Hymenoplasty & Other Procedures
Hymen repair or reconstruction: This is a religiously and culturally sensitive surgical procedure. Most surgeons will not promise restoration of virginity, but reconstruction of hymen to a virgin-like state can be guaranteed. The cultural background for such request is compassionately considered, with utmost confidentiality. Occasional requests also come from those who have sadly experienced child abuse or rape. Awareness of factors which many disrupt the hymen such as horse riding, use of tampon, is vital. Vulvoplasty: This is cosmetic surgery performed on the outside genital structures include removal of unwanted fat from different parts of the vulva, such as in the pubic area, around the outer lips (vulva lipoplasty). Perineoplasty can be done to improve the looks of a badly sutured or badly healed episiotomy or ageing perineum, to provide a more youthful appearance. Hoodectomy, or removal of the fold of skin around the clitoris, is performed to expose the clitoris and make it more sensitive. However, there is limited evidence on outcome, other than anecdotal. G-Spot Augmentation: There is a controversy about the existence and location of G-Spot, which is said to enhance female orgasm, with several claims of more intense and deep and often multiple orgasms. The G-spot is said to lie directly behind the pubic bone within the front wall of the vagina. It is usually located about half way between the back of the pubic bone and the front of the cervix, along the course of the urethra and near the neck of the bladder, where it connects with the urethra. The size and exact location vary. By injecting collagen into this area, as a 15-minutes clinic augmentation procedure can help to revolutionize many women's sex life. It is currently available in the UK and EU. Surgery for Stress Incontinence
There are many different operations for stress incontinence. Recent advances have lead to the development of Injectables, which are compounds that can be injected around the urethra to help it to close more effectively. The newest and most hopeful of these is called Bulkamid. read more Bulkamid, is a new minimally invasive treatment for Stress Urinary Incontinence. This involves injection of Hyaluronic acid around the urethra at the bladder neck, which allows it to close more effectively and therefore improve or cure incontinence. (Hyaluronic acid occurs naturally throughout human body). This procedure can be done in the clinic setting, under local anaesthesia. About 30-40% of patients are cured of their incontinence whilst overall 60-70% will see a significant improvement after treatment. This procedure is particularly beneficial to younger women who have worrying stress incontinence, which is not severe enough to justify major surgery. It allows for vaginal birth in future, which is not the case with other surgical treatments. The treatment can last up to 3 years and it can easily be repeated when necessary. Although the cure rates are not as high as the more invasive operation, as a walk-in procedure, that takes only a few minutes, this treatment, is acceptable to many women who leak urine on exertion, who want more than pelvic floor exercises, but who do not wish for more involving surgical procedure. Sub-urethral Sling; e.g. Tension free Vaginal Tape (TVT): This is now the most widely performed operation for stress incontinence. The idea behind it is that stress incontinence results from weakness of the supporting tissues of the urethra, from the top to the middle portion. The aim of the tape is to reinforce the supports to the mid-urethra and thus restore continence. The procedure can be performed under local, regional or general anaesthesia. The tape or sling is placed at the mid-urethra. Your specialist can discuss more with you about the pros and cons of this procedure. However, the major advantage of the TVT over the long established Colposuspension, is that it has a very quick recovery time. Colposuspension involved an abdominal incision and elevating the neck of the bladder, to avoid loss of urine, during cough. The results are quite similar with both procedures, but complications are different. Patients for TVT are treated as day cases or have an overnight stay in hospital, and most are fully back to normal within two weeks. After colposuspension, patients stay in hospital for about five days and it is can take up to six weeks before they can resume normal activities. There are different types and modifications of these TVT-type sling procedures. TOT procedure |
Labial Reduction or Labiaplasty
This is the surgical removal of excess or unequal vaginal lips to restore to what is considered acceptable to the woman. It is usually done on the inner lips, but can be done on the outer lips, if appropriate. Many women are born with large or unequal labia, while others develop this condition with childbirth or age. Most often, ladies request labial reduction surgery because they are not satisfied with the larger size of their inner lips (labia minora), which often protrudes outside the outer lips (labial majora). They may find this embarrassing, especially as it frequently becomes noticeable with tight underwear or sport or swimming wears. In some others, the excess skin protrusion can result in constant irritation with tight pants or jeans or cause discomfort when engaging in sports or other physical activities. For some others, it simply gets in the way during sexual intercourse. Labia reduction is a simple and reasonably safe solution for these problems. Female Urinary Incontinence
Incontinence is an involuntary leaking of urine. It is a very common and upsetting problem, but many women will not consult their doctors about this problem, as it is quite embarrassing. This burden and embarrassment may however affect self-esteem and place stress on relationships. There are 3 main types of incontinence: stress, urge, and mixed incontinence. More than half of incontinence is due to weakness of the neck of the bladder. This type is called stress incontinence. Urinary Stress Incontinence is the leaking of small amounts of urine during normal, daily physical activities, such as laughing, coughing or exercise. It affects women in all age groups, but the most common predisposing factors are childbirth and pregnancy. Other risk factors include obesity, smoking, and hysterectomy. Urodynamic tests, which look at the function of the bladder, are performed to clarify the diagnosis but these tests are not always necessary as many patients can be treated symptomatically. It's now easier to get specialist help and appropriate treatment, than before. Help is available through lifestyle changes, various medications, pelvic floor exercises and surgery. There are available devices (pelvic toners, cones, etc), which help to ensure that pelvic floor exercises are done correctly and effectively, but patients need to be very motivated. It can take up to six months of regular exercises to notice a realistic difference. New medications are available for both types of incontinences, but the treatment of urge incontinence is largely medical. Side effects can limit prolonged use. http://www.continence-foundation.org.uk
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Procedures
We provide a range of cosmetic gynaecological treatment and pelvic floor restoration surgery as well specialist female cosmetic surgery procedures.
Vaginal Tightening or Vaginoplasty
This is the surgical procedure for vaginal relaxation, which occurs when the vaginal supports loose their tone, strength and control. The vagina becomes quite roomy and slack, as its supporting muscles and tissues have become stretched and torn during childbirth. Unfortunately, it usually does not return to its pre-pregnancy state and Kegel's pelvic floor exercises do not always help. Thus, the vagina is no longer at its best possible sexual functioning state. Many women complain of loss of sensation during sexual intercourse, which reduces sexual satisfaction for them, and also for their partners. It is quite common for this to be the source of disharmony and resentment. Worse still, the emotional toll with loss of self-esteem and confidence can result in fear of entering another relationship or even guilt, self-blame or depression. Some women complain of vaginal air-trapping or vaginal wind, which can be very embarrassing. It can occur on its own and sometimes during sexual intercourse. The same goes for vaginal water trapping, with annoying dribbling of fluid long after coming out of the bath or pool. Vaginal tightening surgically restores the stretched or damaged supporting tissues and the muscles of the perineum. The stretched and excess vaginal skin is removed resulting in immediate reduction in vaginal size, which should allow more friction and return of sensation during sexual intercourse. Pelvic Floor Relaxation
- Prolapse The pelvic floor is the medical jargon used to describe the group of muscles within the pelvis, which support the bladder, bowel - and in women, the vagina and the womb. When these muscles loose their tone, strength, control and support, they are said to be relaxed. Many people are familiar with "prolapse"; this is the end result of pelvic floor relaxation, if untreated early. Prolapse is very common particularly as women get older. It may not cause any significant problems and in those women no treatment is needed, except for female sexual cosmetic reasons, when vaginal tightening can be considered. Two factors are important in the development of prolapse: 1) Childbirth - during childbirth the supports of the vagina and uterus are stretched and often damaged. 2) Menopause - after 'the change', levels of the hormone oestrogen fall. This makes the tissues weaker. Hormone Replacement Therapy and pelvic floor exercises may help prevent prolapse. There are different types of prolapse and more than one type can be present at the same time. When the front wall of the vagina is affected the bulging caused by the sagging tissues is called a cystocoele or bladder prolapse or urethrocoele (prolapse of urethra - the little tube coming from the bladder) When the back wall of the vagina is affected the bulging caused by the sagging tissues is called a rectocoele or (bulging of back passage) or enterocoele (the bulging of small intestines into the back wall of the vagina). Uterine (Womb) prolapse occurs when the uterus falls or is displaced significantly downwards from its normal position. There are varying degrees of severity depending on the descent. This produces a general feeling of heaviness and fullness, or a sense that the uterus is falling out. Signs and Symptoms The commonest symptom complained of is 'something coming down' or a feeling of a bulge or heaviness in the vagina or lower abdomen. This may come on gradually or may have occurred after heavy lifting. Sometimes it can cause lower back pain. Some women complain of leaking urine with cough or sneeze, if the neck of the bladder is also weak. If the prolapse affects the back wall of the vagina there may be problems emptying the bowel fully. A prolapse is more of a nuisance than a serious problem and even if untreated is unlikely to cause any serious problems, apart from the feeling of being "loose" vaginally, which can cause sexual dissatisfaction. Sometimes if the womb is coming right down, it can become ulcerated and bleed or get infected. Treatment for Prolapse This depends on the type and degree of prolapse, the general fitness or health of the woman and her choice: Pelvic Floor Exercises are very useful in minor degrees of prolapse and should be tried first. A physiotherapist will instruct on how to carry out these exercises effectively. Ring Pessary: This is a plastic ring (PVC) that is inserted into the vagina by a doctor. It comes in different sizes and the doctor will choose the correct size. It stays in place on its own and if in the correct place, you should not even know it is there. The doctor will change this at the clinic every 4-6 months. An oestrogen cream may be used once or twice a week, in addition. Shelf Pessaries: Sometimes the prolapse is so much that the ring pessary falls out. In this case the doctor may try a shelf or other types pessary. Surgical: There are many different operations available to treat prolapse and the one chosen by the specialist will depend on the type and degree of prolapse and whether there are any waterworks (urinary) complaints. Whether your family has been completed or if you are still having sexual intercourse is important. Some of the usual operations include: Anterior Repair - sometimes called a bladder repair it is performed when the prolapse is affecting the front wall of the vagina. At operation the excess vaginal skin is removed and the tissues brought back together. If there is a problem of urine leakage with coughing or sneezing, extra stitches will be placed around the 'bladder neck'. This is sometimes called a 'bladder buttress'. Vaginal hysterectomy & Repair - performed if the womb is coming down. Posterior Repair - performed if the back wall of the vagina is bulging. At operation the excess skin is removed and the tissues brought back together again. There are other more complex operations for pelvic floor restoration. |