1) Vaginal rejuvenation surgery is growing in popularity as a way to improve vaginal tone and sexual gratification, though there is little scientific evidence of its benefits or risks. 2) Proponents argue gynecologists are well-suited to perform this procedure, while critics argue it may do more harm than good for healthy women and could restrict access if patented. 3) There is ongoing debate around the ethics of performing elective cosmetic procedures without evidence of medical need.
Endometrial cancer in a woman undergoing hysteroscopy for recurrent ivf failurecare women scentre
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Adrenal Mass in Pregnancy: Diagnostic Approach and DilemmasApollo Hospitals
An adrenal incidentaloma is a mass lesion greater than 1 cm in diameter, incidentally found during radiologic examination for other reasons.
1. Such “adrenal incidentalomas” are increasingly recognised in clinical practice.
2. This is attributed to routine use of sophisticated and sensitive imaging techniques, with a reported prevalence of 4.4%.
3. Incidental findings of such masses pose dilemmas in evaluation and management, as current recommendations based on expert opinion.
4. Are open to debate in terms of cost and clinical
benefits. The uncertainties in management multiply with
such adrenal incidentalomas in the context of pregnancy.
We report a rare case of a large adrenal incidentaloma
complicating second trimester of pregnancy. This case
outlines the huge decisional dilemmas, both for the patient
and healthcare provider.
This highly interactive and multidisciplinary workshop is
designed to increase the practical knowledge and skills critical
to establishing and maintaining a successful program for
the care of patients with peritoneal surface malignancies.
The first day of the course will focus on a real time HIPEC
surgery procedure streamed live to the conference venue,
providing unique learning opportunities. National experts will
share their knowledge and experience essential to creating
a successful and comprehensive peritoneal malignancy
program for gastrointestinal and gynecologic malignancies.
Survivor care when one has been through breast cancer treatment is getting complicated with time. This is as it aims to have control over the long term implications of cancer and its diagnosis as well as psychosocial desires
Enviage Vaginal Biofeedback by David Bychkov, PhD, CEO of Exmovere HoldingsDavid Bychkov, PhD
In 2010-2012, Exmovere Holdings, Inc. was exploring how to provide high tech Kegel training exercises and pelvic floor psychophysiology services to female patients at Clinica of Virginia, it's Medicare/Medicaid clinic subsidiary in Fairfax, Virginia. For more info on Exmovere and David Bychkov, visit www.davidbychkov.com
We like to counsel our patients extensively and empower them to make the best informed decision to restore their quality of life, Every woman deserves to receive the highest quality of care, most technologically advanced and the least invasive treatment. Our team is proud to offer cutting-edge novel treatments by being highly specialized in the field of female pelvic medicine and reconstructive surgery.
How to have quality of life in Advanced ovarian malignancyRajesh Gajbhiye
Presentation given by Dr Rakhi Gajbhiye, Mauli Hospital Nagpur at MGIMS sewagram for an International conference on Womens Health Fatal Disorders Survival with Quality in collaboration with FOGSI.
This was the function to commemorate 100 th birth centenary of Dr Sushila
Hysteroscopy Newsletter 4th Issue online!!!
Dear colleagues,
We are pleased to inform you that the fourth issue of our publication is ready and available for you to enjoy. We hope that our great enthusiasm and eagerness for a better knowledge of hysteroscopy, will make reading this journal arouse your interest in this fascinating field. Hysteroscopy Newsletter is an opened forum to all professionals who want to contribute with their knowledge and even share their doubts with a word-wide gynecological community.
SHARE & ENJOY IT !!!!!!
http://www.hysteroscopy.info/
Adrenal Mass in Pregnancy: Diagnostic Approach and DilemmasApollo Hospitals
An adrenal incidentaloma is a mass lesion greater than 1 cm in diameter, incidentally found during radiologic examination for other reasons.
1. Such “adrenal incidentalomas” are increasingly recognised in clinical practice.
2. This is attributed to routine use of sophisticated and sensitive imaging techniques, with a reported prevalence of 4.4%.
3. Incidental findings of such masses pose dilemmas in evaluation and management, as current recommendations based on expert opinion.
4. Are open to debate in terms of cost and clinical
benefits. The uncertainties in management multiply with
such adrenal incidentalomas in the context of pregnancy.
We report a rare case of a large adrenal incidentaloma
complicating second trimester of pregnancy. This case
outlines the huge decisional dilemmas, both for the patient
and healthcare provider.
This highly interactive and multidisciplinary workshop is
designed to increase the practical knowledge and skills critical
to establishing and maintaining a successful program for
the care of patients with peritoneal surface malignancies.
The first day of the course will focus on a real time HIPEC
surgery procedure streamed live to the conference venue,
providing unique learning opportunities. National experts will
share their knowledge and experience essential to creating
a successful and comprehensive peritoneal malignancy
program for gastrointestinal and gynecologic malignancies.
Survivor care when one has been through breast cancer treatment is getting complicated with time. This is as it aims to have control over the long term implications of cancer and its diagnosis as well as psychosocial desires
Enviage Vaginal Biofeedback by David Bychkov, PhD, CEO of Exmovere HoldingsDavid Bychkov, PhD
In 2010-2012, Exmovere Holdings, Inc. was exploring how to provide high tech Kegel training exercises and pelvic floor psychophysiology services to female patients at Clinica of Virginia, it's Medicare/Medicaid clinic subsidiary in Fairfax, Virginia. For more info on Exmovere and David Bychkov, visit www.davidbychkov.com
We like to counsel our patients extensively and empower them to make the best informed decision to restore their quality of life, Every woman deserves to receive the highest quality of care, most technologically advanced and the least invasive treatment. Our team is proud to offer cutting-edge novel treatments by being highly specialized in the field of female pelvic medicine and reconstructive surgery.
How to have quality of life in Advanced ovarian malignancyRajesh Gajbhiye
Presentation given by Dr Rakhi Gajbhiye, Mauli Hospital Nagpur at MGIMS sewagram for an International conference on Womens Health Fatal Disorders Survival with Quality in collaboration with FOGSI.
This was the function to commemorate 100 th birth centenary of Dr Sushila
Hysteroscopy Newsletter 4th Issue online!!!
Dear colleagues,
We are pleased to inform you that the fourth issue of our publication is ready and available for you to enjoy. We hope that our great enthusiasm and eagerness for a better knowledge of hysteroscopy, will make reading this journal arouse your interest in this fascinating field. Hysteroscopy Newsletter is an opened forum to all professionals who want to contribute with their knowledge and even share their doubts with a word-wide gynecological community.
SHARE & ENJOY IT !!!!!!
http://www.hysteroscopy.info/
Airbrush Liposculpture(R) offers a faster and safer alternative to bariatric ...Robert Cucin MD JD FACS
A white paper with some case studies illustrating how serial liposuction with the Airbrush(R) Liposculptor as a combined modality therapy can offer an end run to a better body and healthy metabolism in weeks rather than years.
Running head COURSE PROJECT- ROUGH DRAFT .docxSUBHI7
Running head: COURSE PROJECT- ROUGH DRAFT
1
Course project- Rough draft
Weltee Wolo
Rasmussen College
Author Note
This paper is being submitted on November 22, 2016, for Holli Rich’s B371/GEB3110
Research and Report Writing HSA3110 course
COURSE PROJECT- ROUGH DRAFT
2
1. Introduction
Currently, in the United States and all over the world, women and men alike are undergoing
procedures to rectify or enhance one part of their body or more. The industry is a multi-million
dollar one that is reported to generate $10.1 billion each year. Most of them go into the
procedure without adequate knowledge of the probable consequences of the surgeries. For those
who are slightly aware, they still go ahead and get the surgeries done on them and only after the
results have been realized do they start regretting. When such cases take place is when one sits
down to reflect whether the pain and the features are worth the effort of cosmetic surgery. The
report below is a compilation of findings from research carried out to establish just how much
damage the cosmetic surgery has impacted people and expert opinion on the issue.
2. Background
Women account for ninety-one percent of cosmetic surgery patients worldwide. As of 2010,
the number of those undergoing surgery had risen by 5 per cent from the previous years. Many of
the surgeries started off as quick fixes that later on motivated the women to get into dangerous
forms of operations. According to the American Society of Plastic Surgeons, the motivation of
undergoing the procedures is fast moving from improving appearances to look younger. Younger
women are now reported to be undergoing these procedures at an alarming rate than they were
before ever in history. The Society says that women seeking cosmetic surgery in their 30s have
risen by 4%, 19 to 34 is the age that prevails among liposuction procedures at a rate of 30%. The
American Society for Aesthetic Plastic Surgery states that the new wave of surgeries being seen
in recent years is those of the modern young woman seeking to trim out unwanted fat to look
COURSE PROJECT- ROUGH DRAFT
3
perfect. It also states that the most common form of aesthetic surgery is the insertion of breast
implants.
3. Collection of data
3. 1. Primary data
3.1.1. Interviews
For this particular study, a group of patients who had undergone plastic surgery was
picked. There were a total of 25 patients categorized into the different form, so procedures have
undergone. For the study ...
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Should OB/GYNs Offer Vaginal Rejuvenation?
1. The Female Patient VOL. 32 June 2007
V
aginal cosmetic surgery is among the fastest
growing trends in plastic surgery. Today,
more than 140 surgeons in some 21 coun-
tries are providing these services in response to
their patients’ demands.
Vaginal rejuvenation (colpoperineoplasty) is
designed to correct vaginal relaxation and enhance
sexual gratification.1,2
All OB/GYNs are familiar
with the signs and symptomscystocele, rectocele,
enterocele, uterine prolapse, and stress urinary
incontinencebut little attention has been paid to
the resulting sexual dysfunction. Approximately 30
million American women are experiencing these
symptoms as a consequence of vaginal childbirth
and/or aging. The damage to the muscles, fascia,
and supportive tissue of the pelvic floor, vaginal
canal, and perineum relax the fibromuscular tube
of the vagina, leading to poor tone, strength, and
control. In the process, the internal and external
vaginal diameters increase greatly, and the perineal
body thins and separates in the midline. The vagina
can no longer function physiologically to provide
optimum sexual gratification.
Vast medical resources have been spent to
improve men’s sex lives with pharmacologic aids,
penile implants, and pumps. By comparison, little
has been done to improve the sex lives of women.
Robert Jason, MD, is medical director, Laser Vaginal Reju-
venation Institute of New York, Lake Success; Great Neck
Women’s Medical Care, Lake Success, NY; and ExAblate
of Metropolitan New York; and attending physician, Long
Island Jewish Medical Center, New Hyde Park, NY; and North
Shore University Hospital, Manhasset, NY.
Should OB/GYNs Offer
Vaginal Rejuvenation?
V
aginal rejuvenation is not medicine! Frankly,
until this question was posed, I had never
heard of it. So I performed an Internet search,
and got 190,000 responses in 0.18 seconds. I found
the information contained in these listings to be dis-
turbing, and even appalling. This procedure raises
serious ethical, professional, and heath care concerns
for physicians, patients, and society as a whole.
As promoted by its proponents, vaginal rejuvena-
tion encompasses recognized surgical procedures
for conditions such as labial hypertrophy, cysto-
cele, and rectocele. However, when performed for
“rejuvenation,” these surgeries are carried out on
women who have no demonstrable and/or signifi-
cant vulvovaginal abnormalities. How far we have
come from the tenets espoused 30 years ago in the
spirit of Our Bodies, Ourselves.1
The demand for this surgery appears to arise from
the skewed “need” of some normal women to be
“perfect,” and the willingness of some physicians
to pander to the insecurities of this population.
Our society is increasingly driven by customer
demand; in medicine, it is called “patient-centered
care.” That is, what the patient wants, the patient
can haveregardless of whether it is truly needed.
Rationing and allocation of resources based on
need is not the American way. We can fix eyelids
Kathleen Fitzgerald, MD, is clinical professor of obstetrics
and gynecology, Warren Alpert Medical School, Brown Uni-
versity, Providence, RI; district I past chair, American College
of Obstetrics and Gynecology; and past president, Rhode
Island Medical Society, Providence.
In the
HOT SEAT
continued on next pagecontinued on next page
CON
Kathleen Fitzgerald, MD
PRO
Robert Jason, MD
PRO
CON
Opinions expressed in this department are the authors’ and do not reflect those of The Female Patient.
2. The Female Patient VOL. 32 June 2007
Nonsurgical measures like Kegel exercises are of
limited use in many of these patients. However,
laser colpoperineoplastya modification of a stan-
dard, existing gynecologic surgical techniquehas
been shown to successfully meet patients’ needs
and requirements. Indeed, the surgery has been
demonstrated to lead to a 96% improvement in
vaginal support and sexual gratification.1
I have performed cosmetic surgeries on an out-
patient basis in state-licensed ambulatory surgical
centers over the past decade. The procedures are
relatively bloodless and less painful than standard
gynecologic vaginal recon-
struction. Along with my
associates, I have found
that this procedure results
in very high patient sat-
isfaction. Patients world-
wide are thrilled to have
found a solution to this
pervasive problem. They
are grateful and appreciate
our interest in the quality
of their sexual health.
Gynecologists are uniquely
qualified to perform vagi-
nal rejuvenation; our train-
ing makes us the optimal
choice. In addition, if the
demand is left for the plastic surgeons to fill, then
ultimately another major procedure will be lost to
us. Our gynecologic colleagues pioneered (and then
relinquished) liposuction, sclerotherapy, and endo-
scopic breast implantation. Let’s not lose vaginal
rejuvenation as well. Is this procedure beneficial for
our patients? Absolutely!
REFERENCES
1. Pardo JS, Sola VD, Ricci PA, Guiloff EF, Freundlich
OK. Colpoperineoplasty in women with a sensation of
wide vagina. Acta Obstet Gynecol Scand. 2006;85(9):
1125-1127.
2. Karram MM. Vaginal operations for prolapse. In: Baggish
MS, Karram MM, eds. Atlas of Pelvic Anatomy and Gyne-
cologic Surgery. Philadelphia, Penn: WB Saunders; 2001:
378-397.
and noses to satisfy the desire for a “new look,” so
why not the labia as well?
Indeed, the term “vaginal rejuvenation” has been
trademarked and some of the procedures patented,
and the whole package is now offered by a fran-
chise operation. The application of this business
model to medicine is disturbing in view of our
guiding medical-ethical principles: do no harm,
protect patient autonomy, act only in beneficence,
and allocate resources with justice to the individual
and society. In medicine, patents and trademarks
are now restricting access
to innovative tools for
scientific information and
researchto the detriment
of patients and society.
Where is the evidence-
based medicine to justify
such surgery in this “nor-
mal” population? There
is no current scientific lit-
erature or plan for future
studies on the benefits and
risks of these procedures in
essentially healthy women.
Improving sexual func-
tion and pleasure for the
woman and/or her partner
are often cited as justifica-
tion for surgery. However,
vaginal “tightening” at age 35 years may render the
vagina impassable by age 55 years. The American
College of Obstetricians and Gynecologistsas
well as experts in menopause, sexual function/
dysfunction, and vulvodyniahave all expressed
concerns about this lack of scientific support and
the potential long-term physical and psychological
harm to women.2
More fundamentally, how far
are physicians willing to go in using our technology
and skills to satisfy desires that do not represent
true need?
REFERENCES
1. Boston Women’s Health Book Collective. Our Bodies, Our-
selves: A Book by and for Women. New York, NY: Simon
Schuster; 1973.
2. Navarro M. The most private makeovers. New York Times.
November 28, 2004. Available at: http://query.nytimes.
com/gst/fullpage.html?res=9D06E0DA123EF93BA15752C
1A9629C8B63sec=healthspon=pagewanted=all.
Gynecologists
are uniquely
qualified to
perform vaginal
rejuvenation;
our training
makes us the
optimal choice.
There is no
current scientific
literature or plan
for future studies
on the benefits
and risks of
these procedures
in essentially
healthy women.
Jason, continued Fitzgerald, continued
In The Hot Seat
Vaginal Rejuvenation