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Expert Urology

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surgery

in hospital or surgery center
Elevate cystocele repair with mesh

This is performed for vaginal prolapse of the bladder and/or apex of the vagina. Under general anesthesia, the patient is placed in the lithotomy position (with legs in stirrups) and the entire surgery is performed vaginally, with no abdominal incisions. The vaginal tissue is separated from the bladder wall and permanent mesh is placed behind the bladder for support. It is attached to the sacrospinous ligament (a ligament in the pelvis) using mesh arms. The vaginal tissue is closed using a stitch that will dissolve. The procedure takes approximately 45 minutes to complete. You will be in the hospital overnight with a gauze vaginal packing and catheter draining the bladder. Both of those will be removed the morning after surgery and you will be asked to void prior to discharge. If you are unable to void then you may be discharged to home with a catheter draining to a bag that will be removed in one week. There is no prep for the procedure. For 6 weeks post op you will be asked to have no straining, no lifting over 20 pounds and no sex or tampons in the vagina. Most women feel back to normal after approximately 2 weeks.

Mini arc sub urethral sling

This is performed for the treatment of stress urinary incontinence or in conjunction with cystocele repair for prevention of that type of incontinence . Under general anesthesia, the patient is placed in the lithotomy position (with legs in stirrups). A small incision is made in the vagina under the urethra and a tunnel is created in which a small mesh hammock is then placed under the urethra. The vaginal tissue is closed with a stitch that will dissolve. It takes approximately 30minutes. When only this procedure is performed, without other surgeries, it is performed as an outpatient and you will be discharged to home with a catheter draining the bladder overnight. You will be instructed on how to remove the catheter and will do so the morning after the surgery. There is no prep for the procedure. For 6 weeks post op you will be asked to have no straining, no lifting over 20 pounds and no sex or tampons in the vagina. Most women feel back to normal after approximately 1 week.

Ureteroscopy

This is performed for the diagnosis and or treatment of ureteral disease including stones, strictures (scarring) or tumors. Under general anesthesia, the patient is placed in lithotomy position (legs in stirrups) . The bladder is entered through the urethra with a very thin scope that is placed into the ureter for direct visualization of the ureter. It may be accompanied by a laser removal of the stone if a stone is found or biopsy of a mass if that is found. It is usually followed by placement of a ureteral stent (see below). The procedure is can take anywhere from 30-90 minutes, depending upon the indication for which it is performed. It is an outpatient procedure and you will be discharged to home after the procedure. After effects may include some blood in the urine, increased urgency and frequency of urination.

Ureteral Stent Placement

This is performed for obstruction of the ureter either due to stone, stricture or tumor. May also be placed after ureteroscopy for prevention of kidney obstruction and ureteral scarring. Under general anesthesia a scope is inserted into the bladder through the urethra. A wire is placed into the kidney using xray guidance. The stent, a thin plastic tube, is then placed over the wire. The wire is removed and the stent remains in place, with coils at each end to prevent it from migrating up or down. It is performed as an outpatient and you will be discharged after the procedure. The stent is allowed to remain in place for a specified period of time, usually 7-10 days but it can remain in place for up to 3 months without the need to be changed. It is removed in the office using a cystoscope (a small lighted tube into the bladder) under local anesthesia. After effects may include blood in the urine, increased urgency and frequency of urination as well as some kidney and/or bladder pain.

Extracorporeal Shock Wave Lithotripsy (ESWL)

This is performed for stones in the kidney or ureter. It is performed under general anesthesia. The stone is located using X-ray guidance and a specific number of external shocks are given in order to crush the stone into tiny sand-like particles that are easier to pass. The fragments are usually passed within the first few days after the procedure. The procedure is performed as an outpatient and you will be sent home with a strainer to collect the fragments . Please bring the fragments to your follow up visit. After effects may include blood in the urine and kidney pain.

Trans urethral resection of the prostate (TURP)

This is performed for benign prostatic hyperplasia (BPH). Under general anesthesia, a lighted scope is passed into the bladder and the prostate is shaved internally in order to widen the urethra and make voiding easier. The prostate chips are sent for pathologic evaluation. You will be sent home with a catheter that will be removed in anywhere from one to 7 days. After effects may include blood in the urine, increased urgency and frequency of urination, burning with urination.

Trans urethral resection of bladder tumor (TURBT)

This is performed for bladder cancer or masses that are concerning for bladder cancer and need to be biopsied. Under general anesthesia, a lighted scope is passed into the bladder and the tumor is shaved off of the bladder wall. The tumor chips are sent for pathologic evaluation. You will be sent home with a catheter that will be removed in anywhere from one to 7 days. After effects may include blood in the urine, increased urgency and frequency of urination, burning with urination.

Cystolitholapaxy

This is performed for bladder stones. Under general anesthesia, a lighted scope is passed into the bladder through the urethra. Then, using laser or some other means, the stone is pulverized until the particles are small enough to be washed out of the bladder. You may be sent home with a catheter draining the bladder to a bag for a few days. After effects may include blood in the urine, increased urgency and frequency of urination, burning with urination.

Laparoscopic radical nephrectomy

This is performed for kidney cancer or masses suspected to be cancerous. Under general anesthesia several small incisions are made on the abdomen through which a camera and instruments are passed. Usually, one of the surgeon’s hands is passed through another larger but still small incision on the lower abdomen. The kidney is removed through this hand port. The procedure takes approximately 2hours and you will be in the hospital for 2 days or so. After effects include pain at the incision sites.

Robotic Laparoscopic radical prostatectomy

This is performed for prostate cancer. Under general anesthesia several small incisions are made on the abdomen through which a camera and instruments that are attached to the surgical robot are passed. The surgeon sits at a console away from the bedside and performs the surgery, guiding the robot in removing the prostate gland. The urethra is stitched back to the bladder and a catheter is left indwelling to a bag for several days to a week . You will be discharged to home after 1-2 days in the hospital. After effects may include pain, blood in the urine, burning with urination.

Implantation of Interstim sacral neuromodulation device

This is performed for either overactive bladder or urinary retention with the inability to void. You will be lying on your stomach and , using x-ray guidance , the surgeon finds the correct area where the nerves that control the bladder are found on the lower back area. One wire is placed into that area and tunneled under the skin. It is then attached to a battery pack that is implanted under the skin as well. Incisions are closed with stitches that will dissolve. This may also be done in a staged fashion with stage 1 being implantation of the wire that is left externalized for a trial period of approximately 2weeks followed by a 2nd stage that is either removal of the lead or implantation of the battery pack, dependent upon the outcome of the trial. After effects may include pain at the incision sites.

Our Services

Laser Vaginal Rejuvenation® for the Enhancement of Sexual Gratification

Laser Vaginal Rejuvenation® (LVR®) will effectively enhance vaginal muscle tone, strength, and control. It will also effectively decrease the internal and external vaginal diameters as well as build up and strengthen the perineal body (they are immediately outside the vagina and above the anus). Sexual gratification for the female according to Masters and Johnson is directly related to the amount of frictional forces generated. We can accomplish this with LVR.

Our mission is to empower women with knowledge, choice, and alternatives.We encourage patients to participate in their healthcare and surgical design. In one of our patient surveys, women were asked; do women want to be loose or relaxed or do women want to be tight? Women answered 100% -women want to be tight. LVR can accomplish what ever you desire.

We have learned a tremendous amount from listening to women we have treated. Women come to us because they want knowledge, choice, and alternatives. Women want their physician to listen to them and provide viable solutions. Women throughout this nation and the world have told us that Kegels do not work - but no one is listening. Women who have had children want a solution to rejuvenate the vagina and achieve the best sexual experience possible. For women with no children, solutions are available through design modification to accomplish their desires.

No one wants to age or lose optimal function anywhere, and this includes the vaginal and vulvar structures: LVR has the solution. We have found that the vaginal and vulvar issues women are self-conscious about can be solved with LVR.

Patients with involuntary loss of urine with coughing, sneezing, laughing, exercising, or sex can have their stress urinary incontinence corrected along with enhancement of sexual gratification.

Vaginal Relaxation is the Loss of the Optimum Structural Architecture of the Vagina

In vaginal relaxation, the muscles are relaxed and have poor tone, strength, and control. The internal and external diameters increase. The muscles of the perineum are weak and poorly supported. Under these circumstances, the vagina is no longer at its optimum physiological state. As a result, the sensual side of sexual gratification is diminished. LVR was designed to enhance sexual gratification for women who for whatever reason lack an overall optimum architectural integrity of the vagina.

Designer Laser Vaginoplasty®

Designer Laser Vaginoplasty® (DLV®) is the aesthetic surgical enhancement of the vulvar structures (labia minora, labia majora, mons pubis, perineum, introitus, hymen).

Laser Reduction Labioplasty can sculpture the elongated or unequal labial minora (small inner lips) according to ones specification. Most women tell us that they do not want the small inner lips to project beyond the large outer lips. Many women bring us Playboy and say that they want to look like this.With laser reduction labioplasty, we can accomplish the desires of the woman. Our labioplasty techniques can also reconstruct conditions that are due to the aging process, childbirth trauma, or injury. Although our experience and techniques provide us the ability to design most anything that one can desire, our most common DLV procedures are as follows:

Laser Perineoplasty can rejuvenate the relaxed or aging perineum. It can also enhance the sagging labia majora (large outer lips) and labia minora.Overall, the procedure can provide a youthful and aesthetically appealing vulva.

Augmentation Labioplasty can provide aesthetically enhanced and youthful labia majora by autologous fat transplant (removal of the patients fat via liposculpturing and transplanting it into the labia majora).

Vulvar Lipoplasty can remove unwanted fat of the mons pubis and upper parts of the labia majora. Liposculpturing can alleviate the unsightly fatty bulges of this area and produce an aesthetically pleasing contour.

Hymenoplasty (reconstruction of the hymen) can repair the hymen as if nothing ever occurred. The Laser Vaginal Rejuvenation Institute is sensitive to the needs of women from all cultures that embrace these particular issues because of cultural, social, or religious reasons.

Combination of DLV with LVR LVR and DLV (can be performed in combination by Dr. Gabal. They can also be scheduled at the same time with most other cosmetic surgical procedures performed by a plastic surgeon.

ADDITIONAL SERVICES OFFERED BY NEW WOMAN MD

G. Spot Amplification™ ( G. Shot™) is a revolutionary scientific breakthrough that enhances and enlarges the G-spot. This is a safe drug free, fast, painless, and effective procedure, which takes less than 5 minutes in the doctor's office. After the G. Spot Amplification™, Women have claimed to experience a peak in their sex drive and have noticed a heightened state of arousal. They also had enhanced sexual gratification and more intense feeling of sexual pleasure.

Designer Laser Vaginoplasty® (DLV)

Designer Laser Vaginoplasty® (DLV®) is the aesthetic surgical enhancement of the vulvar structures (labia minora, labia majora, mons pubis, perineum, introitus, hymen).

Laser Reduction Labiaplastycan sculpture the elongated or unequal labial minora (small inner lips) according to ones specification. Most women tell us that they do not want the small inner lips to project beyond the large outer lips. Many women bring us Playboy and say that they want to look like this. With laser reduction Labiaplasty, we can accomplish the desires of the woman. Our Labiaplasty techniques can also reconstruct conditions that are due to the aging process, childbirth trauma, or injury. Although our experience and techniques provide us the ability to design most anything that one can desire, our most common DLV procedures are as follows:

Laser Perineoplasty can rejuvenate the relaxed or aging perineum. It can also enhance the sagging labia majora (large outer lips) and labia minora.

No one wants to age or lose optimal function anywhere, and this includes the vaginal and vulvar structures: LVR has the solution. We have found that the vaginal and vulvar issues women are self-conscious about can be solved with LVR.

Overall, the procedure can provide a youthful and aesthetically appealing vulva.

Augmentation Labiaplasty can provide aesthetically enhanced and youthful labia majora by autologous fat transplant (removal of the patients fat via liposculpturing and transplanting it into the labia majora).

Vulvar Lipoplasty can remove unwanted fat of the mons pubis and upper parts of the labia majora. Liposculpturing can alleviate the unsightly fatty bulges of this area and produce an aesthetically pleasing contour.

Hymenoplasty (reconstruction of the hymen) can repair the hymen as if nothing ever occurred. The Laser Vaginal Rejuvenation Institute is sensitive to the needs of women from all cultures that embrace these particular issues because of cultural, social, or religious reasons.

Our Designer Laser Vaginoplasty® procedures are highly customized to each patients individual needs and expectations. Laser Reduction Labiaplasty of the labia minora.

Photo of Laser Reduction Labiaplasty before and after

Aesthetic Reconstruction and Enhancement of the Vulvar structures damaged by childbirth, trauma, aging, and certain other causes.

Laser Perineoplasty for the aesthetic rejuvenation of the aging vulvar structures and entrance to the vagina.

Laser Hymenoplasty for restoration of the hymen.

Aesthetic Augmentation Labiaplasty of the (underdeveloped, or aging) labia majora using your own fat for transplantation.

Liposculpturing for the aesthetic reduction of the prominent or protruding mons pubis (fatty pubic mound) and labia majora (large outer lips of labia).

Laser Vaginal Rejuvenation (LVR®)

Laser Vaginal Rejuvenation® for the Enhancement of Sexual Gratification

Laser Vaginal Rejuvenation® (LVR®) will effectively enhance vaginal muscle tone, strength, and control. It will also effectively decrease the internal and external vaginal diameters as well as build up and strengthen the perineal body (they are immediately outside the vagina and above the anus). Sexual gratification for the female according to Masters and Johnson is directly related to the amount of frictional forces generated. We can accomplish this with LVR.

Our mission is to empower women with knowledge, choice, and alternatives. We encourage patients to participate in their healthcare and surgical design. In one of our patient surveys, women were asked; do women want to be loose or relaxed or do women want to be tight? Women answered 100% -women want to be tight. LVR can accomplish what ever you desire.

We have learned a tremendous amount from listening to women we have treated. Women come to us because they want knowledge, choice, and alternatives. Women want their physician to listen to them and provide viable solutions. Women throughout this nation and the world have told us that Kegels do not work - but no one is listening. Women who have had children want a solution to rejuvenate the vagina and achieve the best sexual experience possible. For women with no children, solutions are available through design modification to accomplish their desires.

No one wants to age or lose optimal function anywhere, and this includes the vaginal and vulvar structures: LVR has the solution. We have found that the vaginal and vulvar issues women are self-conscious about can be solved with LVR.

Patients with involuntary loss of urine with coughing, sneezing, laughing, exercising, or sex can have their stress urinary incontinence corrected along with enhancement of sexual gratification.

Vaginal Relaxation is the Loss of the Optimum Structural Architecture of the Vagina

In vaginal relaxation, the muscles are relaxed and have poor tone, strength, and control. The internal and external diameters increase. The muscles of the perineum are weak and poorly supported. Under these circumstances, the vagina is no longer at its optimum physiological state. As a result, the sensual side of sexual gratification is diminished. LVR was designed to enhance sexual gratification for women who for whatever reason lack an overall optimum architectural integrity of the vagina.

The following conditions are treated effectively using the Laser Vaginal Rejuvenation® procedure:

  • Elevate cystocele repair with mesh
  • Transurethral resection of prostate

Photo of Laser Reduction Labiaplasty before and after

Combination of LVR® & DLV®

Combination of DLV® with LVR®

LVR® and DLV® can be performed in combination. They can also be performed with most cosmetic surgical procedures; the most popular of these are Liposculpturing, breast implants, breast reduction, tummy tuck, nose surgery, and eyelid surgery.

  • Sometimes it is appropriate to combine procedures to achieve the best outcomes for our patients.
  • Laser Vaginal Rejuvenation® can be performed in combination with any of the Designer Laser Vaginoplasty® procedures.
  • Procedures in the Designer Laser Vaginoplasty® category can be combined to resolve multiple concerns.

COMBINATION OF LASER VAGINAL REJUVENATION® AND/OR DESIGNER LASER VAGINOPLASTY® WITH OTHER COSMETIC SURGICAL PROCEDURES

Laser Vaginal Rejuvenation® and/or Designer Laser Vaginoplasty® can also be combined with other plastic surgery procedures performed by a plastic surgeon.

G.SPOT AMPLIFICATIONtm (G.SHOT TM )

G.Spot Amplification TM (G.ShotTM) is a revolutionary scientific breakthrough that enhances and enlarges the G-spot. This is a safe drug free, fast painless, and effective procedure which takes less than 5 minutes in the doctor's office. After the G.spot AmplificationTM, Women have claimed to experience a peak in their sex drive and have noticed a heightened state of arousal. They also had enhanced sexual gratification and more intense feeling of sexual pleasure.

Office Hours
Monday - Friday 8:30am - 5:30pm
Contact Info
720 N. Tustin Ave, Suite 104
Santa Ana, CA 92705
Phone: 949-825-7650