Patient is a 75 year old female with progressive loss of pelvic support and the pictures show a complete loss of support for the uterus, bladder and the bowel. This is called a complete procedentia, the end stage prolapse of all pelvic organs. The patient also had stress urinary incontinence.
This patient underwent a vaginal hysterectomy, suspension of the vaginal cuff and repair of the bladder and the posterior wall of the vagina as well as a sling operation for incontinence. The final picture is the completion of the operation. There was minimal blood loss and the patient recovered postoperatively very well and was discharged home the next day.
This patient is a 36 year old female with two uncomplicated vaginal deliveries, complained of stress urinary incontinence, pressure with exercise, and lack of sensation during intercourse. The before pictures show a gaping opening of the vagina, reflecting damage to the internal and external supportive structures, poor tone in the muscles and connective tissue supporting the bladder and the rectum. This patient underwent a sling operation, and a total reconstruction of the vaginal support tissue, as well as cosmetic repair of the vaginal opening. This patient was discharged home the same day of the operation and was back to work in one week.
This patient is a 22 year old female with chronic complaint of pain with penetration, first noticed when tried to place a tampon at the age of 15. The evaluation revealed thickened hymenal ring. The patient was not able to tolerate any further evaluation in the office.
During the operation, the hymenal ring was removed and a vaginal septum (a wall dividing the vaginal cavity in two) was discovered. The vaginal septum was removed meticulously. Care was taken to avoid any damage to muscular and nervous organs and minimal trauma to avoid scar tissue formation. The patient was discharged home an hour after this operation and was back to school the next day. Full recovery in 6 weeks.
This patient is a 45 year old female with complaints of stress urinary incontinence and difficulty with control of her bowel movements. She had undergone two vaginal deliveries, during one a vacuum suction was used. Evaluation of the pelvic organs revealed damage to the muscles that control the outflow of urine and damage to the anal sphincter.
The patient underwent a sling operation and repair of the anal sphincter muscles. A full reconstruction of the vaginal connective tissue supporting the uterus, rectum, and the bladder was also performed.
The patient was kept overnight in the hospital for observation and was discharged home the next day. The patient returned to work in one week and full healing occurred at 6 weeks.