Medical advice
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Ask the Doctor
By Aram Bonni, MD, FACS, FACOG Published: September 01, 2010
Aram Bonni, MD is Board certified by the American Board of Obstetrics and Gynecology. He is the only surgeon with approved fellowship trainings in both Urogynecology-Pelvic Surgery and Cosmetic Surgery. His background and training provide a unique expertise under one roof. His scope of practice extends from gynecology, female bladder matters, urinary incontinence, and pelvic floor disorders to advanced and minimally invasive surgeries including robotic surgery. He also offers many state-of-the-art cosmetic gynecological surgeries and procedures.
Q: How and why does a prolapse happen? And if I have surgery to correct my prolapse, how long will it last? – S.A.
A: There are no direct cause and effect relationship established. Women that are obese, smoke or have had a history of smoking, have had vaginal deliveries and have genetic predisposition to prolapse are at increased risk of suffering from pelvic organ prolapse. There are many different types of pelvic organ prolapse and many different ways of repairing them. Those are important factors in how long will the repairs last as is the surgeons experience and the methods used. For instance doctors with fellowship training in Female Pelvic Medicine and Reconstructive Surgery (aka Urogynecology and Pelvic Surgery) are generally much more experienced in performance of these procedures. Methods and techniques of repair are also important factors. For instance the addition of the Da Vinci Robot has helped achieve much more precise repairs with a lot less blood loss and postoperative pain while decreasing the time necessary to recover from such surgeries.
Q: After four children, I find that I am self conscious and have quite a bit of discomfort during sexual intercourse. I am just now considering vaginal rejuvenation and was wondering if vaginoplasty and labioplasty are typically performed together and if you are familiar with any post surgery problems that could occur. – R.T.
A: What you are experiencing is quite common after four childbirths. Vaginoplasty and labioplasty could be performed safely together.
Some of the postoperative problems may include but is not limited to pelvic pain, scarring and change in axis of the birth canal, dyspareunia or pain with intercourse, bleeding, infection, asymmetric labia and dysfunctional voiding symptoms in the immediate postoperative period. Overall, though, they are pretty safe procedures for the right candidate in expert hands.
Q: I am 27 years old and just got married a year and a half ago. After marriage, I seem to be suffering from repeated UTI’s. I have visited the doctor and he prescribes medicine to treat however I do not understand why they are re-occurring and what I can do to prevent them in the future. Please help. Thank you. – P.P
A: Repeated urinary tract infections are not that uncommon among new partners. It usually is intercourse related. A full evaluation that at least would include history and physical exam, blood tests and serial urogenital cultures are often necessary. Other causes of frequency and painful urination should also be considered and ruled out. If your symptoms have lasted this long you should consider an uro-gynecological evaluation.
Q: Not sure if this is a question for your particular specialty. I seem to have lost my sex drive and am really concerned. I am 41 years of age and it seems to have been diminishing slowly the last 5 years and now seems to be completely gone. Are there safe options for women to help increase their sex drive? – A.A.
A: Female sexual dysfunction is a complex and not yet completely understood branch of medicine. It may have many different causes. There is usually a combination of psychological, social and physical factors that play significant role in its development and as such they all need to be evaluated and treated. There are plenty of safe options and treatments available. They may vary from medications and hormonal adjustments in different preparations such as injectables, patches, gels and pills to psychotherapy and behavioral modification. In rare occasions surgery may also be of help.
Q: I was comparing notes recently with my friends and I do not seem to urinate very often during the day in comparison to all of them. We are all in our late 40’s and all of us need to get up in the middle of the night to urinate. Is it healthy to try to urinate more often or could I be causing future problems by not going frequently during the daytime? – L.D.
A: Bladder is an organ that acts as a reservoir for the urine generated by the kidneys. It also needs to properly eliminate the urine collected. There are many factors involved in proper functioning of the bladder in its filling and voiding phases. Generally speaking and in presence of a healthy urinary system there is no need for one to force urination or even to try and urinate more often. In healthy individuals the amount of urine output is related to the amount of fluid intake. Often times not drinking enough is the cause of decrease in number of day time voids. There are many problems that may cause increased urination at night time. Up to twice a night is usually considered normal. Aging causes kidneys to lose their concentrating capability. This means that kidneys have to eliminate the toxic materials in a larger volume of urine and therefore the bladder gets full at night time which in turn makes you use the bathroom despite the fact that both kidney and the bladder are just functioning fine.
Q: I know that drinking a lot of water is healthy in general. My question is how does drinking a lot of water help or hinder with bladder control problems? – O.R.
A: Drinking lots of water or usage of diuretics and certain medications increase the volume and amount of urine produced. This puts the bladder to work and therefore it generally creates more problems in patients with bladder control issues. This is at times misunderstood and patients try to avoid drinking water and proper hydration which could cause more serious health problems. A balanced water intake of about 60-70 oz in 24 hours is usually recommended for patients with bladder control problems that do not have any other coexisting medical conditions.
– Aram Bonni, MD, FACS, FACOG
• Diplomate, American Board of Obstetrics and Gynecology
• Fellowship trained in Urogynecology & Pelvic Surgery
• Fellowship trained in cosmetic surgery
To schedule an appointment with Dr. Aram Bonni, please call 949.916.2100
Do you have a personal health question for Dr. Aram Bonni? Please send them to askthedoctor@churmmedia.com
• Get headlines in your hand at OCMETRO.com/apps
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Q: How and why does a prolapse happen? And if I have surgery to correct my prolapse, how long will it last? – S.A. A: There are no direct cause and effect relationship established. Women that are obese, smoke or have had a history of smoking, have had vaginal deliveries and have genetic predisposition to prolapse are at increased risk of suffering from pelvic organ prolapse. There are many different types of pelvic organ prolapse and many different ways of repairing them. Those are important factors in how long will the repairs last as is the surgeons experience and the methods used. For instance doctors with fellowship training in Female Pelvic Medicine and Reconstructive Surgery (aka Urogynecology and Pelvic Surgery) are generally much more experienced in performance of these procedures. Methods and techniques of repair are also important factors. For instance the addition of the Da Vinci Robot has helped achieve much more precise repairs with a lot less blood loss and postoperative pain while decreasing the time necessary to recover from such surgeries. Q: After four children, I find that I am self conscious and have quite a bit of discomfort during sexual intercourse. I am just now considering vaginal rejuvenation and was wondering if vaginoplasty and labioplasty are typically performed together and if you are familiar with any post surgery problems that could occur. – R.T. A: What you are experiencing is quite common after four childbirths. Vaginoplasty and labioplasty could be performed safely together. Some of the postoperative problems may include but is not limited to pelvic pain, scarring and change in axis of the birth canal, dyspareunia or pain with intercourse, bleeding, infection, asymmetric labia and dysfunctional voiding symptoms in the immediate postoperative period. Overall, though, they are pretty safe procedures for the right candidate in expert hands. Q: I am 27 years old and just got married a year and a half ago. After marriage, I seem to be suffering from repeated UTI’s. I have visited the doctor and he prescribes medicine to treat however I do not understand why they are re-occurring and what I can do to prevent them in the future. Please help. Thank you. – P.P A: Repeated urinary tract infections are not that uncommon among new partners. It usually is intercourse related. A full evaluation that at least would include history and physical exam, blood tests and serial urogenital cultures are often necessary. Other causes of frequency and painful urination should also be considered and ruled out. If your symptoms have lasted this long you should consider an uro-gynecological evaluation. Q: Not sure if this is a question for your particular specialty. I seem to have lost my sex drive and am really concerned. I am 41 years of age and it seems to have been diminishing slowly the last 5 years and now seems to be completely gone. Are there safe options for women to help increase their sex drive? – A.A. A: Female sexual dysfunction is a complex and not yet completely understood branch of medicine. It may have many different causes. There is usually a combination of psychological, social and physical factors that play significant role in its development and as such they all need to be evaluated and treated. There are plenty of safe options and treatments available. They may vary from medications and hormonal adjustments in different preparations such as injectables, patches, gels and pills to psychotherapy and behavioral modification. In rare occasions surgery may also be of help. Q: I was comparing notes recently with my friends and I do not seem to urinate very often during the day in comparison to all of them. We are all in our late 40’s and all of us need to get up in the middle of the night to urinate. Is it healthy to try to urinate more often or could I be causing future problems by not going frequently during the daytime? – L.D. A: Bladder is an organ that acts as a reservoir for the urine generated by the kidneys. It also needs to properly eliminate the urine collected. There are many factors involved in proper functioning of the bladder in its filling and voiding phases. Generally speaking and in presence of a healthy urinary system there is no need for one to force urination or even to try and urinate more often. In healthy individuals the amount of urine output is related to the amount of fluid intake. Often times not drinking enough is the cause of decrease in number of day time voids. There are many problems that may cause increased urination at night time. Up to twice a night is usually considered normal. Aging causes kidneys to lose their concentrating capability. This means that kidneys have to eliminate the toxic materials in a larger volume of urine and therefore the bladder gets full at night time which in turn makes you use the bathroom despite the fact that both kidney and the bladder are just functioning fine. Q: I know that drinking a lot of water is healthy in general. My question is how does drinking a lot of water help or hinder with bladder control problems? – O.R. A: Drinking lots of water or usage of diuretics and certain medications increase the volume and amount of urine produced. This puts the bladder to work and therefore it generally creates more problems in patients with bladder control issues. This is at times misunderstood and patients try to avoid drinking water and proper hydration which could cause more serious health problems. A balanced water intake of about 60-70 oz in 24 hours is usually recommended for patients with bladder control problems that do not have any other coexisting medical conditions. – Aram Bonni, MD, FACS, FACOG • Diplomate, American Board of Obstetrics and Gynecology • Fellowship trained in Urogynecology & Pelvic Surgery • Fellowship trained in cosmetic surgery To schedule an appointment with Dr. Aram Bonni, please call 949.916.2100 Do you have a personal health question for Dr. Aram Bonni? Please send them to askthedoctor@churmmedia.com • Get headlines in your hand at OCMETRO.com/apps |
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