Monthly Archives: September 2017

What is Vaginal Rejuvenation?

I am thrilled with the growth of vaginal rejuvenation treatments in my field. More and more women are starting to have the conversation with their doctors about their feminine health, and the range of non-surgical procedures to improve women’s vaginal health is expanding.

However, the language commonly used around the revolutionary treatments such as ThermiVa and MonaLisa Touch can be vague. What does the term feminine or vaginal rejuvenation mean and how does a woman know if the treatments can fix her uncomfortable symptoms?

Vaginal or feminine rejuvenation is the enhancing of the vagina’s function and cosmetic appearance.

The desire for better sex, a more youthful appearance, and convenience are the main reasons women are choosing non-surgical procedures for rejuvenation. Additional reasons include:

• Perimenopausal and menopausal women experiencing dryness, leaky bladder, or laxity
• Women suffering from dryness due to bioidentical hormones
• Women experiencing dryness from breast cancer treatments
• Women who have discomfort wearing yoga pants, a bathing suit, or riding a bike
• Women that have difficulty achieving orgasm
• Mothers that have vaginal laxity, leaky bladder, prolapse, or decreased sensitivity due to vaginal births

Lastly, I wanted to leave you with a few other notes about vaginal rejuvenation that I think are helpful to be aware of. First, the results can last up to one year and can vary from person to person. Secondly, the procedures are not typically covered by insurance.

If you are interested in vaginal rejuvenation, my team and I are available to help you determine which non-surgical treatment option is best for you. Email us today at!

-Dr. P

Squashing Myths About In-Office Cystoscopy Tests

Many women are frightened by the idea of a cystoscopy test. When I sit down with my patients to discuss the procedure, they mainly express concern about pain and discomfort.  However, this procedure can provide great insight into a patient’s bladder health and should not be feared. Below is a list of FAQ’s to help ease your mind about your upcoming cystoscopy test.

What is an in-office cystoscopy?
A cystoscopy test is a procedure that allows me to examine the bladder lining, by inserting a scope into the bladder through the urethra. A cystoscopy test can be compared to a colonoscopy, but for the bladder.

Why would a woman need to have this procedure?
A woman would need a cystoscopy test if she has a polyp, tumor, or other abnormality. Additional reasons for a cystoscopy include blood in the urine that a physician found in a laboratory exam, bladder irritation, overactive bladder, or continuous bladder infections.

What misinformation have women heard about this procedure that’s wrong? Why should they not be nervous?
Most women think a cystoscopy test is very painful. Usually women hear this from others who have had a cystoscopy performed in the past, using a rigid scope. Now, we use a flex scope that is much smaller and less painful. The cystoscopy test only takes two to three minutes and the level of discomfort felt can be compared to a pap smear.

How should women prepare for this procedure?
It is important to come to the office with a full bladder so we can take a urine sample.  If you feel like you might have an infection, please let my office know before the procedure so we can treat the infection before performing the cystoscopy.

What does the process of having an in-office cystoscopy look like at Houston Female Urology?
First, the patient comes in for a regular appointment. We then take a urine sample to check for infection. Next, the medical assistant prepares the area and inserts a numbing jelly in the urethra. Once the area is numb, I fill the bladder with water. The scope is then inserted through the urethra into the bladder for the quick test. The results are discussed with the patient right away. Once complete, the patient will get dressed and go to the bathroom to empty the bladder. If there is any discomfort, we can provide a medication to help.

Will the patient feel much pain after they leave the office?
A patient should not feel any pain once they leave our office. There can be a slight burning but the feeling should go away after a couple of hours and is not a common side effect.

Please call my office if you have any other questions about your cystoscopy test. My team is always available to make sure you feel comfortable before coming in for your visit!

-Dr. P

Thanking God for the privilege

It has been a long time since I wrote in my blog.  The holiday season is very busy for surgeons (having met their deductible, many people try to have surgery before the end of the year), and then the time just got away from me.   I started this entry right before Thanksgiving.

As a Christian, my life is dedicated to trying to bring glory to God in any little way that I can.  Now, I often fail, but it’s a striving and a focus that informs my day to day living.  I don’t think that we have a “spiritual life” and a separate “secular life”.   I think it is all integrated.   As such, when I come into an exam room or the operating room, I am thinking “What is God doing here?  How can I join in with His work?”  Sometimes it is as simple as giving her an antibiotic, other times it is praying about a struggle in her life, or praying that the surgery and recovery go well, and using my surgical skills to help her.

I used to pray with every patient before surgery and take a spiritual history on every patient, but that began to seem a little too rote and forced.  Now I follow the leading of the Spirit.  When I feel that I need to pray or ask probing questions, I do it.  It is amazing how God answers, often in ways I didn’t expect.   Just the other day, I prayed with a patient who had just found out she had rectal cancer.  I could see that she needed the comfort of knowing that God will be with her in her fight.

Patients are often surprised to have their doctor pray with and for them. Sometimes I feel a little silly praying for a what is for me a simple routine bladder lift; I mean, it’s not brain surgery or heart surgery. But then again, for the patient, there is nothing simple or routine about it.  I typically pray for the surgery to go well, for the entire OR team, for the patient to be healed and to recover well, and for her to have peace as she goes into surgery.   Most patients are very grateful for the prayer.  Occasionally I can see that someone feels uncomfortable, so I try to be sensitive to that before I pray.

I have some examples that show how God has answered prayers in my practice and in my life.  One day the robot at the hospital broke down before my case.  That was just one of many things that had happened that day.   There were odd delays and unexpected events that occurred. Everyone did great and no one was harmed by any of the issues.   But it was really stressful on me, because things weren’t going smoothly.   I just continued to lean on the Lord and pray for my patients and for our whole surgical team.   One of my patients told me that she was shocked when I prayed for her, but she told me that a sense of peace filled her heart and any nervousness that she had was gone.  Her surgical procedure was changed at the last minute due to the equipment malfunction so there was a lot of anxiety for her.  But the Lord gave her amazing peace.  She is now several weeks postop and doing great.

Another example was a stone case. I had been covering this patient in prayer for a few days prior to the surgery date due to her underlying health issues and the size of her stone.  This case went from a simple laser case to an open bladder case because the stone was bigger and harder than anticipated.    I was also concerned because I thought the bladder had partially ruptured when I was using the laser.  When I realized that I had to open her up, I called my office to let them know that I would be running late for my other patients due to the change in the plan.  I didn’t know it at the time, but my staff then all took a moment to join hands and pray for our patient.   Well, the open surgery went about 500% better than I had expected:  there was no rupture, the bladder was not as malformed as I thought it might be given her underlying disease, and the stone popped right out (it was about a 4 inch stone).  Another answered prayer!  She recovered beautifully and is doing better than ever.

Not only do I pray for my patients, but my staff does, too.   We all get to participate in what God is doing.  He cares about every part of our lives, even our urological health!

I have always been so thankful for the privilege of being a doctor and specifically a female urologist.  I hope that God is honored in my service to my patients.   I am humbled for the opportunity.

A Q&A about the MonaLisa Touch

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When I first learned about the MonaLisa Touch laser, I wondered if it was too good to be true. Could a vaginal laser really help post-menopausal women and breast cancer patients experience healthy regrowth of their thinning vaginal walls? I had to see it to believe it. I traveled to California in November 2015 to watch other doctors perform the treatment. To my amazement, many women reported back with noticeable changes after only one session.

I had to bring the MonaLisa Touch to Houston Female Urology – and the response has been amazing. Not only are the treatment sessions approximately five minutes, my patients say that the laser is virtually painless and they can continue on with their day as soon as they leave the office.

I want to share some honest answers with you. I asked one of my patients, Sharon S., to answer a few questions and share her real experience with the MonaLisa Touch. See what she said:

What was life like before your first MonaLisa Touch treatment?
I had age-related symptoms of dryness, burning and pressure resulting in frequent trips to the bathroom. I also experienced drips when sneezing and coughing. I thought I was going to have to learn to live with these problems; however, after my first MonaLisa Touch treatment, I saw improvements in all areas, and I couldn’t wait for my second and third treatments.

Tell me about the day you had the treatment…
On the day of my first treatment, I left the office and continued with what I had scheduled without a problem. The procedure was no worse than having a pap smear. Within the first week of my first treatment I saw a difference in each of the symptoms I was experiencing. I was actually pleasantly surprised that I had improvements so soon.

How did your MonaLisa Touch treatment impact your life?
I have had all three of my treatments, and I can say there has been an even bigger difference with the symptoms I was experiencing. I stopped using my estrogen cream because the problem with dryness was gone, the burning is not a problem, and the pressure when needing to urinate is gone. I am making less trips to the bathroom at night (unless I drink an unusual amount of water before bed), and experiencing no drips. Not only have I experienced a difference, but my husband said that he could tell a difference during intimacy. I also have been able to tell a difference. It is worth it, and I would do the procedure again without question.  

This really works. My patients and other women throughout the world are seeing results. Are you ready to learn more? Join me for a free seminar at my office about the treatment. Give us a call! (281) 717-4003

-Dr. P

Bladder Botox: bringing relief to my patients

Botox is well known for its cosmetic purposes. If we’re honest, the first thing that comes to mind for most people is a procedure that targets and relaxes facial wrinkles. Fortunately for those suffering with urinary incontinence, Botox can also provide a powerful answer for this problem. This can be treated with an injection in the muscle of the bladder to ease the symptoms of an overactive bladder.

The New York Times recently conducted an in-depth report on incontinence. The study found that, “About 20 million American women … have urinary incontinence or have experienced it at some time in their lives. The number, however, may actually be higher because most patients are reluctant to discuss incontinence with their doctors. In fact, research indicates that many patients will not admit to having the problem even when questioned directly.”

As a urologist who exclusively treats females, the last thing I want is for my patients to feel like they have to stay quiet and learn to live with this condition. I’m always pleased to tell women about bladder Botox and the relief and freedom it provides. I understand that this is a tough topic to approach for many, but my team at Houston Female Urology handles this discussion with empathy, care and kindness.

Bladder Botox is a quick in-office procedure that is well tolerated by our patients. The treatment begins by flushing the bladder with a local anesthesia through a catheter to numb the bladder. Then a scope is passed up the urethra into the bladder, and a small needle is placed through the scope where several injections are made to spread the Botox throughout the muscle of the bladder. This significantly relaxes the bladder, and my patients are able to return home on the same day of the procedure.

The Botox begins to work at about one week with its full effects beginning at two weeks. While this procedure is not permanent, it lasts approximately six to eight months when injected in the bladder. There are no limitations to the extent of use, and my patients are so happy with the results I tend to see them once or twice each year for Botox injections.

One of the best parts of my job is bringing hope to women who often silently struggle with urology issues. It’s so rewarding to see my patients’ faces when they see the light at the end of the tunnel after Botox – they have their lives back.

Dr. P