Urethropexy
Whatis "Urethropexy"?
Urethropexy is a surgical procedure where the support of a woman's urethra isre-supported through sutures that surround the urethra's pelvic floor and vaginal tissues toher pubic bone.
Whatis "vulvar health"?
Vulvarhealth is a term that covers the many health issues of a woman's - or younggirl's vulva. This includes vulva care, gynecology,feminine hygiene, vaginal health, vaginalhygiene, menstruation, and the changes inwomen's vulvas from menarcheto menopause.
Husbandsand fathers - as well as women and mothers need to learn more about vulvahealth, to provide the care and support the special women in their lives mayneed. Husbands and fathers have a unique role in providing the healthcare andknowledge, especially those single dad's that have young daughters.
Vulvarhealth is an area that is related to the health and care of the vulva. Manymen and women are afraid to use the term "vulva" due to its'technical, and medical sound, and most simply prefer to call the vulva a"vagina." Yet that would be incorrect. The vagina is justone part of the vulva. Nobody, with the exception of a doctor, can see a woman'svagina, and only he/she can see a woman's vagina by looking into the vagina,using a special instrument called a speculum.
It'stime to begin calling a "spade a spade." When mother's andfathers are bathing, or toilet training their daughters, they should explainthat the vulva, which is on the outside, has several parts, and that her vagina,is on the inside.
Whatis/are Vulvar Diseases?
Vulvodynia-chronicvulva discomfort, vulvar vestibulitis,dysesthetic vulvodynia
Vulvardystrophy-broad term to describe various epithelial changes. In 1987-ISSVDInternational Society Studies of Vulvar diseasefound the following symptoms; a. nonneoplastic. b.intraepithelialneoplasms - spuamous cell CIS c. nonsquamousintraepithelial neoplasia
HSV
Womenwith HSV reports flu like symptoms, pain, itching, UTI symptoms, vaginaldischarge, sores on labia, anus, perineum, buttocks, thighs, dyspareuniaVesicles, ulcers, pustules, tender adenopathy, 70% will have lesion in vagina
Syphilis
Womenwith syphilis report painless sores in vulvovaginal area. Primary - red,round, firm ulcer with granular base with well-formed edges. Secondary- moist,mucus lesions which resemble herpes. Moist cutaneous lesions called condylomalata, appear flat and gray. Adenopathy, maculopapular rash.
CondylomaAcuminata
Womenwith CA report new bump: itching, generalized pruritus, last pap. Warty,flesh colored, sharp and pointed, cauliflower, + acetowhite
Candidiasis
Womenwith candidiasis report burning, itching, discharge, dyspareunia, vulvar edema,h/o diabetes, high carbohydrate diet, use of AB, frequent intercourse, h/osteroids, HIV.
Bartholin'sGland Infection
Womenwith barthloin's gland infections eportr unilateral bump. Reports active sex,recent trauma, new sexual partner leading to infections, fever, complaints ofpain with intercourse, warmth, tender to touch, difficulty walking, sitting. H/OCrohn’s disease.
ContactDermatitis
Womenwith contact dermatitis report vulvovaginalitching, rash, and increased incidence when wearing tight pants. The vulvaskin is red, inflamed, edematous, vesicles or bullae if severe, weeping,crusting and lichenification.
LichenSclerosus
Womenwith LS report vulvovaginal itching, familiallinkage, edema, superficial ulcers, burning, area feels different. Womenwith LS in all ages, show symptoms in clitoris, prepuce, labial majora, minora,edema, scarring, color, appearance of tissue paper of skin.
LichenPlanus - Women with lichen planus report vulvar itching, burning, withvulvovaginitis symptoms on mucosal surface of vulva. Dyspareunia, painfulerosive areas. Bleeding on contact, stenosis of introitus. The vulva has whiteraised lesion with reticular, lacy pattern. Erosive reddened area bordered byreticular white epithelium. External labia has appearance of lichen sclerosus +acetowhite. Other signs may appear in her mouth.
VulvarNeoplasm-Melanoma - affects mostly postmenopausal women that affects theclitoris and labia majora. Usually no symptoms.
VulvarIntraepithelial Neoplasm - Pruritus, vulvar burning, pain, discharge,bleeding, may report urethra, vaginal and anal symptoms. White, dk, red,ulcerated, raised warty, or nodular lesions. Labia mayora most common site,minora, clitoris and perineum.
Vulvodynia(Vulvar Pain Syndrome) - Various levels of burning, stinging, pain, dryness,irritation, rawness. No pruritus. May report long term hx.
VulvarVestibulitis is a burning, dysuria, frequency, with repeatedyeast infections or HPV. Significant/severe pain with touch or attemptingintercourse.
Paget'sDisease
VulvarPruritis, usually affecting older women. The vulva appears red/tan withscaly lesions.
What is Vulvar Cancer?
Vulvarcancer is cancer that is found in and on the vulva.
Whatis Vulvar Vestibulitis?
VulvarVestibulitis is a condition which causes redness and pain of the vestibule. VulvarVestibulitis is an inflammation of this skin and the mucous secreting glandsfound in the skin. The mucous secreting glands are called the lesser vestibularglands.
VulvarVestibulitis may include all the area around the opening of the vagina butis normally seen in the lower part of the vaginal opening.
VulvarVestibulitis occurs in women of all ages. It can occur in women who aresexually active and also in women who have never been sexually active.
Manywomen with this problem have suffered physically and emotionally for months oryears, have seen a number of physicians, and have tried many unsuccessfultreatments in search of relief.
Whatare the signs and symptoms of VulvarVestibulitis?
* 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 thevestibular area.
* Vestibular redness
* The urge to urinate frequently or suddenly.
How is Vulvar Vestibulitisdiagnosed (identified)?
Yourdoctor or health care provider will examine the vulva and vestibule to identifythe common skin changes seen with vulvarvestibulitis. Pain is usually felt if the vestibule area is touched with acotton tipped applicator. A sample of your vaginal discharge is collected andtested to rule out infection.
Whatcauses Vulvar Vestibulitis?
The exact cause is unknown, but many studies are being conducted to determinethe cause of vulvar vestibulitis.
Thefollowing factors have been associated with vulvarvestibulitis:
* HPV (Human Papilloma Virus)
* Chronic Yeast Infections
* Chronic bacterial infections
* Chronic changes of pH (acid-basebalance in the vagina)
* Chronic use ofchemicals/irritants such as detergents, soaps, spermicides or lubricants.
What is the treatment for VulvarVestibulitis?
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 vulvovaginalareas.
How it Works: Decreases redness, irritation, and burning. Caution: Use only asprescribed by your doctor. Overuse may result in thinning of the skin which willmake your problem worse rather than helping it.
* Trichloroacetic Acid (TCA) may beused in some cases as determined by the severity of the symptoms you have. TCAis a chemical that is used to destroy small areas of the irritated skin allowingnew healthy skin to grow in its place.
* Interferon Injections are used toincrease your body's response to infection.
Helpful treatment hints for VulvarVestibulitis:
* Vitamin A and D Ointment Howit 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 thevulvovaginal areas of discomfort.
How it Works: Numbs areas before intercourse.
Caution: After applying, wait until area becomes less sensitive beforeintercourse. Burning may occur for a short time (
* Witch Hazel Pads (TUCS Pads) How it is used: Apply to the vulvovaginalareas of discomfort.
How it Works: Decreases burning and irritation after intercourse and urinating.
* Cleansing Bottle - Pour plain luke-warm water over the vulva afterurinating 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 crystalsin the urine which may cause burning.
* Cranberry Juice How itis used: Drink an 8oz. glass every day.
How it Works: Increases the acid content of the urine to decrease bladderirritation.
* Limit High Oxalate Foods - May decrease amount of oxalate crystalsin urine. Oxalate crystals cause urinary symptoms such as the urge to urinatefrequently or suddenly.
* Baking Soda Soak- Soak in luke warm bath water with 4 to 5 tablespoonsof baking soda to help soothe vulvar itching and burning. Soak 1 to 3 times aday for 10 to 15 minutes. If you are using a sitz bath, use 1 to 2 teaspoons ofbaking soda.
Whatis a Vaginal Vault Prolapse?
The vaginal vault is the area at the top of the vagina, next to and adjacent tothe cervix. It can only “fall” or descend downwards toward the introitus, orthe entrance of the vagina, after a woman's womb has been removed(hysterectomy). Vaginal Vault Prolapseoccurs in about 15% of women who have had a hysterectomy for uterine prolapse,and in about 1% of women who have had a hysterectomy for other reasons.
Whatis Pelvic Organ Prolapse?
PelvicOrgan Prolapse is a very common condition, particularly among older women.It's estimated that half of women who have children will experience some form ofPelvic Organ Prolapse in later life. Many women, particularly because they mayno longer be sexually active, and fail to continue receiving their annual pelvicexams, don't seek help from their doctor. Therefore, the actual number of womenaffected by Pelvic Organ Prolapse is unknown.
Pelvic Organ Prolapse may also becalled; genital prolapse, pelvic relaxation, pelvic prolapse, uterine prolapse,uterovaginal prolapse, pelvic floor disorder, urogenital prolapse or vaginalwall prolapse.
Whatis Pelvic Prolapse?
PelvicProlapse is another term used for "pelvic organ prolapse." Pelvic prolapse is a very common condition, particularly among older women. It'sestimated that half of women who have children will experience some form ofPelvic Organ Prolapse in later life. Many women, particularly because they mayno longer be sexually active, and fail to continue receiving their annual pelvicexams, don't seek help from their doctor. Therefore, the actual number of womenaffected by Pelvic Organ Prolapse is unknown.
Pelvic Prolapse may also be called; genitalprolapse, pelvic relaxation, uterine prolapse, uterovaginal prolapse, pelvicfloor disorder, urogenital prolapse or vaginal wall prolapse.
What is a Prolapsed Uterus?
AProlapsed Uterus refers to a collapseduterus, or descended uterus, or other change in the position of the uterus inrelation to the surrounding structures within the pelvis. The pelvis containsmany soft tissue structures vital to normal body functions, supported primarilyby the diaphragms, layers of muscles, fibrous coverings called fasciae, andvarious ligaments and tendons. These soft tissues of the pelvis derive theirultimate 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 ofthe
vagina.
• Third-degree prolapse (sometimes referred to as total prolapse) occurs whenthe entire uterus extends outside the vagina.
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