This patient is a 45-year-old female who has had 4 vaginal deliveries and comes to Atlanta Ga from South Carolina. She first saw Dr Miklos in 2018 with complaints of vaginal prolapse symptoms: pressure, vaginal bulge and less friction with intercourse. She also admits to urine leakage with cough as well as urgency, frequency of urination.
She had a hysterectomy only 8 weeks prior for excessive vaginal bleeding and painful periods. She did not allow her gynecologist to repair her vaginal prolapse. Dr Miklos previously diagnosed her with a cystocele and rectocele. She explained that she has noted less friction with sex over the past 10 years and it has progressively gotten worse.
Her examination confirmed a grade 1 cystocele and a grade 2 rectocele (grades 1-4). She elected to proceed with surgical vaginal rejuvenation after first discussing non-surgical rejuvenation devices: Mona Lisa, Viveve, ThermiVa and Votiva. Dr Miklos explained that these devices only tighten the skin of the vagina and does nothing for the broken fascia and relaxed pelvic floor muscles. This is analogous to a plastic surgeon using laser on the face to tighten the skin (for a non-surgical facelift) and then actually performing surgery ie facelift to get more permanent results.
He also explained that most surgeons will only tighten the opening of the vagina but to achieve surgical success in vaginal rejuvenation surgery the surgeon must address at least 50-75% of the length of the vagina. Her surgery was performed without complications and her results are apparent. (Figure 1 & 2)
