GENERAL UROGYNECOLOGICAL SURGERY
WHAT IS REGENERATIVE MEDICINE?
Regenerative Medicine encompasses many medical fields – Orthopedics and Spine Surgery, Sports Medicine, Gynecology, Urology, Oncology, Dermatology, Plastic surgery, Vascular Surgery, Cardiac surgery, etc.
Regenerative Medicine is the branch of medicine that develops methods to regrow, repair or replace damaged or diseased cells, organs or tissues. Regenerative medicine includes the generation and use of therapeutic stem cells, tissue engineering and the production of artificial organs. It uses autologous blood, bone marrow or adipose components to stimulate the body’s own repair processes. A common source for regenerative cells and growth factors are bone marrow aspirate concentrate (BMAC), platelet rich plasma (obtained from one’s own blood) and adipose derived stem cells.
Aesthetic Gynecology is now very common practice among women. It deals with the visual appearance, sensation and other cosmetic issues in relation to the health and functioning of the female reproductive system including the vagina, uterus, ovaries and breasts. Whether it is due to time, age, gravity, genetics, childbirth and/or chronic pelvic issues, a woman may see changes to her body that she may want to reverse, remove or reshape.
There are several procedures that fall under aesthetic gynecology. Most women opt for treatments to improve their exterior beauty and intimate lives. With advancements in the medical industry, it is now possible to alter, correct and remove unwanted elements from the body with more precision, safety, and little down time.
Mediclinic Dubai Mall offers both non-surgical and surgical solutions for Aesthetic Gynaecology services. FemiLift is the latest minimally-invasive treatment using an FDA approved Co2 laser to treat common feminine issues:
- Stress urinary incontinence (SUI)
- Vaginal tightening
- Post menopause indications
- Post delivery rehabilitation
- Vaginal dryness
- Recurring infections
These types of feminine issues arise from menopause, and hormone deficiencies related to cancer therapy and post-labour conditions. What makes FemiLift so popular amongst women – over 200,00 to date – is the fact that this simple treatment can be performed in an outpatient setting, with little downtime and side-effects. If you are experiencing involuntarily urine leakage or suffer from vaginal dryness, burning or recurring infections, you may very well benefit from FemiLift.
Other non-surgical solutions include using PRP (Platelet Rich Plasma), Plasma gel and Hyaluronic Acid Fillers to:
- Improve appearance of pigmented vulva
- Treatment of Kraurosis and vulvovaginal atrophy
- Scleroatrophic lichen of vulva
- Augmentation of Labia Majora and Minora
- Intimate contouring and G spot augmentation
- Dyspareunia treatment after Episiotomy and perineotomy during labour
- Clitoral contouring
- Activation of the female orgasm and female sexuality
- Treatment of Sexual and orgasmic dysfunction
Surgical solutions include: Labia plasty (minora, majora reduction/ augmentation), clitoral hood (reduction/ lifting), vaginoplasty, perineplasty.
Vaginal atrophy (atrophic vaginitis) is thinning, drying and inflammation of the vaginal walls that may occur when your body has less estrogen. Vaginal atrophy occurs most often after menopause.
For many women, vaginal atrophy not only makes intercourse painful but also leads to distressing urinary symptoms. Because the condition causes both vaginal and urinary symptoms, doctors use the term “genitourinary syndrome of menopause (GSM)” to describe vaginal atrophy and its accompanying symptoms.
Genitourinary syndrome of menopause (GSM) signs and symptoms may include:
- Vaginal dryness
- Vaginal burning
- Vaginal discharge
- Genital itching
- Burning with urination
- Urgency with urination
- Frequent urination
- Recurrent urinary tract infections
- Urinary incontinence
- Light bleeding after intercourse
- Discomfort with intercourse
- Decreased vaginal lubrication during sexual activity
- Shortening and tightening of the vaginal canal
The earliest signs are skin fragility, bruising, and sometimes blistering. Lesions typically cause mild to severe itching. When lichen sclerosus manifests in children, the appearance may be confused with sexual abuse. With time, the involved tissue becomes atrophic, thinned, hypopigmented (there may be flecks of postinflammatory hyperpigmentation), fissured, and scaly. Hyperkeratotic and fibrotic forms exist.
Severe and longstanding cases cause scarring and distortion or absorption of normal anogenital architecture. In women, this distortion can even lead to total destruction of the labia minora and clitoris. In men, phimosis or fusion of the foreskin to the coronal sulcus can occur.
- Clinical evaluation
- Sometimes biopsy
Diagnosis of lichen sclerosus can usually be based on appearance, especially in advanced cases; however, biopsy should be done on any anogenital dermatosis that does not resolve with mild conventional therapy (eg, topical hydrocortisone, antifungal drug). It is especially important to biopsy any area that becomes thickened or ulcerated, because lichen sclerosus is associated with an increased frequency of squamous cell carcinoma.
- Lichen sclerosus can cause anogenital bruising, itching, or blistering early, and atrophy and scarring later.
- Risk of subsequent squamous cell carcinoma is increased.
- Consider the diagnosis with any persistent anogenital dermatosis.
- Treat with long-term, high-potency topical corticosteroids, close monitoring, and sexual and psychologic support.
What is Urogenital Atrophy?
Urogenital Atrophy is a condition which most often occurs during and after the menopause when the lack of
the female hormone oestrogen affects the vagina ,urethra & bladder trigone.
After the menopause the amount of oestrogen produced by the ovaries falls. The lack of oestrogen leads to
a thinning of the tissues around the vaginal area and a reduction in the number of the small mucus
producing glands. There is also a loss of fat around the genitals producing a different appearance than
previously. As a result the vagina can become shorted, less elastic and dryer with less lubricating mucus;
the genital skin also looks paler. These changes usually take months or years and vary between women.
How common is Urogenital Atrophy?
Vaginal dryness occurs in about 1 in 4 women leading up to the menopause, it becomes more common
after the menopause when about 1 in 2 women are affected. About 7 in 10 women in their seventies have
What signs & symptoms can occur?
The changes described above may occur but without causing any symptoms or discomfort. However, some
of the following symptoms may occur in some women. All of the following symptoms can be caused by
other medical conditions but atrophic vaginitis is a common (and usually treatable) cause of these
- Painful intercourse – as the vagina is smaller/shorter, drier and less likely to become lubricated
during sex, intercourse can become painful. The skin around the vagina is more easily made sore
and this aggravates the problem.
- Vaginal bleeding – as the vaginal and uterine tissue is thinner and more fragile it can occasionally
lead to spotting and bleeding. If you notice any post-menopausal vaginal bleeding you must always
report it to your GP.
- Vulvo-vaginal Discomfort – if the vulva or vagina becomes tender and inflamed some women can
experience constant discomfort.
- Infection and discharge – the vagina is less resistant to infection after the menopause and
sometimes becomes infected. An offensive (smelly) unpleasant vaginal discharge may need
treatment from your GP.
- Itch – the skin around the vulva is more sensitive and more likely to itch in some women. This
produces a tendency to scratch which then makes the skin more likely to itch. An itch/scratch cycle
follows which can be both difficult to break and quite distressing.
- Urinary problems ( frequency/urgency to pass urine)– these may be due to thinning and
weakening of the tissue around the neck of the bladder or around the urethra (the opening for
urine). A prolapse or weakening of part of the vaginal wall may also cause urinary symptoms which
may increase with age.
There is no evidence that topical oestrogens/hormone replacement will prevent or help urinary symptoms. Urinary symptoms that may occur include one or more of the
- Passing water too often (frequency)
- Not being able to hold on (urgency)
- Pain when passing urine (dysuria)
Microfractured and Purified Adipose Tissue (LipogemsTM system) Injections for Treatment of Atrophic Vaginitis
Jennifer Fantasia, Halland Chen, and Janice A. Santos Cortes
J Urol Res 3(7): 1073.
Autologous adipose tissue graft in the vulva in severe vulvar lichen sclerosus atrophicus: clinical case
Davide De Vita, Carmen Sciorio, Serena Spartano
September 2016 – Vol. 28 – N. 5 – Supplement – Quarterly – ISSN 2385 – 0868
Menopause: new frontiers in the treatment of urogenital atrophy
G.A. Casarotti, P. Chiodera, C. Tremolada
European Review for Medical and Pharmacological Sciences 2018; 22: 567-574