In my clinical experience, pain is minimal for the diVa vaginal laser procedure, and mild to moderate for the external vulvar/labial BBL tightening procedure. The sensitivity also decreases with each procedure. DiVa vaginal laser is recommended in a package of 3 treatments, each 1 month apart. Clients report feeling less discomfort with each procedure (if they feel any), even though we are increasing the energy distributed with each visit. Most describe a 1-2/10.DiVaTyte vulvar/labial tightening with the BBL attachment is recommended 3-5 times, each session as often as weekly to biweekly. As the tissue is heated, sensitivity is heightened; still, no more uncomfortable than a facial laser treatment, and at most 4-5/10 reported by my patients, again with decreasing sensitivity with subsequent sessions.
Urinary incontinence can have many etiologies. diVa vaginal laser is a fantastic alternative to painful and costly incontinence surgeries, but there are limitations. Prominent anterior vaginal wall defect/cystocele (a weakening of the anterior vaginal wall, allowing the bladder to drop "down" into the vaginal cavity (posteriorly, when speaking anatomically) is an example of where surgical management would be indicated. Severe stress incontinence (laugh, run, jump, sneeze) where even minimal increase in pressure or position leads to uncontrollable leakage is probably another situation where surgical expertise would be indicated. Mild to moderate stress incontinence, especially coupled with risk factors such as vaginal childbirth, multiple children or large birthweights, as well as menopause status, are very good candidates for diVa vaginal laser therapy. By deep penetrative therapy with the powerful erbium laser allowing for the most significant collagen stimulation, neovascularization, and growth of new epithelial cells, bladder improvements with vaginal rejuvenation have never been more robust. Typical response is seen within 2-4 weeks of first procedure, and build from there.
Pain relief is not necessary with the diVa vaginal laser. For our clients, intravaginal topical anesthesia (cream or ointment) is placed for 30 minutes, which is very adequate for most/all settings. Patients describe the procedure as a "knocking" feeling as the device machinates, as well as some warmth. Some clients with a history of trauma or surgical scar may have increased sensitivity in that area; interestingly, my experience with these individuals is that by the 3rd procedure (initial treatment package is recommended to be 3 procedures), that sensitivity/pain is gone. When I discover the location of sensitivity for these patients, I do tend to make an extra pass with a therapeutic setting concentrating on that area. I have not had any clients request any pain medications following the procedure, either immediately or over the following days.
