Hysterectomy - Know Your Options

Do you need a hysterectomy?

It is important to know your options when choosing the route and method of hysterectomy.

A hysterectomy is a surgical procedure for removing the uterus. Some of the most common reasons for undergoing a hysterectomy include uterine fibroids, severe vaginal bleeding, uterine prolapse, endometriosis, and or chronic pelvic pain. A hysterectomy may also be performed to treat both cervical and uterine cancer.

Hysterectomy is one of the most frequently performed surgical procedures in the United States. A hysterectomy can be performed vaginally, abdominally, or with laparoscopic or robotic assistance. When choosing which route and method is best for you, your physician will take a number of factors into consideration. 

The American College of Obstetricians and Gynecologists recommend that the hysterectomy is ideally performed vaginally or laparoscopically, as they are less invasive, involve less risk of bleeding and infection, and require the least amount of recovery time. One of the benefits of the laparoscopic hysterectomy is that it helps the doctor to avoid abdominal hysterectomy in many cases. Laparoscopic hysterectomy also allows the surgeon full visibility of the pelvis, as compared to the vaginal approach.

It is recommended that abdominal hysterectomy be chosen as a last resort, when the vaginal or laparoscopic approaches are not feasible. Ultimately your physician will discuss your options and determine how a hysterectomy can be performed most safely to fulfill your medical needs. Dr. Zapata is a board-certified surgeon who is highly qualified and trained to perform all methods of hysterectomy, including robotically assisted hysterectomies.

Below is a comparison of the three most commonly performed hysterectomy options. 

Reference:

Choosing the route of hysterectomy for benign disease. ACOG Committee Opinion No. 444. American College of Obstetricians and Gynecologists. Obstet Gynecol 2009;114:1156–8.

Labiaplasty Surgery Explained

We have seen a growing number of patients requesting labiaplasty. Today we want to take the time to answer some of the most frequently asked questions patients have concerning labiaplasty.

 

What is labiaplasty?

Labiaplasty is a procedure for reducing the labia minora (inner lips) or the labia major (outer lips). Some women are born with enlarged labia, which cause them to experience embarrassment and discomfort in tight clothing, while exercising, and/or with sexual intercourse. Women may also experience a change of their labia after childbirth, traumatic injury, weight changes, or simply with aging.

 

Why do women undergo labiaplasty?

The purpose of labiaplasty is to reduce the size of the labia, alleviate discomfort, and improve the overall appearance of the labia. This procedure, typically combined with vaginal rejuvenation, can also be extended to the clitoral hood.

 

WHAT TECHNIQUES ARE USED TO PERFORM LABIAPLASTY? 

There are two primary techniques for reducing the labia minora. The wedge technique involves removing a "V" shaped wedge from the labia minora. This technique allows your surgeon to remove excess skin while preserving the natural edge of the labia. The wedge technique also minimizes the amount of incisions, which results in less scar tissue. 

 

Image via labiaplastyguide.com

 

With the trim technique, one continuous incision is made to remove the natural edge of the labia minora. While the trim technique typically allows for greater reduction than the wedge technique, it also results in more scar tissue.

 

Image via labiaplastyguide.com

 

DOES LABIAPLASTY REQUIRE ANESTHESIA? 

Labiaplasty is performed under local anesthetic or with oral medication for sedation. This procedure can be done in our office or in the outpatient surgery center. The procedure lasts 1-2 hours.

 

How long does recovery time take?

Patients are expected to experience swelling and discomfort in the area for 1-2 weeks. We use dissolvable sutures, which means no sutures will need to be removed and scarring typically fades after about a month. Any strenuous activity should be avoided for 1 week after surgery and both sexual activity and tampon use should be avoided for 4 weeks after surgery.

 

What are the risks involved with labiaplasty?

As with any surgical procedure, there are certain risks involved with labiaplasty. The primary risks include damage to nerve, blood vessels, and surrounding tissues. Other risks include permanent sensation changes and hypersensitivity.