COMPLETE VESTIBULECTOMY SURGERY
Transcription
COMPLETE VESTIBULECTOMY SURGERY
2/20/13 VESTIBULAR ANESTHESIA TEST My dearest Dr. G. and Catherine, All is more than well. I'm sitting while I write to you--wearing panties for the first time in over three years and...a pair of G's jeans!!!!! Last time I was able to wear pants was the G. W. Bush administration, at least. I can't thank you both enough for giving me a type of hope I've not dared dream of for so long.-----------Am looking forward to speaking with former patients of the procedure and moving forward! A world of thanks, Neuro-Proliferative Vestibulodynia COMPLETE VESTIBULECTOMY SURGERY 1 2/20/13 Neuro-Proliferative Vestibulodynia Positive vestibular anesthesia test can help predict surgical outcome A positive vestibular anesthesia test predicts that the patient can be pain-free if there is: 1) elimination of diseased vestibular tissue that is associated a high density and proliferation of Cafferent nociceptors that has led to unrelenting and conservative treatment resistant vestibulodynia 2) the healthy vagina (NO PATHOLOGY) is surgically connected to the healthy vulva (NO PATHOLOGY) Neuro-Proliferative Vestibulodynia Alternative to conservative treatment for neuroproliferative vestibulodynia is outpatient surgery to remove ALL diseased vestibular tissue Complete vestibulectomy: right and left anterior vestibulectomy, millimeters from the urethral meatus PLUS classic posterior vestibulectomy with vaginal advancement flap 2 2/20/13 Neuro-Proliferative Vestibulodynia COMPLETE VESTIBULECTOMY REMOVING ALL VESTIBULAR TISSUE – EVEN 1-2 MMS FROM THE URETHRAL MEATUS 8/13/12 8/13/12 8/13/12 8/13/12 8/13/12 3 2/20/13 POST-OP 4 months PRE-OP 4 2/20/13 Neuro-Proliferative Vestibulodynia Neuro-Proliferative Vestibulodynia Outpatient surgery is 1 hour Recovery restrictions from surgery for 3 months: Bed rest for most of day, No heavy lifting (<10 pounds), No sexual/physical activity, Frequent baths (3-4/day), Frequent icing, Walking permitted Post-op success is very dependent on post-op: psychologic therapy – at 3 months pelvic floor physical therapy - at least 3-6-12 months 5 2/20/13 6
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