Should the ovaries be removed at the time of hysterectomy for prolapse?
January 23, 2013
At times, a partial or total hysterectomy is recommended at the time of prolapse repair. Whether or not to remove the ovaries at the time of hysterectomy is a separate and distinct issue. If the patient is not menopausal and the ovaries are fully functioning, the ovaries are left in place unless they are abnormal. If the patient is menopausal […]
Botox and the Bladder
January 17, 2013
Botulinum Toxin, better known as Botox, is now approved by the U.S. Food and Drug Administration to treat adults with overactive bladder. Botox had previously been approved to treat urgency incontinence due to known neurologic injuries such as spinal cord trauma, stroke and Multiple Sclerosis. Now its use is expanded to treat patients with overactive bladder or OAB where the […]
What is the difference between a Sacrocolpopexy and a rectopexy or sacrorectopexy?
January 9, 2013
During a da Vinci sacrocolpopexy, surgical mesh is used to restore the normal anatomy of the vagina. Sacrocolpopexy is used to treat pelvic organ prolapse including uterine prolapse, cystocele, rectocele, vaginal vault prolapse and enterocele. Rectopexy is used to treat rectal prolapse. The rectum is the final portion of the large intestine and is located above the anus. Rectal prolapse […]
Labiaplasty Pre and Post-Operative Instructions
January 3, 2013
BEFORE Surgery Shaving: Shave entire area prior to the procedure. Hibiclens: The night before surgery, clean labia with Hibiclens then rinse off thoroughly with water. (Hibiclens is an anti-bacterial surgical soap that may be purchased over-the-counter). EMLA: apply a thick layer of the cream to the labia and clitoral skin 4 hours before your procedure; rubbing the cream in thoroughly to all […]
Is a Vaginoplasty Procedure the same as a Labiaplasty Procedure?
December 14, 2012
The answer is no. A Labiaplasty involves the removal of the extra or uneven labia minora (inner vaginal lips). A vaginoplasty is a reconstructive procedure of the vagina that is performed when the vagina is shortened, either congenitally or from prior vaginal surgery. A perinorrhaphy (sometimes referred to as perineoplasty) is an important part of vaginal prolapse repairs in patients […]
What is Prolapse?
December 7, 2012
A prolapse occurs when the pelvic muscles and ligaments that function to support the vaginal uterus weaken and allow the bladder, rectum, uterus, or small intestine to drop into the vagina. A prolapse may be asymptomatic or may cause bothersome symptoms or even inhibit activities of daily living. Some women describe prolapse as the sensation of something dropping in the […]
How much labial skin is removed at the time of labiaplasty?
November 6, 2012
The goal of labiaplasty surgery is to remove enough of the labia minora to alleviate symptoms associated with enlarged labia. These symptoms may include chronic irritation, discomfort and rubbing during sexual intercourse, and when wearing tight fitting clothing. Some women with labial hyperplasia also complain of recurrent yeast infections or vulvar vestibulitis symptoms. By removing excess labial tissue, symptoms of […]
Intrinsic Sphincter Deficiency (ISD) and Stress Incontinence
October 27, 2012
Intrinsic Sphincter Deficiency (ISD) occurs when there is weakness of the urethral sphincter. ISD may be caused by genetics, nerve damage from prior surgery, or neurological disorders. Urinary leakage typically occurs more frequently and in greater volumes in cases of ISD than in cases of stress urinary incontinence without ISD. The mid-urethral sling is the mainstay of treatment for ISD. […]
Initially, collagen was used as the bulking agent. Coaptite and Durasphere are newer bulking implants that last longer and maintain durability over time. Coaptite combines calcium hydroxylapatite particles and a sodium carboxymethylcellulose carrier gel to form a scaffold that promotes tissue infiltration around the urethra to strengthen the urethra and decrease the urinary leakage associated with ISD. Durasphere EXP is […]
Chronic Constipation
September 11, 2012
Constipation is infrequent bowel movements of difficulty passaging stools. This may occur short-term and be managed easily with diet and lifestyle modifications. Chronic constipation lasts for a long period of time, may worsen over time and may require more elaborate treatment. Chronic constipation can have a number of different etiologies and should be evaluated to determine the cause and proper […]
How Successful is InterStim in the Treatment of Urinary Urgency, Urgency Incontinence, Urinary Retention and Fecal Incontinence?
August 9, 2012
InterStim may be a good treatment of urinary urgency, urge urinary incontinence, urinary retention or fecal incontinence. Many of these symptoms are first treated conservatively with behavioral modification and medications. Sometimes, physical therapy is also employed. If symptoms are still intolerable, or if patients cannot tolerate the medications used, InterStim is considered. InterStim is a dynamic form of treatment which […]