Case # 24470

56 yo mother of four from Carlsbed, New Mexico was self-referred to Board Certified, Fellowship-Trained Urogynecologist and renowned cosmetic surgeon Dr. Oscar Aguirre through an internet search on Urinary Incontinence and vaginal rejuvenation. She presents with an eight year history of urinary incontinence, which has worsened over the past couple years and describes stress incontinence while exercising.  She has also noticed decreased vaginal sensation and pleasure during intercourse. She describes vaginal looseness and increasing difficulties with orgasm. She is also bothered by her large labia, asymmetry and pulling and dragging during sex. She states concerns about the aging aesthetic appearance of her vulva and desires aesthetic improvement. Dr. Aguirre performed a thorough pelvic exam at which time she was found to have stage II cystocele, stage II distal rectocele, distally torn pelvic floor muscles and a very large anal skin tag. After discussing all surgical and non-surgical options, patient decided to move forward with scheduling surgery to be performed at an out-patient surgery center under anesthesia. Dr. Aguirre performed medically necessary procedures which included placement of Suburethral Sling and Rectocele Repair. At the same time Dr. Aguirre performed Vaginoplasty, Labiaplasty of Labia Minora and Anal Tag Excision. She returned to the office for her regularly scheduled postoperative appointment at which time Dr. Aguirre performed Labia Major Puff procedure.