Diagnostics and Treatments

Robotic Surgery and Urogynecology

TENSION FREE VAGINAL TAPE PLACEMENT

Midurethral synthetic sling procedures are the treatment of stress urinary incontinence (SUI) are gaining increased attention from surgeons specializing in female pelvic reconstructive techniques seeking successful patient outcomes through reproducible simplicity.

PELVIC FLOOR REHABILITATION (BIOFEEDBACK TREATMENT THERAPY)

Pelvic floor physiotherapy (PFPT) is considered to be a salient component of the conservative management of women with urogenital dysfunction including urinary incontinence and pelvic organ prolapse (POP). PFPT is an important adjunct to the management of female pelvic and sexual pain disorders which are often associated with bothersome bladder symptoms. These are variety of treatment methods which include a behavioral therapy, exercise instructions, manual therapy, biofeedback and electrical stimulation.

SACROCOLPOPEXY

Sacrocolpopexy is a surgical procedure that can be used to correct vaginal prolapse. During the procedure, a piece of mesh is attached to the top of the vagina and the other end is attached to the sacral promontory that is located at the back of the pelvic floor and lower part of the spine. Surgeons use specially designed instruments to lift the prolapsed organs back to their correct anatomical position and attach them with permanent sutures.

ANTERIOR VAGINAL REPAIR

Anterior repair is used to tighten the front (anterior) wall of the vagina. It is used when the bladder drops out of its normal position and bulges into the front of the vagina, causing the front wall of the vagina to sag. This condition is known as anterior wall prolapse, cystocele or dropped bladder.

POSTERIOR VAGINAL REPAIR

Posterior repair is used to tighten the back (posterior) wall of the vagina. It is used when the rectum drops out of its normal position and bulges into the back of the vagina, causing the back wall of the vagina to sag, which may result in bowel dysfunction. This condition is known as posterior wall prolapse, rectocele or fallen rectum.

URODYNAMICS

Urodynamic tests for urinary incontinence are measurements taken to evaluate the bladder's function and efficiency. The actual tests done vary from person to person. It is relatively simple and can be done in a doctor's office. Other tests require expensive and sophisticated instruments to measure the amount of pressure experienced by thebladder and urethra.

VAGINAL PESSARY

A vaginal pessary is a removable device placed into the vagina. It is designed to support areas of pelvic organ prolapse. A variety of pessaries are available, including the inflatable, doughnut, and Gellhorn.

Minimally Invasive Hysterectomy - Laparoscopic and Robotic Hysterectomy

Hysterectomy is the surgical removal of a woman's uterus. This surgery can be done through small incisions using a thin, lighted scope with a camera on the end (a laparoscope). This is called a laparoscopic hysterectomy.
In robotic-assisted laparoscopic hysterectomy, the surgeon uses a computer to control the surgical instruments. The computer station is in the operating room. The surgeon is able to control the robot's movements steadily and precisely. This lets him or her get into tiny spaces more easily and has a better view of the operation than with conventional laparoscopic surgery.

Aesthetic Gynecology

  1. Labiaplasty - is a plastic surgery procedure for altering the labia minora and the labia majora, the folds of skin surrounding the human vulva.
    • Labia Majora (outer layer) - are two prominent longitudinalcutaneous folds that extend downward and backward from the mons pubis to the perineum. Together with the labia minora they form the labia of the vulva. The labia majora is homologous to the male scrotum.
    • Labia Minora (inner layer) - also known as the inner labia,inner lips, vaginal lips or nymphae,[1] are two flaps of skin on either side of the human vaginal opening in the vulva, situated between the labia majora(outer labia, or outer lips). Inner lips vary widely in size, color, and shape from individual to individual.
  2. Vaginal Tightening - is the tightening of the pelvic muscles to achieve or maintain the right degree of elasticity of the pelvic floor muscles.
    • Laser (Femilift) – is a state-of-the-art, minimally-invasive outpatient solution that incorporates CO2 technology to provide optimal care for various feminine concerns. The procedure is fast, painless and completely safe, and provides highly effective results.
    • G-Shot Amplification - is a simple, nonsurgical, physician-administered treatment that can temporarily augment the Grafenburg spot (G-Spot) in sexually active women with normal sexual function.
    • O-Shot Amplification - is a sexual and cosmetic rejuvenation procedure for the vagina using the preparation and injection of blood-derived growth factors. [The growth factors must be used in the specific way specified by the trademarked procedure to constitute the Orgasm Shot™/O Shot™.
    • Whitening of the Labia Majora -
  3. Perineoplasty - (also perineorrhaphy) denotes the plastic surgery procedures used to correct clinical conditions (damage, defect, deformity) of the vagina and the anus.
  4. Botox Injection for the vagina for vaginismus - Vaginismus is an abnormal, cramp-like condition of the vaginal muscles. It particularly interferes with sexual intercourse making penetration painful and sometimes impossible. Refraining from sex is, of course, not the ideal solution. - Botox is a proven long-term muscle relaxant. It has been used extensively in facial aging and spasticity. It is administered by fine needle injection directly into the offending muscles. Botox will paralyze and relax cramping muscles temporarily. The effect usually lasts between 2 and 6 months after which treatment can be repeated. - The antispasmodic effects disappear completely after a while, but the effect of a normal sex life during this period can eventually heal vaginismus completely. Our experience has shown that women need an average of 2 repeat treatments to be rid of this terrible vaginal tension. It is extremely rare that the treatment needs to be repeated permanently (every 6 months).
  5. Treatment for Stress Urinary Incontinence - Treatment options for stress urinary incontinence (SUI) in women are designed to prevent the involuntary loss of urine from the urethra during increases in intraabdominal pressure that occur during physical activity, coughing, or sneezing.
    1. Nonsurgical therapies include:
      1. Behavioral therapy (eg, bladder training, fluid and dietary modification)
      2. Drug therapy
    2. Surgical therapy include:
      1. Anterior Repair
      2. Transabdominal (Retropubic) Suspension approach
      3. Laparoscopic Procedures
      4. Transvaginal Needle Suspension
      5. Sling Procedures – Tension-free Vaginal Tape Placement (TVT)
      6. Bulking Agents
  6. Femilift - is a state-of-the-art, minimally-invasive outpatient solution that incorporates CO2 technology to provide optimal care for various feminine concerns. The procedure is fast, painless and completely safe, and provides highly effective results.
  7. Treatment for Vaginal Laxity - A diminishing in the tightness and sensitivity of this tissue if often a real concern as the overstretching that can sometimes occur can damage these collagen fibers is known as VAGINAL LAXITY.
    1. Home Remedies:
      1. Kegel Exercise
      2. Certain formulations like virgin herbal spray or virgin herbal creams
    2. Surgical Intervention:
      1. Vaginoplasty
      2. Labiaplasty:
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