Pubovaginal Sling with Abdominal Fascia
April 9, 2015
There are several approaches that can be used for the treatment of stress urinary incontinence. Stress urinary incontinence (SUI) is the leakage of urine with physical stressors, such as coughing, sneezing, laughing or with exercise, causing abdominal pressure to increase. When leakage is minimal and not disruptive to activities of daily living, patients may be satisfied with relief from kegel […]
Labiaplasty Technique: Wedge vs. Trimming
March 16, 2015
Typically, labiaplasty and clitoral hood reduction combines both the trimming and the wedge technique.
In the image above, the trimming technique was used to reduce the majority of the overgrown labia. The top part of the labia that also forms part of the clitoral hood is removed with the wedge technique. This combination approach allows for a more natural transition from the clitoral hood to the labia. Care is taken to leave the frenulum […]
In the image above, the clitoral hood is not enlarged, and the trimming technique alone is used to reduce the labia. This allows for a natural appearing contour to the labia.
In the image above, the labia extend into the perineum past the posterior fourchette. Removal of the excess skin in the perineal and posterior fourchette area is done using the trimming technique. Care is taken to avoid over tightening of the opening to the vagina when removing enlarged labia in this area. This is achieved by excising the skin to […]
What is Labia Majora Reduction?
March 16, 2015
The labia majora is the outer portion of the vagina as seen below. The labia majora is made of skin covering fat and blood vessels. Labia Majora reduction can be done for different reasons. Some women may notice a bulge of this area resulting in discomfort in tight clothing or bathing suits or displeasure in the overall appearance. Others may […]
Overactive Bladder and Urge Incontinence
February 11, 2015
Women with frequent urination and sudden unstoppable urges to urinate are considered to have overactive bladder or OAB. OAB can be a result of abnormalities of the nerves that supply the bladder or due to abnormalities of the muscle of the bladder itself. This can result in a sudden urge to urinate, urge incontinence (not being able to make it […]
Vulvar Vestibulitis
February 10, 2015
Vulvar Vestibulitis is characterized by pain limited to the vestibule, the area surrounding the opening of the vagina. The pain of Vulvar Vestibulitis is present when pressure is applied to the vestibule (sexual intercourse, tampon insertion, prolonged sitting) and is described as burning, soreness, stinging, rawness, throbbing, or itching. Causes include: Chronic irritation to the vestibule from irritants such as creams, […]
Is This Normal After Delivery?
January 27, 2015
There are changes that can occur effecting the strength and support of the pelvic floor following vaginal delivery. These changes are more common with larger birth weights, multiple deliveries, increased age and when there is a family history of urinary incontinence or prolapse. Many women experience a new onset of stress urinary incontinence (leakage of urine with coughing, sneezing, jumping […]
Vaginal Hormone Use Before Prolapse Surgery
January 16, 2015
Why do I need vaginal hormone cream before my pelvic prolapse surgery? Vaginal estrogen in cream or pill form is often prescribed to menopausal women before vaginal surgeries, such as prolapse surgery. Estrogen is a hormone made predominantly by the ovaries. Under the influence of estrogen, the vaginal lining has a thick cellular wall. When estrogen production decreases around the […]
Power Morcellation No Longer Utilized at Austin Urogynecology
December 30, 2014
Several months ago, we posted an update on new recommendations regarding power morcellation used during laparoscopic and robotic hysterectomies. Since that time, most of the hospitals where Dr. Shashoua operates have elected to stop carrying all power morcellators. This decision has been made because of concern for the small risk of spreading an undiagnosed uterine sarcoma (a type of cancer). […]
Do Vaginal Incisions Affect Sensation During Intercourse?
December 23, 2014
Incisions are made inside the vagina for vaginal prolapse repair, da Vinci robotic prolapse repair, and mid-urethral sling procedures. Some women are concerned that these incisions will affect the Graffenberg spot (G-spot), which is an area of condensed nerve tissue in the vagina. However, vaginal sensation is not decreased in any way after vaginal incisions heal. The goal of any […]
Estrogen for Treatment of Recurrent UTIs
December 8, 2014
Why do I need vaginal estrogen before surgery? Vaginal estrogen in cream or pill form is often prescribed to post-menopausal women before vaginal surgeries. Estrogen is a hormone made predominantly by the ovaries. Under the influence of estrogen, the vaginal lining has a thicker cellular wall. When estrogen production decreases around the time of menopause, this results in a thinning […]