Sexual Health: Women: Bladder surgery's pleasant side effect: better sex

Note: Comments from Dr. Hailparn's patient are here.

(Feb. 10, 2004) -- Surgery to fix a leaky bladder could also enhance your sex life.

Call it a facelift for "down there."

The final frontier of plastic surgery is no longer uncharted territory, as a handful of gynecologists across the nation are refurbishing childbirth-weary genitalia, literally tightening and reshaping the birth canal.

"Laser vaginal rejuvenation surgery," or LVR, removes excess or sagging tissue in and around the vagina to "effectively enhance vaginal muscle tone, strength and control," according to a brochure by Dr. Edward Jacobson, a gynecologist who opened the Laser Vaginal Rejuvenation Institute last July.

Childbirth can wreak havoc on the pelvic floor muscles, causing the vaginal diameter to increase and muscle tone to decrease. Consequently, sex may not be as pleasurable, and incontinence may result. Usually, gynecologists recommend Kegel exercises (flexing the muscles used to stop urination), which are thought to help restore tone, but Jacobson says that his patients find them worthless.

The main reason women have LVR, Jacobson says, is to have "enhanced sexual pleasure for them and their partners because it creates more friction" during sex.

Jacobson also performs little-known surgeries like cosmetic "vaginal labioplasty" (streamlining the inner lips for women with asymmetrical or large labia) and "hymenoplasty" (restoring the hymen to virgin-like condition, which is required by some religions before marriage).

LVR also can correct urinary stress incontinence, a condition that causes urine to leak out when a woman sneezes, laughs or otherwise puts pressure on her bladder. In fact, it was while performing standard stress incontinence surgery several years ago that Dr. Jacobson discovered the surgery can do more than just strengthen pelvic floor muscles, especially when a laser is used.

"I had a woman who had surgery for (incontinence). When she came back for the follow-up, she and her husband said their sex life was improved," Jacobson says. "The real clincher was when she referred a friend who wanted the same thing but didn't have incontinence."

Jacobson had a hunch that other doctors were noticing these unintended sexual results. He was right: Dr. David Matlock of Beverly Hills was already well on his way to establishing a practice devoted solely to these laser procedures. Jacobson, and most other doctors in the country who perform LVR, trained under Matlock.

And now, Jacobson is reaping the benefits of delving into a burgeoning field. His patients fly in from all over the world and willingly pay about $6,500 for the surgery, which lasts about 90 minutes and is performed in an outpatient setting.

"There's a large interest and demand for this to be done," he says.

Jacobson says some of his patients have stress incontinence, but for the most part, they are middle-aged mothers who wanted to increase friction during sex, or women who were unhappy with the appearance of their labia. Some women have both surgeries at the same time.

Jacobson and other doctors performing LVR claim a high patient satisfaction rate and low risk of injury. However, vaginal plastic surgery is so new that physician-member organizations like the American College of Obstetricians and Gynecologists and the American Society of Plastic Surgeons have no formal statements on the procedures, and don't require medical students to learn them.

Ilene, a 42-year-old marketing executive from Boston, was willing to take the risk. She went to another LVR specialist, Dr. Troy Robbin Hailparn of San Antonio, Texas, for her LVR and cosmetic labioplasty about six months ago.

Ilene, who asked that her last name be withheld by The Journal News to protect her privacy, developed stress incontinence after giving birth to two large babies. She also felt sex wasn't as satisfying. Doctors offered little help.

"It was all very discouraging," Ilene says. "And when you tried to press the doctor for a solution, some became very condescending. One was even hostile."

While searching for solutions on the Internet, Ilene discovered Dr. Hailparn's Web site. She made an appointment and flew to Texas to undergo LVR and labioplasty last October. After six weeks of healing, she resumed sexual activity. She's been elated with the results.

"If you've suffered from incontinence problems, the indignity and embarrassment, always worrying if you wet your pants and being on guard — it was horrible. How can you enjoy life like that?" she says. "Now, six months out from the surgery, I don't have any of those problems and my sexual desire and increased sexual sensitivity have returned."

Go to www.cosmeticgyn.net for more information on laser vaginal rejuvenation surgery.