Case # 25644

32 yo mother of two from Commerce City, Colorado located the office of Board Certified, Fellowship-Trained Urogynecologist and Master Cosmetic Surgeon Dr. Oscar Aguirre of Parker, Colorado through an on-line Google search of vaginal looseness and no libido. She has a 10 year history of loss of vaginal sensation and libido which she attributes to a difficult vaginal delivery requiting forceps assistance. Her second set of concerns deal with very heavy periods, for which she saw a gynecologist who on ultrasound did confirm possibility of adenomyosis and has been given the option of endometrial ablation versus hysterectomy. She presents for second opinion. Dr. Aguirre performed a thorough pelvic examination which revealed scarring from a previous right mediolateral episiotomy. There is stage I anterior vaginal relaxation with good UVJ support, and a stage II symptomatic pelvic relaxation contributing to primary symptom of loss of sexual pleasure. All history and findings were discussed in detail with the patient as well as all her surgical and non-surgical options. From a surgical standpoint, Dr. Aguirre recommended an endometrial ablation. She is not in-network with Dr. Aguirre going through her insurance so she has decided to return to her gynecologist for this. She desired to proceed with vaginal repair with Dr. Aguirre therefore he recommended, and performed in an out-patient surgical center, posterior Vaginoplasty. During initial examination she was also found to have an anal skin tag which Dr. Aguirre did an in-office Excision of Anal Skin Tag. She returned to the office for her regularly scheduled postop appointments with excellent results.