Comprehensive Urology

Vaginal Reconstruction

At Comprehensive Urology in Los Angeles, we offer a variety of vaginal reconstruction procedures as well as vaginal repair procedures. Vaginal reconstructive surgeries emphasize the repair of genital defects and restoration of the genitals to ensure proper function.

Our vaginal repair procedures include sling procedures, vaginal robotic surgery, bladder augmentation, and prolapse repair.

Comprehensive Urology offers a wide range of vaginal reconstruction surgeries to address a provide a solution for your condition, whether it is prolapse, incontinence, or trauma. Our highly trained urologists can offer insights into our vaginal reconstruction treatments and help patients determine which procedure can provide the optimal results.

At Comprehensive Urology in Los Angeles, we offer a variety of vaginal cosmetic procedures as well as vaginal reconstructive procedures. Comprehensive Urology provides both cosmetic and reconstructive vaginal procedures. Our cosmetic surgeries are designed to enhance the aesthetic appeal, symmetry, and proportion of the genitals. Comparatively, our reconstructive surgeries emphasize the repair of genital defects and restoration of the genitals to ensure proper function.


Vaginal Reconstruction
Treatment Options

 

Vaginoplasty:

Vaginoplasty is a surgery designed to tighten the vagina. With vaginoplasty, separated muscles in the vagina are reconnected, and extra mucosa skin from the back side of the vagina is removed. Also, the procedure ensures external skin from the vagina is removed, resulting in an improved aesthetic appearance.

Women may choose to undergo vaginoplasty after childbirth. Vaginoplasty helps women address vaginal laxity due to stretching of tissues or separation of muscles. The procedure also helps women address a lack of tone in the vagina that may lead to sexual dysfunction.

Vaginal Robotic Surgery for Pelvic Floor Reconstruction:

One of the most exciting advances in pelvic reconstruction has been incorporation of the da Vinci robot technology in the repair of significant pelvic floor descent and repair. Its main use is with a procedure called sacral colpopexy, which lifts and corrects all types of pelvic prolapse, and in some cases can be done without hysterectomy. It is also useful in repairing vaginal fistula. The new technology does not replace well known and successful approaches to surgery, but simply allows the surgeon to accomplish the same results through very small incisions in the belly, decreased blood loss and frequently a faster recovery time.

Bladder Augmentation:

One possible solution for patients with small capacity bladders is the use of bowel tissue to increase the size of the bladder. Bladder augmentation is usually a procedure reserved for patients who have exhausted many other options and continue to have issues with frequency and incontinence.

Bladder augmentation is most often used in patients with a neurologic issue leading to bladder dysfunction, such as multiple sclerosis. It has also been used for patients with severe bladder dysfunction resulting from pelvic radiation, severe interstitial cystitis, or intractable overactive bladder without obvious cause. The main idea with this approach is to allow the patient to maintain a functional bladder where the urethra can still be used in a normal fashion.

This procedure is a serious undertaking and involves many risks and potential complications not only during the procedure and recovery, but also after recovery if proper maintenance and care is not continued.

Vaginal Prolapse Repair:

The main non-surgical option for vaginal prolapse is use of a pessary, which is a small plastic device that is fitted in the vagina to help keep the pelvic floor in proper position. This may be fitted by a urologist or gynecologist and occasionally must be refitted or sized. It is an excellent option for women who are not sexually active, or who wish to avoid surgery but have significant issues due to vaginal prolapse. It does require maintenance care with a physician for regular cleaning and evaluation of the tissue to assure no problems surface. There are several types of rectal and vaginal prolapse repair treatments.

Sling Procedures For Stress Incontinence

The term “sling” causes confusion and frequently significant hesitancy for patients because it has been used to encompass many different procedures and techniques. For simplification in this section, a sling is simply referring to surgery to help patients with stress incontinence.

Stress incontinence is a specific type of urinary leakage caused by activity that increases abdominal pressure such as coughing, laughing, sneezing, exercise, and going from sitting to standing. The sling is a support to the urethra to try to prevent this leakage. It can be made from mesh, animal based dermis, cadaveric fascia, or your own tissues harvested from another site on the body.

A sling procedure is performed through the vagina and sometimes requires small incisions in the inner thigh or lower abdomen as well. The recovery time is short, usually 1 to 2 weeks, but restrictions on activities continue for 6 to 8 weeks. The rate of success and durability of the repair depends on the material used, surgical approach, as well as the severity of leakage experienced by the patient before the operation. It is important to note that this is not the same procedure that has received so much media attention for the use of mesh, and it continues to be considered safe by the FDA and the use of mesh with a mid-urethral sling continues to be the “gold” standard in repair.

Pelvic Floor Therapy

Pelvic floor therapy is a form of physical therapy that helps patients address urinary or fecal incontinence, frequent urination or constant urges to urinate, and/or pain in the pelvic area. It consists of a series of exercises tailored to a patient’s condition.

Comprehensive Urology allocates time and resources to learn about a patient and develop a personalized pelvic floor therapy program. Our team of expert physical therapists teaches patients how to perform various pelvic floor exercises for effective treatment.

Surgical Rectocele Repair

A rectocele forms if the lower pelvic muscles are damaged due to childbirth, labor, or a prior pelvic surgery, or if the pelvic muscles weaken due to aging. It develops at the end of the large intestine (rectum) and moves against the back wall of the vagina. When this occurs, an individual may experience lower back pain and/or painful intercourse.

Surgical repair of rectocele addresses defects of the vaginal wall. It connects torn or stretched tissue due to vaginal prolapse. It also strengthens the vaginal wall, thereby reducing the risk of future prolapse.

Sexual Dysfunction

Sexual dysfunction may occur due to physical and/or psychological causes. Our team performs in-depth patient evaluations to identify the root cause of sexual dysfunction. By doing so, we can help patients determine the best course of action to treat sexual dysfunction.

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