Nov 8, 2012 | Sexual Health, Urogynecology, Women's Health
Is scarless surgery possible? Amazingly, yes. Procedures that allow surgeons to use the natural openings (orifices) of the body instead of cutting into the abdomen leave absolutely no scars and are not only possible, but also preferable!
Scarless surgery (also called natural orifice surgery) is the ideal route for hysterectomy according to all professional gynecological societies. With these techniques, women recover quickly with very little pain and no scarring to indicate that they actually had surgery. Scarless surgery is less expensive than traditional, open surgeries, as well.
Unfortunately, it is harder and harder for women to find a gynecologist who is adequately trained to perform natural orifice surgery through the vagina. High-tech device manufacturers are pouring tremendous resources in marketing robotic and laparoscopic instruments to surgeons and also providing them with expensive postgraduate training programs. While these alternative routes are appropriate in the few cases when natural orifice vaginal surgery is not possible, most of the time they just add cost, recovery time and scars.
If surgery is in your future, make sure you educate yourself and talk with your doctor about all the available options.
Lisa Dabney, MD, is the Co-Director of Urogynecology and Reconstructive Pelvic Surgery at St. Luke’s and Roosevelt Hospitals.
Oct 25, 2012 | Sexual Health, Urology
Guest blog post by Doron S. Stember, MD, Urologist at Beth Israel Medical Center.
Two major medical organizations, the American Urological Association and the European Urology Association, have each recently published guidelines related to the vasectomy procedure, otherwise known as male sterilization. At Beth Israel Medical Center, we have actually been performing vasectomies according to these new recommendations for many years.
The following is a list of 10 key concepts, outlined in the new guidelines, which we always discuss at the initial visit:
1. Men who undergo vasectomy should have the intent that they will be sterile permanently.
2. Sperm banking is offered prior to vasectomy; if banked sperm is ever used it will require in vitro fertilization
3. Vasectomy reversal is also possible if a man’s circumstances change in the future, but this procedure is not always successful and is potentially expensive.
4. After a vasectomy, men must continue to use contraception until the technique’s success is proved by post-vasectomy semen analysis.
5. Most patients tolerate vasectomy extremely well and have minimal need for pain medications, but there is a very small (1 to 2%) chance of chronic scrotal pain.
6. Despite persistent misinformation available on the Internet, vasectomy is not associated with erectile dysfunction, prostate cancer, stroke, testicular cancer or heart problems.
7. In contrast to female sterilization (tubal ligation surgery), vasectomy is much less expensive and does not require general anesthesia. Both male and female sterilization are equally effective at pregnancy prevention.
8. Men should avoid ejaculating for about a week after vasectomy in order to allow the tissue to heal.
9. Post-vasectomy semen analyses are critically important for confirming the absence of sperm in the ejaculate. Remember, the ejaculate will not look any different in appearance (or volume) except when analyzed under a microscope.
10. Informed, written consent is essential at the counseling visit. New York State requires a 30-day waiting period for the time that consent is signed until the day that vasectomy can be performed.
Men who are interested in learning more about the vasectomy procedure are encouraged to make an appointment by calling 212-844-8900.
Doron S. Stember, MD, is an Urologist at Beth Israel Medical Center.
Sep 15, 2012 | OB/GYN, Sexual Health, Women's Health
Barely-there underwear, Brazilian bikini waxes and shaved pubic hair have become cultural beauty standards for women. What most women don’t take into account is that the skin of a woman’s genital area is more sensitive than the skin on her face. The very practices women undertake to keep their private areas “pretty and pristine” are actually doing just the opposite. These new grooming routines are landing women in my office with complaints of irritation and discomfort. These symptoms are the result of harsh grooming procedures and tight clothing, and they’re your body’s way of saying, “Stop torturing me!”
What we call a “yeast infection” is an overpopulation of the yeast microorganism Candida albicans, which is found normally in the vagina. The way to prevent irritating yeast and other bacterial infections is to make sure that there is a healthy population of good bacteria in the vagina. These good bacteria are called probiotics and one of them, Acidophilus lactobacillus, has a name that means “acid-loving.” Help keep an acidic and healthy environment “down there” by following all of these tips:
Are you using panty liners? If so, STOP! Panty liners actually trap moisture and allow yeast infections to grow.
Wear cotton underwear ONLY, and I don’t mean just a cotton underwear crotch. The entire pair of underwear should be 100% cotton—it’s the least irritating fabric and it allows moisture to evaporate.
Underwear should not rub against the genital and anal areas, as they do with thongs or tight bikinis. Instead, panties should comfortably cover the sensitive areas, yet be loose enough not to chafe.
Are you waxing or shaving your pubic hair? Don’t! We evolved with pubic hair for a reason—it protects the vagina from dirt and other irritants. Continually removing pubic hair can cause ingrown hairs, decreased sensitivity, irritation and red bumps.
Skip skin-tight exercise pants. I know you want to look cute in your workout clothes, but opting for loose-fitting cotton shorts will help prevent vaginal irritation and infection.
Avoid harsh soaps or douches. The vaginal region should be treated gently and kept on the acidic side, which is the opposite of most soaps. Wash gently with plain water and use a very dilute solution of vinegar, if you feel douching is necessary.
Lisa Dabney, MD is Co-director of Urogynecology and Reconstrucitve Pelvic Surgery at Roosevelt Hospital.
Updated on Jun 30, 2022 | Men's Health, Sexual Health, Uncategorized, Urology
Guest blog post by Doron S. Stember, MD, Urologist at Beth Israel Medical Center.
At some point in their lives, nearly half of American men experience erectile dysfunction (ED), the inability to achieve or maintain an erection. While the major male hormone, testosterone, is important for overall male health, including maintaining muscle strength, bone density and sense of well-being, the relationship between testosterone and ED is less straightforward.
ED Isn’t Always Caused by Low Testosterone
While testosterone is closely linked to libido, or sexual drive, many men who complain of ED may have normal erectile function, but decreased libido. On the other hand, a major study showed that men with low testosterone who failed to have a response to Viagra had a significantly improved response to Viagra when their testosterone levels were treated.
The Bottom Line
There is a common misconception, even among physicians, that treating low testosterone will significantly improve erections in men with ED. It’s a good idea to screen for testosterone levels if you have ED, especially if you have failed to respond to Viagra or a similar medication. Treating a low testosterone level, however, should rarely be considered as the first-line or only therapy for ED. Low testosterone may not be causing your ED and treatment for low testosterone has potential side effects and implications that should be carefully discussed.
Talk to Your Doctor
If you have problems with erectile function, libido or both, consult with your doctor. He or she can help define the cause of the problem, as well as help you understand your treatment options. The good news is that there are many ways to address erectile function and low libido and the best choices can be customized to your specific issues and goals.
