Vaginal tISSUE Restoration (vrt) tHERAPy for POP; Round One

Heading into a medical procedure you’ve not previously experienced can be a bit nerve wracking, I don’t care who you are or what your area of expertise is. There is no such thing as a worry-free procedure with inaugural health treatments. As a pelvic organ prolapse advocate, I intersect with clinicians daily, have witnessed some relatively invasive procedures, and have watched more than my fair share of surgical videos. But being the body on the table…let’s just say the analytical brain takes the day off and anxiety comes up a tad. Did I have concerns about having a radio-frequency vaginal procedure-absolutely! Vaginal procedures in general raise anxiety for most women no matter what is being addressed. There’s something about being naked from the waist down with legs spread wide and people or machines poking at your nether regions that brings out the angst in the strongest of us.

To clarify my backdrop, in 2008 I had transvaginal mesh repair for rectocele and cystocele, along with a mesh free enterocele repair. Over the years, I’d noticed symptoms I was not sure were related to a return of POP or to the aging process. An appointment with my FPMRS urogynecologist the summer of 2015 confirmed that my repairs were all intact, no mesh erosion, all was well in that camp. That undoubtedly meant symptoms I was noticing were related to the aging process. As a POP advocate, rest assured I do the right stuff most of the time regarding floor and core exercises, body stature, and diet. But despite daily efforts, I didn’t feel being pro-active was turning out as successful at maintaining pelvic health as I wanted, based on symptoms I was experiencing.

In line of duty I explore POP avenues and read research nearly every day, so I was very excited when I first learned about new vaginal tissue restoration (VTR) POP treatments that improve symptoms without cutting into the abdominal cavity. These procedures are currently becoming more popular to address some of the symptoms of pelvic organ prolapse (they have been utilized in Europe for about 10 years), enabling women to postpone or avoid surgery. After a year of exploration into research and brain-picking several clinicians and industry reps about radio-frequency and laser vaginal restorative treatments, I was happy to have an opportunity to experience radio-frequency vaginal restoration up close and personal. My curiosity was specifically related to the value of these treatments as a long-term post maintenance tool after POP surgical procedures. POP surgery does not prevent the aging of vaginal and pelvic tissues.

On the morning of my first of three radio-frequency procedures, I shared with a friend that I was a bit anxious. I was of course concerned that despite being told and reading in multiple studies that these procedures are not painful, that mine would be. Radio frequency produces heat to generate collagen production, while laser treatment causes microscopic punctures in vaginal tissue, also stimulating collagen production. I totally freak out about needle stuff, no matter if it is a simple blood test or pin prick-I’m a needle wienie-so was thrilled upon exploration to discover that both types of vaginal procedures were supposed to be painless. I’d been in the room when a woman had radio frequency treatment, and she didn’t even bat an eyelash.

Beyond pain, other treatment concerns I was anxious about were similar to those women with pelvic organ prolapse worry about, the issues that come with aging. Am I going to leak gas when someone is poking around down there? Will my shaven pubic patch look as ridiculous to the clinician as it does to me and make her laugh?  What if I experience spillage? Will I be clean enough? I don’t care where you hail from or what your backdrop is, these are concerns that most women experience in like circumstances. To compound my anxiety, there would be a clinician audience observing, learning the procedure. I wasn’t concerned about being a model to educate clinicians, but was a bit nervous not knowing if they would be male or female. A male gyne working down below is one thing, a room full of them looking-yikes, even though they see female anatomy every day. On my way to the clinic, I felt naked despite being fully clothed, and envisioned a room full of clinicians chuckling to themselves about my pubic haircut. Obviously, it did not occur; in this arena, clinicians see every hair style, piercing, and tattoo you could imagine-my look was hardly radical.

On the day of procedure, the treatment itself very comfortable on the inside, but did get uncomfortably warm in a couple of spots on external labial tissues. As soon as I informed the physician assistant providing my treatment that I was feeling uncomfortable (my procedure took place at a gynecologist’s office) she added more gel, and I was again comfortable. The PA and I chatted comfortably throughout the procedure. I left the office with vulva red and a bit swollen, but with no discomfort whatsoever.

The day after the procedure I recognized relatively quickly that I needed to urinate less frequently. To say I was intrigued is a bit of an understatement. I was not expecting this kind of result to manifest so quickly. I am not usually placebo impacted, but I had to wonder if this treatment was working well for me because I wanted it to after listening to difficulties women navigate all day every day, ever hopeful better POP treatments will come along.

Two days’ post-procedure, my overactive bladder (OAB) was gone-completely eliminated. Let me express that I did not realize I had OAB, likely because running to the bathroom 97 times a day was my normal. The next day I noticed that I’d only had to get up once in the middle of the night prior to urinate, and in days to follow my overnight pattern became urination once between 4 and 6 hours after I went to bed, depending on how much water I drank before bedtime. This little perk alone had me doing cartwheels. Labial tissues returned to their normal color as well and swelling subsided.

At five days, I noticed there was no fecal “residue” when defecating (no need to wipe and wipe and wipe to get clean), stool was more formed instead of my usual gravel shaped stress stool, and I absolutely noticed less rectal pressure. I no longer needed to run to the bathroom when urge hit whether for urination or defecation, I could take my time getting there. I also noticed less gas buildup.

At eight days, I absolutely noticed more vaginal moisture. In the past six months, I’d been experiencing advancing atrophy despite having balanced my hormones for over 20 years with bio-identical hormones. My external tissues would become very irritated by soap when I showered-this was no longer an issue after radio-frequency.

I had no interest in these treatments from the aesthetic angle; I’m perfectly comfortable with the way my bottom end presents (as opposed to my neck skin sag…geez don’t get me started on that end).

Over the course of the month, the positive effects of my first treatment waned, as I was told and read in research would occur if I completed one treatment only. Three treatments are recommended for both radio frequency and laser vaginal restoration, with annual renewal for continued most effective benefit. I am currently two weeks post my second treatment, and the benefits I received from the first returned. I am pleased to share the I have experienced:

* Elimination of overactive bladder (urinary urge and frequency).

* Radical reduction in overnight urination to one time.

* Radical reduction in fecal urge and need to get to bathroom immediately.

 Elimination of rectal pressure.

* Radical improvement in atrophy.

* Reduction in gas, better able to control passing gas.

* Radical reduction in fecal residue when wiping.

* Better formed stool.

* Urine stream radically stronger.

The one symptom I was hoping would be improved that I have not noticed much change in is intimate sensation. I’ve read reports of women becoming multi-orgasmic (who doesn’t want that, sign me up!), and over the years I’ve noticed a reduction in sensation which may or may not be related to surgical scar tissue/adhesions or possibly nerve damage from childbirth. I’m obviously thrilled at the other symptoms which have improved however, outcome without a doubt being significantly improved quality of life.  

I give these treatments a big thumb’s up. We clearly need additional research to spark approval by Medicare, enabling the cascade to insurance coverage so more women can have access. Once in a blue moon a treatment gives me hope-file these treatments under that category.