstetricians and Gynecologists state that labiaplasty may be appropriate in properly selected patients, but does not currently support clitoral hood reduction because more research is needed to assess that surgerys safety, risks and effectiveness. If you choose to have a labiaplasty, it is vital that you find a board-certified surgeon with A LOT of experience. If youre interested in learning more about other vaginal rejuvenation surgeries, check out more videos on this site!More »
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Are you faced with making a decision about how to treat uterine prolapse? It might help to know what's medically available to you. Check out this video for more information on prolapse surgery options.
Transcript: Uterine prolapse is a condition that occurs when the uterosacral ligaments, which support the uterus...
Uterine prolapse is a condition that occurs when the uterosacral ligaments, which support the uterus and cervix, weaken. As a result, the uterus and cervix can slip from their proper place ABOVE the vaginal canal and fall down INTO it. To fix a prolapsed uterus, there are four different surgical options - none of which are hysterectomy-based! The oldest was developed in 1888 and is called the Manchester procedure. This vaginal operation starts by wrapping the cardinal ligaments in front of the cervix. The cardinal ligaments are the vaginal ends of the previously mentioned uterosacral ligaments. One study found that 96% of Manchester patients did NOT have a recurrence of prolapse within three years. One problem with the Manchester procedure is that it doesnt always pull the uterus ALL the way up the vagina where it should be and stops about midway, instead. A second uterine prolapse surgery option is called sacrospinous uterine suspension. This vaginal resuspension technique anchors the fallen uterus to one or both of the sacrospinous ligaments, which are wedge-shaped ligaments present on either side of the sitting-bones. 80 to 90% of sacrospinous procedures successfully fix uterine prolapse. But potential complications include urinary incontinence, a higher rate of pelvic pain, rectal complaints, and shortening of the vagina. Sacrohysteropexy, a third surgical treatment, involves the flat sacrum bone, located between the buttocks. In sacrohysteropexy, done abdominally, the uterus is anchored to the sacrum. A graft material of synthetic mesh creates this connection, in essence creating an artificial uterosacral ligament. With success rates higher than 90%, many doctors consider sacrum suspensions to be the most resilient option. But since this operation is abdominal, its more invasive and requires a longer recovery. Plus, theres a very small risk that the sacral artery will be nicked during surgery, causing the patient to lose a lot of blood. The fourth and final surgical option to fix uterine prolapse is called uterosacral hysteropexy and involves the uterosacral ligaments, which are those cable-like supports meant to hold the uterus above the vagina. In this vaginal resuspension procedure, the uterosacral ligaments are shortened to elevate and resupport the uterus. Uterosacral surgeries offer the most flexibility, as they can be done vaginally OR abdominally. General success rates range from 90-95%, and complications are rare, including temporary or chronic pelvic pain or constipation. And while our focus is on procedures that do NOT involve hysterectomy, it IS possible to combine any of these re-attachment operations with the removal of the uterus. When that happens, the remaining vaginal cuff is the point of resuspension, instead of the uterus. Of course, no uterine prolapse surgery is right for everyone, and in some cases, surgery may not even be necessary! Your doctor can help you decide what the best option is for you.More »
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Many women suffer from uterine prolapse as a result of age and childbirth. But this condition is now surgically treatable. Learn more about uterine prolapse in this video.
Transcript: I've made it my mission to help women make sense of problems like pelvic organ prolapse, a condition...
I've made it my mission to help women make sense of problems like pelvic organ prolapse, a condition that occurs when a woman's bladder, rectum, or uterus falls from its proper location down into the vaginal canal. When a woman hears this definition for the first time, the next question is almost always the same: What can I do to make sure that NEVER happens to me? And each time, I regrettably unveil the truth. If a woman wants to avoid prolapse, the formula is both simple and unfair: never birth babies and die by age 50. Pelvic organ prolapse occurs when the collagen fibers in the connective tissues holding up the uterus, bladder, rectum and perineum thin out or stretch. It's most common in women who give birth vaginally, but I've seen it in women who have never been pregnant. The biggest problem with pelvic organ prolapse is that women often suffer for years, believing nothing can be done. And it's not only because they're too embarrassed to talk to their doctor about it, but also because their doctor isn't familiar with uterine resuspension and likely says that hysterectomy is the best way to fix prolapse. Consider this: When someone has knee or shoulder ligament problems, it's treated with physical therapy or surgery. These reconstructive procedures are done to correct the exact same type of wear and tear connective tissue defects that occur in the female pelvis. A torn rotator cuff just seems less sinister. The bottom line is you can have a pelvic support tune-up, and you don't have to whack out your organs to do it. To learn more about the latest uterine prolapse treatment options, check out other uterine health videos on this site.More »
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Different patients have different views regarding the use of pessaries. Learn what pessaries are for by taking a look at this video.
Transcript: My patients are rarely neutral about pessaries. They're either mortified at the mere suggestion of wearing...
My patients are rarely neutral about pessaries. They're either mortified at the mere suggestion of wearing the vaginal equivalent of a whiplash collar or they're thrilled at the prospect of avoiding surgery to fix pelvic organ prolapse. Pessaries truly are great for women who are still having babies or who don't have the time or health standing that surgery requires. They're easy to use and make you feel and function like normal when they fit well. When they don't fit well, on the other hand, you may feel pressure or pain in your pelvis and risk the pessary falling out when you cough or go to the bathroom. Pessaries can also cause a vaginal discharge, but this is easily avoided by using vaginal estrogen creams or suppositories on the vaginal skin. If you're like most women, you're curious about how wearing a pessary's going to affect your sex life. The truth is that it depends on the type of pessary you're using. Ring pessaries, which are my personal favorite, are easy to remove for sex or any other reason. The Gelhorn, a stemmed device, or balloon-style pessaries may be much harder or impossible to remove and insert correctly, so they stay inside the vagina, with checkups every 1-6 months, depending on individual response. Remember that pessaries don't cure prolapse, but they can provide effective short or long term treatment. Your gynecologist can help find the best model and fit for you.More »
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What is Hymenoplasty? It is a medical procedure in which the hymen tissue of a woman’s vagina is restored. For more information, watch this video.
Transcript: Plastic surgery to restore your virginity may seem like something born out of the Sex and the City generation....
Plastic surgery to restore your virginity may seem like something born out of the Sex and the City generation. But the truth is, hymen restoration, or hymenoplasty, has been around for centuries. Women typically ask for this controversial surgery because their culture requires virginity on the wedding night. Failing to prove their virginity may result in humiliation, ostracism, divorce, or even violence. Even so, it's hard to find a surgeon willing to perform hymen restoration for a lot of reasons. Many doctors feel it's deceptive. Others say no because it's not medically required or because the idea of requiring evidence of virginity discriminates against women-especially now that we know the hymen may become ruptured or torn from something as simple as playing sports or putting in a tampon and not just having sex. Some gynecologists justify hymen restoration because it serves health, which includes mental and social well-being and women's rights to control their own bodies. The bottom line, though, is that like many cosmetic vaginal surgeries, the risks and complications for hymenoplasty haven't been adequately studied. So for now, at least, it's impossible to know if it's more likely to improve a woman's life or devastate it.More »
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If the labia minora extend beyond the vulva's outer lips by 2 inches, a gynecologist may recommend a labiaplasty.
Transcript: Labiaplasty is a surgical procedure that trims down or reshapes the inner and/or outer lips of the vagina....
Labiaplasty is a surgical procedure that trims down or reshapes the inner and/or outer lips of the vagina. A gynecologist may recommend labiaplasty if the vagina's thin inner lips,or the labia minora, extend more than 2 inches beyond the outer lips, making sex and exercise extremely uncomfortable. But in most cases, this surgery is purely cosmetic and therefore not necessary. If a patient comes to me for labiaplasty because she wants her vagina to look a certain way or thinks it will make sex easier of better, I always advise against it. The simple explanation is that the risks outweigh the benefits. After surgery, you'll have to wear a pad for about a week due to bleeding, you can't have sex for 4 weeks, and you'll feel tender and swollen for several weeks. Plus, like any elective surgery, there's risk of skin infection, nerve pain, bleeding, decreased feeling in the area, and even sexual dysfunction. If you're self-conscious about your vagina or your goal is to increase sexual pleasure, talk to your doctor about more appropriate options.More »
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Bacterial vaginosis is an infection of the vagina that can be brought on by sex. But sex isn't all that's behind this bacterial imbalance.
Transcript: Bacterial vaginosis is the most common vaginal infection in women of childbearing age-and it may stem...
Bacterial vaginosis is the most common vaginal infection in women of childbearing age-and it may stem from sex! Bacterial vaginosis, or BV, occurs when normal, healthy bacteria in the vagina are overrun by bad bacteria. BV often manifests as a strong, fishy odor with discharge that may be grey, white, or yellowish in color. So what causes this vaginal infection to occur? Some doctors say BV is caused by sex, although you don't "catch" bacterial vaginosis from a partner. Instead, the infection occurs when an outside element disturbs the vagina's bacterial balance. Sex-particularly without a condom-can do just that. In addition, douching, wiping from back to front, and using an IUD as birth control may lead to BV. After diagnosis, the infection is treated with antibiotics for several weeks. But, sorry, you shouldn't have sex until BV is completely gone! So why not use this opportunity to convince him you should catch up on your cuddling?More »
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Sex during menstruation may seem like a very odd idea but with the right technique you don’t have to deny yourself the pleasure just because it’s that time of the month. Learn more here.
Transcript: Don't let a little blood stop you from having a great time! Here, tips on getting it on when you're...
Don't let a little blood stop you from having a great time! Here, tips on getting it on when you're menstruating. The best position for minimal mess involves your partner straddling you while you're on your back, a move which slows blood flow. Of course, it's always best to throw an old towel down in this scenario! Or, protect your sheets by wearing one of the newer forms of menstrual cups, like the INSTEAD Softcup. Inserted deep inside the vagina, the cup collects menstrual blood in its dome-like base. The cup works like a tampon, but it can be safely worn-although not felt-during sex. When having sex during your period, know that you are even more susceptible to STDs, as most can pass through menstrual blood. And yeah, you can get pregnant. So period sex should still be protected sex. Enjoy the experience more by being smart!More »
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If you are concerned about your vaginal scent, watch this video to get tips on maintaining a scent that is more pleasing to you. Check out this video to know more.
Transcript: Listen up ladies: Are you uncomfortable with your smell "down there?" The first step to smelling sweet...
Listen up ladies: Are you uncomfortable with your smell "down there?" The first step to smelling sweet is understanding why you don't. A truly unpleasant scent is usually the product of "bad" bacteria in your vagina. Bad bacteria cause the vagina's pH to change from a healthy acidic level to a smell-inducing alkaline one. Outsmart them by changing the way you wash. Harsh products strip away healthy bacteria, encouraging harmful bacteria to enter and leave the wrong kind of scent behind. Instead, wash your outer vaginal lips once daily with a mild, fragrance-free soap. But don't put soap inside your vagina. Your vagina is self-cleaning and can take care of that on its own! And pick panties with 100-percent cotton crotches, to improve air circulation and allow the vagina to breath. If you really want, you can try one of the feminine products which are commonly available, but make sure you scout out "pH-balanced" products to get the best benefits. But if you follow these simple tips, you won't have to use extra products to return to a sexier smelling state!More »
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