32 yo mother of two from Aurora, Colorado with a five-year history of decreased vaginal sensation and urinary incontinence was self-referred to the office of Board Certified, Fellowship-Trained Urogynecologist and renowned Cosmetic Surgeon Dr. Oscar Aguirre of Denver, Colorado, from an internet search on RealSelf for Leakage and Vaginal Tightness. She recalls symptoms starting following her first delivery. Following her second pregnancy, she felt that the symptoms have worsened. She is bothered by decreased sensation with intercourse, her husband “falling out” often and vaginal flatus with exercise and sex. She is also bothered by her tampons being less effective, as her menses leaks around and requires a mini pad. She is also concerned with the gaping appearance of her introitus. Dr. Aguirre performed a thorough pelvic examination which revealed a parous-appearing perineum with an enlarged genital hiatus. There is a complex stage II pelvic organ prolapse with early paravaginal defects, large rectocele and early uterine descent. She performs a weak pelvic floor contraction and there are torn pelvic floor muscles distally. There are also anal skin tags present. After a lengthy consultation discussing all surgical and non-surgical options with Dr. Aguirre, she decided to proceed with the surgical recommendations of Dr. Aguirre. Dr. Aguirre performed in an out-patient surgical facility, Vaginoplasty and Rectocele Repair. She felt that her leakage was not consistent therefore she decided to hold off on further testing and procedures for incontinence. She followed up in the office for her regularly scheduled postop appointments with excellent support and no further gaping, urinary incontinence and vaginal flatus.