Labial Surgery and Medical Ethics

While we agree that people should be able to change their bodies if wish to, it is right to dig deeper into the practice of vaginal/labial functional and aesthetic surgery. Is genital reconstruction tantamount ethically to rhinoplasty (nose jobs)? Are the genitalia off limits" to change and repair? Look at the conclusions of a round-table disussion regarding the issue one year ago:



Vulvar plastic surgery may be warranted only after counseling if it is still the patient's preference, provided that it is conducted in a safe manner and not solely for the purpose of performing surgery. Goodman MP, Bachmann G, Johnson C, Fourcroy JL, Goldstein A, Goldstein G, and Sklar S. Is elective vulvar plastic surgery ever warranted, and what screening should be done preoperatively? J Sex Med 2007;4:269–276.

Women have smaller bladders than men!

Today, I was asked by Cosmopolitan magazine to comment on why women urinate more often. Urologists have always known this to be true. Prospective studies have shown that: (1) men consume more fluids than women (2) men urinate larger quantities at a time and (3) women urinate more frequently than men. While the cause of gender disparity is not completely clear, women may have increased receptor sensitivity to bladder stretch and the lining of the female bladder may be more sensitive to acidic food metabolites that are excreted into the urine.

The more you know.

Gender Equality

As urologists, we have participated in perhaps the most common but controversial procedure on the planet - circumcision of the penis. While many of these procedures are performed according to religious tradition, many other patients are electing to have the procedure performed for reasons of cosmesis and improved hygiene. Men are allowed in Western society to alter the appearance of their genitalia, while women are asked to deal with body image difficulty related to their genitalia, without societal approval of aesthetic repair. Women who have experienced multiple deliveries are asked to live with changes in their vaginas related to birth injury, no matter how severe. Despite the success of vaginal reconstruction, patients are not typically offered this procedure by their gynecologists. This is 2008 and there are effective and satisfactory treatments operations offered by ultra-specialized surgeons.

Update on "The Doctors"

Yesterday, I went to CBS studios in Burbank to tape a segment on "The Doctors", the network's daytime medical talk show. The producers couldn't have been more gracious and I thoroughly enjoyed my time on set. Then, back to the operating room later in the day to perform a urethrolysis procedure, to "unblock" a patient with urinary difficulties following surgery elsewhere for stress urinary incontinence.

Taping a Segment of "The Doctors" on CBS

I was invited by the producers of "The Doctors" to discuss recent innovations in use of the laser for urological procedures. Not sure when the show will run, but am very pleased to participate. Perhaps will discuss my recent book: "Urinary Incontinence: A Woman's Guide to Treatment" published by Addicus books and available on Amazon.com." or will field questions from the other doctors and audience.

A Day in the Life of a Reconstructive Urologist

Nice day today in the office. I saw a patient in the office today who underwent vaginoplasty, labiaplasty (minora and majora) along with anti-incontinence sling approximately two weeks ago. She and I are very happy with her appearance so soon after surgery. I was reminded that she chose me as her surgeon because I was able to perform all elements of her surgery, including the sling procedure for incontinence. (Secretly, I know that she also chose us because I have the best office staff and assistants in the world).