Andrea Wolfe, MD

The O shot is an injection of Platelet Rich Plasma (PRP) to the anterior wall of the vagina as well as to the clitoris.  The injection to the anterior wall of the vagina helps with increasing nerve endings and blood flow to the G spot for sexual stimulation as well as helps to increase the collagen under the bladder neck to decrease stress urinary incontinence.  The clitoral injection also increases nerve endings and blood flow to increase sexual stimulation.  Some women may mistake the increased vaginal sensation as a "tightening" effect, but it is more due to the increased engorgement during arousal stage and increased nerve endings rather than actual tightening of the caliber of the vagina.  If vaginal laxity is a concern, I would recommend a procedure specifically made to tighten the entire length of the vagina in 360 degrees, such as the diVa hybrid fractional laser treatment.

If you are having moderate to severe stress urinary incontinence, an anterior repair and bladder sling can help with those symptoms.  The bladder sling is the most important procedure for the incontinence symptoms if your bladder prolapse is minimal.  The anterior repair is not going to greatly enhance the effect of the sling unless you have significant bladder prolapse.  In the same manner, it will not give you a sexual enhancement either.  Depending on the amount of incontinence you have, you may benefit from the sling plus a global non-invasive procedure (for example the DiVa) that would treat the entire length and 360 degrees of the vagina.  Another option would be to do a procedure like the DiVa plus an O shot.

Over time, the labia majora will lose their collagen elasticity and fat pads which lead to a less youthful appearance.  In addition to laxity, hyperpigmentation can also appear as well.  DivaTyte is a laser treatment which has no downtime and works to tighten the collagen over time.  The Vampire Labial Wing Lift uses a small amount of Juvederm and highly concentrated PRP to increase labial volume along with tightening of the skin and decrease of the hyperpigmentation.  DivaTyte is typically 3-5 treatments every 2 weeks while the Labial Wing Lift is a single treatment.

The O shot and DiVa are therapies which can greatly help sensation, vaginal lubrication, and ability to achieve orgasm.  However, if there are deficiencies in hormones you may find that your desire and arousal phases are weaker.  You may want to meet with a provider that specializes in hormone evaluation to see if there are any deficiencies that can be corrected to optimize your results of the O shot and DiVa.  Typically, we would expect that the O shot lasts 10-16 months and the results of the DiVa to last 12-18 months.  I would encourage you to meet with your provider to discuss a plan of care.  An exam and an in-depth discussion of your gynecologic/sexual history as well as relationship, general health, and medical history may also provide more clues as to why these procedures are no longer working for you.