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Vulvar Vestibulitis
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Vulvar Vestibulitis

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Vulvar Vestibulitis is a condition which causes redness and pain of the vestibule. Vestibulitis is an inflammation of the vulvovaginal skin and the mucous secreting glands found in and around the vulva. The mucous secreting glands are called the lesser vestibular glands.

Vulvar Vestibulitis may include all the area around the opening of the vagina but is normally seen in the lower part of the vaginal opening.

Vulvar Vestibulitis occurs in women of all ages. It can occur in women who are sexually active and also in women who have never been sexually active.

Many women with this problem have suffered physically and emotionally for months or years, have seen a number of physicians, and have tried many unsuccessful treatments in search of relief.

What are the signs and symptoms of Vulvar Vestibulitis?

* Severe pain with pressure (for example: biking, exercise, tight fitting clothes ).

* Vaginal entry such as tampon use or intercourse.

* Burning, stinging, irritation, or raw sensation within the vestibular area.

* Vestibular redness

* The urge to urinate frequently or suddenly.

How is Vulvar Vestibulitis diagnosed?

Your doctor or health care provider will examine the vulva and vestibule to identify the common skin changes seen with vulvar vestibulitis. Pain is usually felt if the vestibule area is touched with a cotton tipped applicator. A sample of your vaginal discharge is collected and tested to rule out infection.

The following factors have been associated with Vulvar Vestibulitis:

* HPV (Human Papilloma Virus)
* Chronic Yeast Infections
* Chronic bacterial infections
* Chronic changes of pH (acid-base balance in the vagina)
* Chronic use of chemicals/irritants such as detergents, soaps, spermicides or lubricants.

What is the treatment for Vulvar Vestibulitis?

Treatment may include any of the following:

* Follow the Guidelines for Vulvar Skin Care
* Steroid Ointments

How it is used: A thin layer is applied to the vulvovaginal areas.

How it Works: Decreases redness, irritation, and burning. Caution: Use only as prescribed by your doctor. Overuse may result in thinning of the skin which will make your problem worse rather than helping it.

* Trichloroacetic Acid (TCA) may be used in some cases as determined by the severity of the symptoms you have. TCA is a chemical that is used to destroy small areas of the irritated skin allowing new healthy skin to grow in its place.

* Interferon Injections are used to increase your body's response to infection.

Helpful treatment hints for Vulvar Vestibulitis:

* Vitamin A and D Ointment How it is used: Apply to the areas of discomfort.
How it Works: Protects the skin, decreases irritation, heals, and soothes.

* Lidocaine Gel may be prescribed after initial treatment.

How it is used: Apply lidocaine gel to the vulvovaginal areas of discomfort.

How it Works: Numbs areas before intercourse.

Caution: After applying, wait until area becomes less sensitive before intercourse. Burning may occur for a short time ( 5 to 10 mins.) after the gel is applied.

* Witch Hazel Pads:

How it is used: Apply to the vulvovaginal areas of discomfort.

How it Works: Decreases burning and irritation after intercourse and urinating.

* Cleansing Bottle - Pour plain luke-warm water over the vulva after urinating to remove urine from irritated area.

* Calcium Citrate Tablets- How it is used: Take orally 1200-1800mg. elemental calcium every day. How it Works: Thought to decrease certain crystals in the urine which may cause burning.

How it Works: Increases the acid content of the urine to decrease bladder irritation.

* Limit High Oxalate Foods - May decrease amount of oxalate crystals in urine. Oxalate crystals cause urinary symptoms such as the urge to urinate frequently or suddenly.

* Baking Soda Soak- Soak in luke warm bath water with 4 to 5 tablespoons of baking soda to help soothe vulvovaginal itching and burning. Soak 1 to 3 times a day for 10 to 15 minutes. If you are using a sitz bath, use 1 to 2 teaspoons of baking soda.

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Gynecologic Urology, also referred to as Uro-gynecology, is a subspecialty within the field of Obstetrics and Gynecology. Uro-gynecology's specialty is female pelvic disorders such as pelvic organ prolapse (bulges that extend from the uterus into the vagina or extend out of the vagina), urinary incontinence, fecal incontinence and constipation.

Doctors that complete their residency in Obstetrics and Gynecology, then go onto complete fellowship training in Uro-gynecology, where they spend several years focusing only on Uro-gynecology and female pelvic disorders.

What is Pelvic Organ Prolapse?

Pelvic Organ Prolapse or Pelvic Prolapse, is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapsee in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown.

Pelvic Organ Prolapse may also be called; genital prolapse, pelvic relaxation, pelvic prolapse, uterine prolapse, uterovaginal prolapse, pelvic floor dysfunction, urogenital prolapse or vaginal vault prolapse.

Pelvic Prolapse is another term used for "Pelvic Organ Prolapse." Pelvic Prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapse in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown.

Pelvic Prolapse may also be called; genital prolapse, pelvic relaxation, pelvic prolapse, uterine prolapse, uterovaginal prolapse, pelvic floor dysfunction, urogenital prolapse or vaginal vault prolapse.

What are the symptoms that indicate a woman is suffering from Pelvic Organ Prolapse?

What is Pelvic Reconstruction?

Pelvic Reconstruction is a surgical procedure performed by gynecologists or uro-gynecologies to repair pelvic organ prolapse and vaginal vault prolapse, among types of prolapse, and to correct the problem(s) and relieve the symptoms.

Typically, Pelvic Reconstruction is performed vaginally and uses an implant to reinforce the strength of the weakened pelvic tissues.

A Prolapsed Uterus refers to a collapsed uterus, or descended uterus, or other change in the position of the uterus in relation to the surrounding structures within the pelvis. The pelvis contains many soft tissue structures vital to normal body functions, supported primarily by the diaphragms, layers of muscles, fibrous coverings called fasciae, and various ligaments and tendons. These soft tissues of the pelvis derive their ultimate support from the bony pelvis.

A Prolapsed Uterus may be one of three types, depending on the severity:

• First-degree prolapse occurs when the uterus sags downward into the upper
vagina.

• Second-degree prolapse occurs when the cervix is at or near the outside of the
vagina.

• Third-degree prolapse (sometimes referred to as total prolapse) occurs when the entire uterus extends outside the vagina.

Colpopexy is the surgical suturing of the prolapsed vagina to a surrounding structure - such as the abdominal wall or the sacrum, which is then called Sacral Colpopexy or Sacrocolpopexy

Sacral Colpopexy, also referred to as also referred to as also referred to as also referred to as also referred to as also referred to as Sacrocolpopexy, is the preferred surgical procedure for treating and correcting Vaginal Vault Prolapse with excellent results. Sacral Colpopexy (Sacrocolpopexy) has a very high rate of success and the surgical procedure involves suturing a synthetic mesh that connects and supports the vagina to the sacrum, or tailbone. The Sacrocolpopexy operation is performed from the abdomen to support the vagina to the ligament on the spine (after previous or present surgery to remove the uterus) by using a synthetic mesh.

Why Is Sacrocolpopexy Performed?

Sacrocolpopexy is performed to treat severe protrusion or bulge(s) of the vagina after removal of the uterus.

A woman's vagina that has one or more of these vaginal protrusion(s) may experience one or more of the following:

• The vaginal lump/bulge or protrusion feels uncomfortable or causes pain.
• Difficulty with urination (e.g. unable to completely empty the bladder)
• Bowel difficulties (e.g. constipation, incomplete emptying of bowels)
• Pain
• Infection
• Bleeding

The objective of the Sacrocolpopexy operation is to relieve the woman's symptoms and to restore her vagina and her vaginal anatomy (as much as possible) and recover her sexual function.

Are there any risks associated with Sacrocolpopexy surgery?

Sacrocolpopexy surgery is a very common and relatively safe operation with excellent prognosis and outcomes. However, like any surgical procedure, there are complications which may occur. Possible complications from Sacrocolpopexy surgery may include:

• Bleeding
• Infection
• Injury to surrounding tissues (e.g. nerve or blood vessels, ureter, intestines)
• Formation of blood clot(s) in the legs or lungs
• Recurrence of problem
• Slow return of bowel or bladder function
• Erosion of synthetic material through vaginal mucosa

What Happens Before Sacrocolpopexy Surgery?

1. Blood tests, electrocardiography (ECG) and chest X-ray may be done to ensure that you are in optimal health for Sacrocolpopexy surgery.

2. Your doctor may prescribe oral or vaginal estrogen (hormone) if you are already menopausal. It is important to comply with this medication as it ensures that your vaginal tissues are optimal for surgery and healing.

3. You will be admitted to the hospital one day before Sacrocolpopexy surgery.

4. You will be given preparations to clear your bowels.

5. Your pubic hair surrounding your vulva will be shaved.

6. You will not be allowed to eat or drink after midnight on the day before the surgery.

7. All your medical and surgical conditions, if any, must be made known to the doctor and must be optimally controlled.

8. If you are on aspirin, please keep your doctor informed. You must stop taking aspirin at least one week before Sacrocolpopexy surgery.

What happens during the Sacrocolpopexy surgery?

The surgery is done under general or regional anesthesia. The anesthesiologist will discuss with you the advantages and disadvantages of both methods.

An abdominal incision is made. The synthetic mesh is stitched to the posterior surface of the vagina and to the ligaments in front of the spine.

A tube / drain may be inserted into the abdomen to monitor the bleeding.

Another tube will be inserted into the urethra as there may be difficulty in urination after the Sacrocolpopexy procedure.

Painkillers, laxatives and antibiotics would generally be prescribed after the procedure.

What happens after Sacrocolpopexy surgery?

1. Immediately after the operation, you may experience one or more of the following:

• Tiredness - You should rest and gradually increase your mobilization until you feel fit to return to your normal activities.

• Discomfort - In the lower part of the abdomen, over the incision. This is to be expected and painkillers should help to relieve the discomfort.

• Vaginal bleeding - Mild to moderate amount of reddish watery discharge after surgery is quite normal. You will need to wear a menstrual pad during the recovery period, but you will not be permitted to use tampons for obvious reasons.

2. One day after surgery, you will usually be allowed to drink and eat. You will be encouraged to move around. Blood chemistries and normal follow-up visits will be performed.

3. The catheter that was placed in your urethra is usually removed the day after surgery. The drain is usually removed two days after the operation.

4. You may be discharged on the third or fourth day after surgery if the doctor is pleased with your progress and the outcome of the Sacrocolpopexy procedure.

5. You should refrain from:

• Strenuous exercise for 2 months. You may return to normal activity after that, or upon clearance by your doctor.

• Using tampons, douching, sexual intercourse and driving for 4 weeks.

• Carrying heavy weights (> 10 pounds) for 6-8 weeks after Sacrocolpopexy surgery.

6. You should (immediately) return to the hospital or notify your doctor if you notic any of the following:

• Heavy vaginal bleeding
• Foul smelling vaginal discharge
• Severe abdominal distension and / or pain not relieved by painkillers
• High fever
• Pain associated with passing urine
• Difficulty in passing urine
• Constipation

Follow-up doctor visits after Sacrocolpopexy surgery

You will be examined by your doctor (at your doctor's office) at approximately; 2 weeks, 4 weeks, six months and and one year after Sacrocolpopexy surgery.

It is important to keep your follow-up appointments to ensure the best possible results.

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Treatment for the removal of Pelvic Adhesions is through a surgical procedure called "adhesiolysis." The adhesiolysis procedure may involve cutting and releasing the adhesions during a laparoscopy procedure or treating the adhesions during a laparotomy.

Pelvic adhesions are bands of scarlike tissue that form between two surfaces inside the body. Inflammation from infection, surgery, or trauma can cause tissues to bond to other tissues or organs.

Pelvic adhesions are the cause of many gynecological problems including significant pain, infertility and conception. Pelvic adhesions are irritations of a woman's pelvic organs as a result of a "pelvic inflammatory event" or from trauma to the area such as in the case of pelvic or gynecological surgery.

What are the symptoms that indicate a woman is suffering from Pelvic Organ Prolapse?

Typically, Pelvic Reconstruction is performed vaginally and uses an implant to reinforce the strength of the weakened pelvic tissues.

Colpopexy is the surgical suturing of the prolapsed vagina to a surrounding structure - such as the abdominal wall or the sacrum, which is then called Sacral Colpopexy or Sacrocolpopexy

Sacral Colpopexy, also referred to as also referred to as also referred to as also referred to as also referred to as also referred to as also referred to as Sacrocolpopexy, is the preferred surgical procedure for treating and correcting Vaginal Vault Prolapse with excellent results. Sacral Colpopexy (Sacrocolpopexy) has a very high rate of success and the surgical procedure involves suturing a synthetic mesh that connects and supports the vagina to the sacrum, or tailbone. The Sacrocolpopexy operation is performed from the abdomen to support the vagina to the ligament on the spine (after previous or present surgery to remove the uterus) by using a synthetic mesh.

Why Is Sacrocolpopexy Performed?

Sacrocolpopexy is performed to treat severe protrusion or bulge(s) of the vagina after removal of the uterus.

A woman's vagina that has one or more of these vaginal protrusion(s) may experience one or more of the following:

• The vaginal lump/bulge or protrusion feels uncomfortable or causes pain.
• Difficulty with urination (e.g. unable to completely empty the bladder)
• Bowel difficulties (e.g. constipation, incomplete emptying of bowels)
• Pain
• Infection
• Bleeding

The objective of the Sacrocolpopexy operation is to relieve the woman's symptoms and to restore her vagina and her vaginal anatomy (as much as possible) and recover her sexual function.

Are there any risks associated with Sacrocolpopexy surgery?

Sacrocolpopexy surgery is a very common and relatively safe operation with excellent prognosis and outcomes. However, like any surgical procedure, there are complications which may occur. Possible complications from Sacrocolpopexy surgery may include:

• Bleeding
• Infection
• Injury to surrounding tissues (e.g. nerve or blood vessels, ureter, intestines)
• Formation of blood clot(s) in the legs or lungs
• Recurrence of problem
• Slow return of bowel or bladder function
• Erosion of synthetic material through vaginal mucosa

What Happens Before Sacrocolpopexy Surgery?

1. Blood tests, electrocardiography (ECG) and chest X-ray may be done to ensure that you are in optimal health for Sacrocolpopexy surgery.

2. Your doctor may prescribe oral or vaginal estrogen (hormone) if you are already menopausal. It is important to comply with this medication as it ensures that your vaginal tissues are optimal for surgery and healing.

3. You will be admitted to the hospital one day before Sacrocolpopexy surgery.

4. You will be given preparations to clear your bowels.

5. Your pubic hair surrounding your vulva will be shaved.

6. You will not be allowed to eat or drink after midnight on the day before the surgery.

7. All your medical and surgical conditions, if any, must be made known to the doctor and must be optimally controlled.

8. If you are on aspirin, please keep your doctor informed. You must stop taking aspirin at least one week before Sacrocolpopexy surgery.

What happens during the Sacrocolpopexy surgery?

The surgery is done under general or regional anesthesia. The anesthesiologist will discuss with you the advantages and disadvantages of both methods.

3. The catheter that was placed in your urethra is usually removed the day after surgery. The drain is usually removed two days after the operation.

4. You may be discharged on the third or fourth day after surgery if the doctor is pleased with your progress and the outcome of the Sacrocolpopexy procedure.

5. You should refrain from:

• Strenuous exercise for 2 months. You may return to normal activity after that, or upon clearance by your doctor.

• Using tampons, douching, sexual intercourse and driving for 4 weeks.

• Carrying heavy weights (> 10 pounds) for 6-8 weeks after Sacrocolpopexy surgery.

6. You should (immediately) return to the hospital or notify your doctor if you notic any of the following:

• Heavy vaginal bleeding
• Foul smelling vaginal discharge
• Severe abdominal distension and / or pain not relieved by painkillers
• High fever
• Pain associated with passing urine
• Difficulty in passing urine
• Constipation

Follow-up doctor visits after Sacrocolpopexy surgery

You will be examined by your doctor (at your doctor's office) at approximately; 2 weeks, 4 weeks, six months and and one year after Sacrocolpopexy surgery.

It is important to keep your follow-up appointments to ensure the best possible results.