66 yo mother of one from Franktown, Colorado located the office of nationally renowned Urogynecologist and master cosmetic surgeon, Dr. Oscar Aguirre through an internet search. She has a six month history of vulvar irritation with walking as well as horseback riding and a long history of painful intercourse. She also states she was recently diagnosed with Lichen Sclerosis Atrophicus which was confirmed with a biopsy. Upon examination, Dr. Aguirre found her to have significant introital stricture contributing to dyspareunia and urogenital atrophy. Separation of the labia majora reproduces her pain with sex in the midline of the posterior fourchette. This is clearly a purse string that is contributing to her dyspareunia. Dr. Aguirre discussed the need for her to continue using the Rx of Clobetasol and Estrogen therapy. She was also provided with a prescription for Osphena to assist her with the dyspareunia. Dr. Aguirre also recommended an in-office cosmetic vulvar procedure consisting of a vaginal flap advancement and revision of her perineum to get rid of her stricture.
Note the Perineal Web and Vulvar Stricture shown in the pre-op photos which is no longer present in the postop views.
