38 yo mother of three from Denver, Colorado was referred to Urogynecologist and cosmetic surgeon, Dr. Oscar Aguirre by a friend of hers. She has a greater than fifteen year history of urinary incontinence and recalls stress-associated urine loss with exercise even before having children. She also has concerns of recurrent urinary tract infections occurring every two to three months and vaginal prolapse. During consultation with Dr. Aguirre she also describes sex as being uncomfortable. She describes discomfort with penetration and is bothered by vaginal looseness. She is also unhappy with the appearance of her vulva, in particular her labia, since she was a teenager. After discussing her surgical and nonsurgical options, she decided to proceed with surgery as recommended. Dr. Aguirre performed medically necessary Abdominal Supracervical Hysterectomy for Prolapse, Uterosacral Ligament Cervical Stump Vault Suspension, Bilateral Paravaginal Defect Repair and RetroArc Sling as well as cosmetic procedures consisting of a Vaginoplasty and laser reduction Labiaplasty of the Labia Minora.
Postoperatively she experienced tenderness along her perineum due to scarring likely related to her history of keloiding. Rather than surgically revising the perineal skin Dr. Aguirre performed a PRP injection to the perineum with excellent resolution of her pain and scarring. This was performed at the time of an O-Shot to improve her orgasmic response.