Posts By cpramudji

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 info@houstonfemaleurology.com!

-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.

7 Things You Need to Know About ThermiVa

For the past few months, I have had the joy of offering ThermiVa treatments to my patients. Many have seen incredible results with ThermiVa and I wanted to provide all of my readers more insight on the treatment and the impact it can have on feminine well-being.

First, what is ThermiVa? The ThermiVa treatments use radiofrequency energy to gently heat tissue and rejuvenate collagen. The treatment works on the internal and external areas of the vagina to restore and revive. After going through a strenuous childbirth, multiple births, or the effects of menopause, the idea of taking back control of vaginal health is enticing to many of my patients. However, they are usually left with many questions about how ThermiVa can help return youthfulness and recover relationships.

Below are a few facts that I believe are helpful to be aware of when trying to decide if the ThermiVa treatment is right for you.

1. The benefits of this treatment include:

  • Reduced dryness
  • Reduced vaginal laxity
  • Improved confidence
  • Increased sensation

2. If you are in good health, you are most likely a good candidate for ThermiVa!
3. There are no risks to the procedure.
4. ThermiVa is performed in 3 treatments that take about 30 minutes.
5. There is no downtime. Most patients resume their normal activities right after the procedure.
6. ThermiVa requires no anesthesia and patients have described the treatment as comfortable.
7. The results vary from person to person, but most patients report immediate improvement!

I know to many of my patients, ThermiVa can either sound too good to be true or just a little scary. My team is here to help answer any additional questions you may have! Please give us a call and set up your consultation to learn more.

Stay tuned for next month’s blog on vaginal rejuvenation. I will provide more detail on what exactly vaginal rejuvenation is and how it can impact your feminine health!

Dr. P

 

Hope for Leaky Bladders

Are you suffering from a leaky bladder?  Is it hard for you to empty your bladder completely? Or maybe you feel like you need to go way too often.

These are common issues for many women and frequently go unaddressed. The good news is that if you do suffer from the above symptoms, I offer specialized urodynamics tests in my office that allow me to narrow down the cause of your bladder problems to properly address your symptoms and provide treatment options specific to your needs.

Urodynamics consists of several tests that provide valuable insight to how a patient’s lower urinary tract (urethra and bladder) are functioning. These tests determine how well the bladder is holding urine and evaluates the bladder’s ability to empty properly. Urodynamic testing is key to determining the cause of bladder incontinence.

It is fascinating what all the tests can tell us! Urodynamics commonly includes the following:

  • Uroflowmetry: measurement of urine volume and speed
  • Postvoid Residual Measurement: measures the amount of urine remaining in the bladder after urination
  • Cytometric Test: measures how much the bladder can hold when it communicates with the brain that it is full
  • Leak Point Pressure Measurement: determines the point at which the bladder leaks are involuntary
  • Pressure Flow Study: measures the pressure the bladder requires to urinate
  • Electromyography: evaluates for nerve or muscle damage

If you are one of the 25% to 45% of women who suffer from bladder leakage, I encourage you to give my office a call! To patients, bladder symptoms may feel like an embarrassing or uncommon problem but I promise it isn’t. Don’t let your bladder condition hold you back from the things you love, my team is here to help you get your life back again.

-Dr. P