DOCTOR'S ADVICE - Should I do a labiaplasty?

Q Doctor could you please give me your advice about the opening of my vagina, or what I think they call the lips? Ever since I had my children, these 'lips' have been too loose and floppy. I feel that I look ugly now, and so I am rather reluctant to take off my clothes in front of my husband. However, I have to admit that he thinks I look great.

My sister lives in Miami, and she told me that there are doctors there who do an operation called labiaplasty. She says that they give you what they call designer vaginas. I could afford to go there and take that operation. Do you think I should go ahead? And what is labiaplasty anyway?

A These days, a lot of women are not happy with the shape or size of their lips known as the labia. Labiaplasty just means 'an operation to reshape or shorten the labia'.

Forget that sales talk of designer vaginas. The area of the female body that we are speaking about is not the vagina. The vagina is inside the body. The labia are part of the vulva, which is the part of the female genitals that lies outside.

In the United States, there are a lot of surgeons who are making a lot of money through altering women's vulvas, mainly through labiaplasty.

This trend of women reshaping their labia has become very popular in the last few years. Some experts say that the reason is that since the beginning of the century, women have for the first time been able to see photos and other images of the vulvas of models and actresses. These pictures always look very neat.

So women tend to assume that if their labia does not look like that, then it means that they are abnormal. This is not the case at all! It is perfectly OK to have labia that are a little asymmetrical or foppy.

Please bear in mind the fact that your husband says you "look great". Men are rarely at all bothered by any slight asymmetry or floppiness in the vulva lips. My guess is that your man would probably say that you do not need this surgery!

For the surgery, the woman is given general anaesthetic. She is lying on the operating table with her legs raised. The surgeon then puts a tight surgical clamp across the lip that is to be shortened. Then he cuts away the section of the lip, often using a laser. Finally, he stitches up, and removes the clamp.

I know that sounds a bit brutal. But you must face the fact that this operation involves cutting away a chunk of your flesh. Not surprisingly, after the operation it will hurt. And there are possible complications such as bleeding and infection.

So what should you do? I suggest that you consult a gynaecologist here in Jamaica. He will be able to tell you whether you really need this operation, or if it's a waste of your money.

Q My wife is 33 and had a coil fitted a month ago. Now, whenever we have sex I get a nasty prickling jab on the end of my organ. What is going on, Doctor?

A The intra-uterine device (IUD or coil) in your wife's womb has a thread that hangs out. This thread is quite tough, and sometimes it can give men a nasty jab. However, some threads just give the men a gentle tickle, which a lot of men like.

In this case, I am almost certain that the end of the thread is simply too sharp, and is sticking into the end of your penis. Therefore, your wife should go back to the doctor who fitted the device, and ask her or him to trim the thread. That should cure the problem.

Q I had a hip replacement surgery months ago. Six weeks ago, I started to feel pain while walking. I was told that the implant had become loose, and that I would need another operation to cement it back in place. What can be done to prevent this from happening?

A Sorry to hear about this. Not all hip replacements are successful, although most are. Really, there are only two things which a patient can do in order to ensure the success of a hip operation. They are:

Keep your weight down to a healthy level.

Do the right types of exercises to the specifications of your surgeon or physical therapist.

Q I have just been told by a doctor that my prostate gland is "a little above average size". Will this affect my sex life?

A No. Most men's prostates get larger as they get older. But the main effect of this is on the urinary system, and not on the sexual apparatus. So men whose prostates are getting larger tend to experience the following:

• Dribbling of urine;
  
• A poor stream of urine;
  
• Difficulty in 'getting started';
  
• Having to keep rushing to pass water;
  
• Frequent urination during the night.

But the enlargement of the prostate gland does not usually affect their sex lives very much.

Q My husband is 33, and he says it is time we "had a more adventurous sex life". So he wants us to try rectal intercourse. What do you think, Doctor?

A I really do not recommend this. Some couples do it, and have no problem with it.

But the fact is that it does hurt for the women, especially on the first try. It often causes cuts and sometimes bruising. Also, there can be hygienic problems, especially if germs get transferred from the woman's bowel to her urinary passages or vagina.

Finally, rectal sex is a very good way of transmitting HIV. Admittedly, if your husband does not have the virus that is not relevant.

Q Since I had my second baby, my vagina has become very loose. My partner is complaining. Could I get an operation to tighten everything up?

A Yes. This is called a 'vaginal repair operation'. But before you choose surgery, I would suggest that you try a course of 'pelvic muscle exercises'. Any midwife, nurse or doctor can advise you how to do these. You need to do them several times a day for at least six months. They build up the muscles around the vagina, so that everything is much tighter, and so that sex is better. If you do these exercises, you may not need to take the operation.

Send questions/feedback to editor@gleanerjm.com and read more Doctor's Advice in the Saturday Gleaner.