Would Vaginal Rejuvenation Help?

So I have had two kids and my bladder is so horrible sex is horrible and i leak too much, do i need bladder surgery i was told by my ob gyn that id need to get my bladder pushed up something like that or would a vaginal rejuvenation be better

Doctor Answers 8

Laser Vaginal Rejuvenation

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You are a prime candidate for Laser Vaginal Rejuvenation for the enhancement of sexual gratification. The procedure will effectively enhance vaginal muscle tone, strength, and control. It will effectively decrease the internal and external vaginal diameters and build up the perineal body. Sexual gratification for the female is directly related to the amount of frictional forces generated according to Masters and Johnson. We can accomplish this with Laser Vaginal RejuvenationYour Stress urinary incontinence will be corrected at the same time. All of the surgery is done vaginally.

The correction of your stress urinary incontinence is performed at the same time by the same vaginal approach. The procedure results in 94% effectiveness in stopping your urinary incontinence.

Our goal is to restore you to a point where you are post virginal and pre-childbearing.

Do I need vaginal rejuvenation

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great question and so common after babies. One approach you say was proposed by your Og/Gyn to do a bladder tack up to lift your bladder and urethra. Some tightening of the vagina occurs with that. As an alternative a non-invasive laser tightening procedure such as FemiLift may be considered if the drop is only mild to moderate. It is very effective but may not help if the bladder is severely dropped

Vaginal rejuvenation (vaginal tightening) does not help reduce incontinence

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Hello "Mommy" with leaky bladder. Thanks for your great question. If your gynecologist felt you were a candidate for having your "bladder pushed up" this means he/she found a dropped bladder as the reason for your stress urinary incontinence. The fact that you lose urine during sex means that you likely have significant stress urinary incontinence. This requires a thorough evaluation do confirm your diagnosis. The surgical gold standard for this condition is a suburethral sling which works extremely well in the right patient and performed by a good surgeon. You do have other options, though, some of which are non-surgical, without the use of mesh, and will improve vaginal sensation and strength of orgasm at the same time! Many women now are looking for alternatives to slings and are getting great results with combination Laser Vaginal Resurfacing with FemiLift and the O-Shot. This combination will reduce, if not eliminate, your leakage PLUS make you feel tighter with sex and experience easier/stronger/multiple orgasms. See link below to read a recent patient testimonial. Vaginal rejuvenation refers to surgical vaginal tightening and may be performed at the time of a suburethral sling. The best surgeon suited to perform these procedures are urogynecologists with experience in both reconstructive and cosmetic vaginal surgery. It's best to postpone these procedures till you're finished having children and can dedicate a proper recovery postoperatively.Best of luck,

Oscar A. Aguirre, MD
Denver Urogynecologist
5.0 out of 5 stars 38 reviews

Rejuvenation vs Reconstruction

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Thank you for your question.  From what you describe regarding your bladder, I would encourage you to seek an evaluation by a Urogynecologist, or Gynecologist, who specializes in vaginal reconstruction to evaluate your pelvic support structures.  It would be preferable, if that person also had experience in vaginal rejuvenation or vaginoplasty, a more "cosmetic" procedure than reconstruction.  From your description, it sounds as if you may require both reconstruction - to correct problems with pelvic support - and rejuvenation, which is intended to improve sexual function by making the vaginal canal tighter.  They are entirely different surgeries and whomever you choose, please make sure that they are well-trained in both reconstructive pelvic surgery and cosmetic surgery of the female genitalia.

Urine incontinence

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Hi!  Child birth takes a toll on women!  Loose vagina and urine leakage is common.  First you need to get an evaluation to see what kind on incontinence you have. Surgery and or levels may be useful. But over the last year I have been treating my patients with stress continence with CO2 laser (CO2RE Intima).  The results have been really nice.    I believe this may be something to consider especially if you are not done with child birth.  There is no to little down time with this and easier to bounce back with young children.

Vaginal tightening vs pelvic floor repair

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Thank you for sharing.  It sounds like both might be appropriate for you.   If you can find a gyn surgeon that does both then that would be ideal.  Best of luck

Rejuvenation vs reconstruction

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Thanks for sharing..... From content of your letter it appears you may need both rejuvenation and reconstruction.  The only way you will know is to be assessed by a surgeon who is well versed in both reconstruction and vaginal rejuvenation.   Rejuvenation is really a cosmetic/function type problem and reconstruction is not.   What is vaginal rejuvenation?  Vaginal rejuvenation really means the internal tightening of the vagina and tightening of the vaginal opening usually to enhance friction for intercourse.   In experienced hands this surgery is approximately 85-90% successful as defined by the patient ( i.e. she is satisfied with the enhancement of friction during the act of intercourse 12 months after surgery).   There are only 4 papers written on this topic and my partner, Dr Moore and I are co-authors of two of these papers.    This surgery is usually accomplished by performing posterior vaginal wall surgery ( known as a posterior repair and coupling this with a levator muscle plication) + a vaginal opening repair known as a perineoplasty.   This requires experience, expertise, and good knowledge of  the pelvic floor.      Patients who have had multiple childbirths may need more than just tightening procedure they actually need vaginal reconstruction. 
What is vaginal reconstruction?  Vaginal reconstruction is what most urogynecologist have been trained to do...to reconstruct the vagina to give the support back and this does NOT focus on tightening the vagina. Reconstruction is for the restoration of the anatomy and also to fix things like urine and fecal leakage or retention.  The urogyencologist has extensive training and is the most experienced of all surgeons in operating on the relaxed vagina.  The second most experienced surgeon for vaginal reconstruction would be the gynecologist.  The urogyn  is trained by first spending  4 years in a residency in obstetrics and gynecologic surgery and instead of going out to practice they then tspend 3 more years of subspecialty training in vaginal reconstruction or the rebuilding of the vagina (when it falls down aka vaginal prolapse - see the next few paragraph for an explanation).  Plastic surgeons, dermatologists, an family practice doctors who have perform cosmetic vaginal surgery do little concept of vaginal reconstruction.  They are not trained in residency to do vaginal surgery nor have they spent 7 years learning vaginal reconstructive surgery like a urogynecologist.  In fact I do not know of any plastic surgical residency in the nation who dedicates more than a few months to training their resident on vaginal surgery.    Vaginal Prolapse is basically the same as the vagina falling down and each area of the vagina which falls has its own descriptive name" Uterine prolapse - the uterus is falling down into the hollow of the vagina and towards the opening of the vagina in severe conditions the uterus can actually fall  out of the vaginal opening and it hangs between a womans legs.  Cystocele - the deeper portion of the ceiling of the vagina gives way and the bladder which is being supported fall downward into the hollow of the vaginal canal. Often these patients will suffer from frequency and urgency of urination as well as vagina pressure.  If the condition is very severe the patient will have difficulty emptying her bladder. Urethrocele - the ceiling of the vagina near the opening of the vagina gives way and the urethra sags.  Often these patients will suffer from cough urine leakage ( aka stress urinary incontinence) Rectocele - the floor of the vagina gives way and the rectum pushes upward into the vaginal canal producing a bulge pushing towards or out of the the opening of the vagina.  Often patients will complain of difficulty emptying their rectum of stool. Urethrocele means there is a lack of support of the urethra and often (but not always) these patients will leak with coughing  and sneezing.Urogynecologist have been trained to treat the anatomy of the vagina to support each of these structure as well as consider the function of urination and defecation as they perform surgery. Often this surgery needs to be accomplished laparoscopically i.e. small incisions through the abdominal wall.   However most urogynecologist have not been trained in the concept of cosmetic vaginal surgery or  vaginal rejuvenation . You certainly would benefit from a thorough evaluation by a urogynecologist or a pelvic floor surgeon/gynecologist.  But you would probably want to choose someone who is also trained or has expertise in vaginal rejuvenation.  So I caution you to choose a surgeon wisely............choose a surgeon who can accomplish both of your needs: 1) restoring friction during intercourse and   2)  decreasing the pressure  inside of the vagina ( which maybe best accomplished by restoring the supportive anatomy of the vagina and NOT JUST TIGHTENING the vaginal opening.  Choose a surgeon who is specialized in urogynecology or vaginal floor reconstruction and cosmetic vaginal surgery.  Please see both sections of my website to get a full understanding and the different between cosmetic vaginal surgery and vaginal reconstruction.  Remember your choice of surgeon should be based upon: experience, expertise, reputation and results and do not solely focus on location, convenience and cost. John R Miklos MD Urogynecologist  & Cosmetic Vaginal Surgeon Atlanta ~ Beverly Hills ~ Dubai

Vaginal rejuvenation is not a cure for urinary incontinence

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There are several types of urinary incontinence and you can have more than one type contributing to your problem. When surgery is required for urinary incontinence it is usually because of an issue with the bladder neck. The goal of the procedure is to support the neck of the bladder and sometimes to slightly overtighten the "valve" that controls the flow of urine. These procedures are all done on the anterior wall of the vagina. Vaginal rejuvenation is a tightening of skin and muscles on the back wall of the vagina which doesn't really do anything for the bladder neck. However, it does provide a mild degree of "backboard" effect in some women. This means that if the bladder is loose and prone to dropping low with activity, tightening the posterior vaginal wall and perineum might provide a little bit of indirect support. This might help a little bit, but it's unreliable and sometimes a temporary effect. See a specialist in pelvic reconstructive surgery who is also expert in vaginal rejuvenation.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.