Dr chris chong will be on radio on these fews dates :-
1) 12th December 2008 at 10.30am ( Friday)
2) 17th December 2008 at 10.30am ( Wednesday)
3) 31st December 2008 at 10.30am (Wednesday)
All on 97.2 fm . Remember to tune in .
Sunday, November 23, 2008
Thursday, November 13, 2008
Women's Sexual + Wellness Forum
22 November 2008, Saturday
Park Hotel (Next to Paragon) Empress Ballroom,
Level 3,270 Orchard Road
Event Host
Daniel Martin,
Presenter of
Body and Soul,
938 Live
Program :
1.00pm : Registration
1.45pm : Welcome speech by Chairperson (Dr Chris Chong)
2.00pm : Let's Talk About Pressure & Pleasure of Sex. Why Don't i Enjoy Sex. ( Dr Chris Chong)
2.30pm : Fibroid & Ovarian Cyst - Their Management & Effect on Fertility. ( Dr Seng Shay Way)
3.00pm : Q & A Session 1
3.25pm : Light Refreshments
3.55pm : Prolapse & Urine Leakage in Every Stg of Womenhood. How it may effect you (Dr chris chong)
4.25pm : Can We Prevent Prolapse & Urine Leakage? (Ms Chooi Sue Ling)
4.55pm : Q & A Session 2
5.20pm : End
To Sign up:
SMS : Send EventsSEXFull Name
No. Of Persons to 81278006 (e.g Events Janice Tan 2)
Phone : 6854 6692 (Mon - Fri : 0830am - 1800pm)
Fax : 68546667
Email : events@parkway.sg
You can also refer to http://www.parkwayhealth.com/
for more information.
For more information or access to our 24-Hour medical
and specialist services, please call out Patient Assistance Centre
Helpline: 67355000, email: ipac@parkway.sg or visit our website http://www.ipac.sg/
Park Hotel (Next to Paragon) Empress Ballroom,
Level 3,270 Orchard Road
Event Host
Daniel Martin,
Presenter of
Body and Soul,
938 Live
Program :
1.00pm : Registration
1.45pm : Welcome speech by Chairperson (Dr Chris Chong)
2.00pm : Let's Talk About Pressure & Pleasure of Sex. Why Don't i Enjoy Sex. ( Dr Chris Chong)
2.30pm : Fibroid & Ovarian Cyst - Their Management & Effect on Fertility. ( Dr Seng Shay Way)
3.00pm : Q & A Session 1
3.25pm : Light Refreshments
3.55pm : Prolapse & Urine Leakage in Every Stg of Womenhood. How it may effect you (Dr chris chong)
4.25pm : Can We Prevent Prolapse & Urine Leakage? (Ms Chooi Sue Ling)
4.55pm : Q & A Session 2
5.20pm : End
To Sign up:
SMS : Send Events
No. Of Persons to 81278006 (e.g Events Janice Tan 2)
Phone : 6854 6692 (Mon - Fri : 0830am - 1800pm)
Fax : 68546667
Email : events@parkway.sg
You can also refer to http://www.parkwayhealth.com/
for more information.
For more information or access to our 24-Hour medical
and specialist services, please call out Patient Assistance Centre
Helpline: 67355000, email: ipac@parkway.sg or visit our website http://www.ipac.sg/
I was a surgeon's nightmare (True Life Story)
Dr Christopher Chong, a consultant uro-gynaecologist at Gleneagles Medical Centre, said the condition is caused by weakness in the muscles and ligaments of the pelvic floor, leading to loss of uterine support.
Pregnancy, childbirth, obesity, and chronic coughing and lifting of heavy objects are some of the factors that predispose a woman to developing the condition,' he said. 'It worsens if not treated.'
For Madam Chin, the problem began in early 2004.
Her regular gynaecologist told her that she was all right, that it was 'just a part of ageing, and that I have to live with it'.'But who could live with the inconvenience of constantly searching for toilets and not being able to control my urine every time I coughed or sneezed?' said Madam Chin.
Her gynaecologist was reluctant to remove her womb because Madam Chin has a history of thrombosis - the formation of clots within the blood vessel.
But Madam Chin, who also suffers from allergic rhinitis, a condition in which the nasal passages are inflamed, often sneezes violently in the morning. That aggravated the incontinence.
A second gynaecologist she consulted, who was willing to take on her case, ordered some blood tests, including cancer markers, before deciding to operate.
Unfortunately, the results came back showing yet another problem - cancer in her left kidney.
Madam Chin had to postpone the correction of her prolapsed uterus for the time being so the cancer in her kidney could be addressed.
My left kidney was removed in November 2004. The cancer was in its early stages so I did not have to go through chemotherapy or radiotherapy after the surgery,' she said.
But the prolapse and incontinence still needed attention and Madam Chin went through another year without solving those problems.
In December 2005, she attended a public forum in Kuching on the treatment of incontinence by Dr Chong.
By then, I was at my wit's end, so I decided to go for the talk. I cornered Dr Chong and told him about my problem,' she said.
He assured her that she could be treated, and Madam Chin and her husband came to his clinic in Singapore three months later.
I presented him with a two-page written medical history and asked a whole lot of questions,' said Madam Chin. 'Dr Chong got a colleague, an anaesthetist, to sit in.
He said the thrombosis was not a problem and that he would carefully monitor it during the surgery. With all my problems, I was considered a surgeon's nightmare but seeing how confident the two young doctors were, I thought it was safe enough to proceed with the surgery,' she said.
She had her operation in April 2006.
Dr Chong removed my uterus, including the ovaries, corrected the incontinence and fixed my prolapsed bowel in a two-hour long surgery,' she said.
She could walk a few hours after surgery and was warded for only three nights.
The surgery put an end to her discomfort. And the relief showed on her face.
When I got back to Kuching and my friends saw me, they said I looked like I had just returned from a holiday abroad,' she said, laughing.
Wednesday, November 5, 2008
RELATIONSHIP BETWEEN INCONTINENCE AND ORGASM
Orgasm is a beautiful end or climax of sexual intercourse and most people are not satiated till this is achieved. not many studies have been done on this subject as this is a very intimate and private affair, and it is difficult to get subjects for the studies. over the years, the physiology of orgasm has changed from it coming from the clitoris alone to that involving many factors, including the uterus, bladder, urethra ( the opening of the bladder ) and contractions of the pubococcygeus muscle ( the muscle surrounding the vagina and supporting the pelvic floor, going into spasm during an orgasm ).
Orgasm can include many full-body experiences such as tingling in the fingers and toes, spasm of arms, legs, face and lower abdomen, emotional outburst and feelings of relief and ecstasy. incontinence is any leakage of urine. the 2 most common reasons are stress incontinence and urge incontinence. stress incontinence is leakage of urine from exertion such as coughing, sneezing, jumping and laughing. this is due to a weakness of the support of the door of the bladder, such that it does not close tight on exertion, leading to leakage. urge incontinence is due to the bladder wall muscles contracting, involuntarily, squeezing urine out before one can reach the toilet.
Orgasm is pleasurable but when associated with urinary incontinence, many may be frightened or turned off by sexual intercourse. urinary incontinence during sexual intercourse is a poorly understood and infrequently volunteered problem. this is different from female ejaculations which can occur at orgasm. urinary incontinence may be from mechanical reasons such as the penis striking on a prolapsed ( dropped ) bladder, pushing urine out of a weakly supported urethra, or bladder contractions / spasm occurring at the same time as orgasm, or both of these reasons. some women lose muscle control throughout their bodies during an orgasm, including the muscle keeping the urethra closed, causing incontinence. a study done some years back in the united kingdom on 324 women found that 79 ( 24% ) experienced urinary incontinence during intercourse, two-thirds of whom had incontinence on penetration ( 70% of them had stress incontinence ) and one-third from orgasm ( 42% had stress incontinence and 35% had urge incontinence from and overactive bladder ).
There is another school of thought that sine contractions occur during orgasm, these contractions caused the bladder to contract as well ( overactive bladder ), leading to incontinence. a person with urinary incontinence should seek medical advice from her gynae, urogynae or her doctor, otherwise the condition may worsen, reducing the success rate from treatment, and affecting their sex life and relationship with her partner. certainly the reason should be sought after as there may be many factors involved. for incontinence occurring just once or twice, when it had never happened before, the reason could be simply a urinary tract infection, which can usually be easily cured with antibiotics.
Other than a physical examination, i will offer my patients a urodynamic study ( computerised assessment of the bladder ). this will help us with the diagnosis of stress and urge incontinence. in simple terms, stress incontinence is treated with pelvic floor ( kegel's ) exercise ( mild cases ) or surgery ( moderate or severe cases ), and urge incontinence is treated with medication and not surgery. hence, making the correct diagnosis is of utmost importance as the treatment is totally different.
Kegel's exercise is useful in not only helping people with stress incontinence, it also helps in strengthening the pubococcygeus muscles. if the pubococcygeus muscle is weak, it may be difficult to go into spasm ( orgasm ) when there is an object in the vagina. it has been also found by another study that females with stronger pubococcygeus muscle ejaculate ( just like the males ) better ( not urinary incontinence ) and have stronger orgasm.
Certain simple measures may be useful. one can pass urine before intercourse as an empty bladder will not leak. medication called minirin can be taken a couple of hours before intercourse to reduce urine formation. for people with overactive bladder, medication such as detrusitol can reduce contractions of the bladder.
A person should be properly assessed before starting medication.urinary incontinence may be more common than we think. help is certainly at hand and can be easily assessed and treated in most cases. sufferers must not suffer in silence otherwise sex life and relationship may be affected.
Orgasm can include many full-body experiences such as tingling in the fingers and toes, spasm of arms, legs, face and lower abdomen, emotional outburst and feelings of relief and ecstasy. incontinence is any leakage of urine. the 2 most common reasons are stress incontinence and urge incontinence. stress incontinence is leakage of urine from exertion such as coughing, sneezing, jumping and laughing. this is due to a weakness of the support of the door of the bladder, such that it does not close tight on exertion, leading to leakage. urge incontinence is due to the bladder wall muscles contracting, involuntarily, squeezing urine out before one can reach the toilet.
Orgasm is pleasurable but when associated with urinary incontinence, many may be frightened or turned off by sexual intercourse. urinary incontinence during sexual intercourse is a poorly understood and infrequently volunteered problem. this is different from female ejaculations which can occur at orgasm. urinary incontinence may be from mechanical reasons such as the penis striking on a prolapsed ( dropped ) bladder, pushing urine out of a weakly supported urethra, or bladder contractions / spasm occurring at the same time as orgasm, or both of these reasons. some women lose muscle control throughout their bodies during an orgasm, including the muscle keeping the urethra closed, causing incontinence. a study done some years back in the united kingdom on 324 women found that 79 ( 24% ) experienced urinary incontinence during intercourse, two-thirds of whom had incontinence on penetration ( 70% of them had stress incontinence ) and one-third from orgasm ( 42% had stress incontinence and 35% had urge incontinence from and overactive bladder ).
There is another school of thought that sine contractions occur during orgasm, these contractions caused the bladder to contract as well ( overactive bladder ), leading to incontinence. a person with urinary incontinence should seek medical advice from her gynae, urogynae or her doctor, otherwise the condition may worsen, reducing the success rate from treatment, and affecting their sex life and relationship with her partner. certainly the reason should be sought after as there may be many factors involved. for incontinence occurring just once or twice, when it had never happened before, the reason could be simply a urinary tract infection, which can usually be easily cured with antibiotics.
Other than a physical examination, i will offer my patients a urodynamic study ( computerised assessment of the bladder ). this will help us with the diagnosis of stress and urge incontinence. in simple terms, stress incontinence is treated with pelvic floor ( kegel's ) exercise ( mild cases ) or surgery ( moderate or severe cases ), and urge incontinence is treated with medication and not surgery. hence, making the correct diagnosis is of utmost importance as the treatment is totally different.
Kegel's exercise is useful in not only helping people with stress incontinence, it also helps in strengthening the pubococcygeus muscles. if the pubococcygeus muscle is weak, it may be difficult to go into spasm ( orgasm ) when there is an object in the vagina. it has been also found by another study that females with stronger pubococcygeus muscle ejaculate ( just like the males ) better ( not urinary incontinence ) and have stronger orgasm.
Certain simple measures may be useful. one can pass urine before intercourse as an empty bladder will not leak. medication called minirin can be taken a couple of hours before intercourse to reduce urine formation. for people with overactive bladder, medication such as detrusitol can reduce contractions of the bladder.
A person should be properly assessed before starting medication.urinary incontinence may be more common than we think. help is certainly at hand and can be easily assessed and treated in most cases. sufferers must not suffer in silence otherwise sex life and relationship may be affected.
UTERINE FIBROIDS
Fibroids are common in women and occur in 20% of females. they are fibrous growth occurring almost always in the uterus ( womb ) of females. there is no known cause for fibroids. most people pass through life without knowing they have fibroids and without any complications from the fibroids
Majority of the people having fibroids do not have symptoms. they are discovered on routine health checks and on ultrasound of the pelvis. majority of them do not need surgery or treatment. the size of fibroids can remain the same, enlarge but rarely strink unless in the menopause
Signs and symptoms of fibroids include : ( the 5 ' p 's )
1. period problems - heavy menses, sometimes with blood clots. the patient can feel giddy, tired and breathless due to anaemia ( low blood count )
2. palpable lump - on examination, the womb can be felt to be enlarged. usually the womb is small and behind the pelvic bone and cannot be felt from the abdomen. once this can be felt, it is considered large, and large enough to consider even surgery
3. pressure symptoms - they can press on the bladder, causing one to want to pass urine frequently, if the compression is severe, the patient may have difficulty in passing urine and even inability to pass urine. they can compress on the rectum giving the sensation of wanting to pass motion often.
4. pain - fibroids can cause severe pain if they are twisted ( those occurring on the surface of the womb ) or if they enlarge too fast over a short period.
5. pregnancy related - if the fibroids blocks the fallopian tubes or occupy the area of implantation of the pregnancy, or if they occupy a large area of the womb, causing fertility problems, then surgery may have to be considered.
the fuel or cause of growth of the fibroids is the hormone, Oestrogen from the ovaries. this hormone will only disappear after the menopause. this goes to say that when a patient is still having monthly periods, there is a higher chance for the fibroids to grow, and when she goes into menopause, there is usually strinkage of the fibroids by at least 50%. if the patient does not have the above signs and symptoms, the fibroids just need monitoring by regular ultrasound and examination. this is especially so if the patient is near the menopause age ( average 51 - 53 years of age ).
fibroids being cancerous is in the region of 0.03%. these are usually more than 6cm in size.
unfortunately, there is no medication to treat fibroids. there is an injection that can strink fibroids up to 50% in size over 3 - 6 months. this injection cannot be given for more than 6 months as it can cause side effects, especially brittle bones leading to fractures. once the injection is stopped, the fibroids will grow again.
When surgery is considered, the question is whether to remove the fibroids ( myomectomy ) or to remove the whole womb ( hysterectomy ). if fertility is desired or for whatever reason that the patient wishes to retain the womb, then myomectomy is done. the risk of fibroids occurring again is about 15%, and this can be from the same site or from new areas. myomectomy can be done by the open abdomen method or by key-hole surgery. key-hole surgery cannot be done for very big fibroids and may not be able to remove small fibroids embedded deep into the womb. if the surgeon is skilled and in selected cases, myomectomy can be done through the vagina. fibroids in the lining of the womb can be removed by hysteroscopic resection ( through a scope through the vagina and the cervix , opening of the womb ).
Hysterectomy can be done by the open method, by keyhole surgery and through the vagina. the advantage of vaginal surgery, if it can be done, is that there are no abdominal scars, recovery is very fast, hospital stay is short ( 1 day in some cases ) and pain is very much less than the other methods.
Complications of surgery include anaesthetic risks, bleeding, infection and injury to surrounding structures such as bowel or the urinary system. newer methods include embolisation of the arteries ( blood vessel ) supplying the womb, and MRI guided destruction of the fibroids. these
Newer methods may not be used for people desiring fertility. for large fibroids, the procedures can take many hours and the patient may complain of pain after the procedure. also, for larger fibroids, as we do not have the histology ( microscopic examination of the specimen ), we may miss the unlikely case of cancer. for smaller fibroids, treatment may not be needed. as of now, the newer methods are for selected cases, that is, not everyone is suitable and we await eagerly for more data and results on our patients.
My advice to my patients is always, " see a doctor when you are well, and not when you are unwell ". do not wait for signs and symptoms from fibroids before seeking treatment. best wishes for good health!
Majority of the people having fibroids do not have symptoms. they are discovered on routine health checks and on ultrasound of the pelvis. majority of them do not need surgery or treatment. the size of fibroids can remain the same, enlarge but rarely strink unless in the menopause
Signs and symptoms of fibroids include : ( the 5 ' p 's )
1. period problems - heavy menses, sometimes with blood clots. the patient can feel giddy, tired and breathless due to anaemia ( low blood count )
2. palpable lump - on examination, the womb can be felt to be enlarged. usually the womb is small and behind the pelvic bone and cannot be felt from the abdomen. once this can be felt, it is considered large, and large enough to consider even surgery
3. pressure symptoms - they can press on the bladder, causing one to want to pass urine frequently, if the compression is severe, the patient may have difficulty in passing urine and even inability to pass urine. they can compress on the rectum giving the sensation of wanting to pass motion often.
4. pain - fibroids can cause severe pain if they are twisted ( those occurring on the surface of the womb ) or if they enlarge too fast over a short period.
5. pregnancy related - if the fibroids blocks the fallopian tubes or occupy the area of implantation of the pregnancy, or if they occupy a large area of the womb, causing fertility problems, then surgery may have to be considered.
the fuel or cause of growth of the fibroids is the hormone, Oestrogen from the ovaries. this hormone will only disappear after the menopause. this goes to say that when a patient is still having monthly periods, there is a higher chance for the fibroids to grow, and when she goes into menopause, there is usually strinkage of the fibroids by at least 50%. if the patient does not have the above signs and symptoms, the fibroids just need monitoring by regular ultrasound and examination. this is especially so if the patient is near the menopause age ( average 51 - 53 years of age ).
fibroids being cancerous is in the region of 0.03%. these are usually more than 6cm in size.
unfortunately, there is no medication to treat fibroids. there is an injection that can strink fibroids up to 50% in size over 3 - 6 months. this injection cannot be given for more than 6 months as it can cause side effects, especially brittle bones leading to fractures. once the injection is stopped, the fibroids will grow again.
When surgery is considered, the question is whether to remove the fibroids ( myomectomy ) or to remove the whole womb ( hysterectomy ). if fertility is desired or for whatever reason that the patient wishes to retain the womb, then myomectomy is done. the risk of fibroids occurring again is about 15%, and this can be from the same site or from new areas. myomectomy can be done by the open abdomen method or by key-hole surgery. key-hole surgery cannot be done for very big fibroids and may not be able to remove small fibroids embedded deep into the womb. if the surgeon is skilled and in selected cases, myomectomy can be done through the vagina. fibroids in the lining of the womb can be removed by hysteroscopic resection ( through a scope through the vagina and the cervix , opening of the womb ).
Hysterectomy can be done by the open method, by keyhole surgery and through the vagina. the advantage of vaginal surgery, if it can be done, is that there are no abdominal scars, recovery is very fast, hospital stay is short ( 1 day in some cases ) and pain is very much less than the other methods.
Complications of surgery include anaesthetic risks, bleeding, infection and injury to surrounding structures such as bowel or the urinary system. newer methods include embolisation of the arteries ( blood vessel ) supplying the womb, and MRI guided destruction of the fibroids. these
Newer methods may not be used for people desiring fertility. for large fibroids, the procedures can take many hours and the patient may complain of pain after the procedure. also, for larger fibroids, as we do not have the histology ( microscopic examination of the specimen ), we may miss the unlikely case of cancer. for smaller fibroids, treatment may not be needed. as of now, the newer methods are for selected cases, that is, not everyone is suitable and we await eagerly for more data and results on our patients.
My advice to my patients is always, " see a doctor when you are well, and not when you are unwell ". do not wait for signs and symptoms from fibroids before seeking treatment. best wishes for good health!
FEEL FREE TO LAUGH AGAIN - STOP THE LEAK IN 10 MINUTES ( THE LATEST SURGERY )
Stress Urinary Incontinence ( SUI ) is the uncontrollable leakage of urine on exertion, such as running, jumping, sneezing, laughing and coughing. Associated causes include child-birth, menopause, obesity, chronic lifting of heavy loads, chronic cough and constipation.
A national survey on 3500 females in Singapore by Dr Christopher Chong revealed that 13.5% sufferred from SUI and a shocking 35.6%in the above 50 age group; that is more than 1 out of 3 females above 50 years old suffer from SUI. This equates to about 190 000 females in Singapore. It is estimated that less than 30 000 have seeked treatment for this problem. Also from the survey, the reasons for this low treatment level were that majority of the females were too embarassed to talk about it ( even with close friends or relatives ), did not know that it is a problem, did not know that it can be treated, and did not know where to seek treatment. Many, sadly, accepted it as part of growing old.
The Tension-free Vaginal Tape ( TVT ) is now the accepted surgery of choice in the treatment of SUI. The latest technique using the same tape is called TVT_O ( TVT-Obturator ) and has been used in Singapore for more than a year. It uses a polypropylene mesh tape placed around the middle part of the baldder neck ( " door " or outlet pipe of the bladder ) without any tension or stitches. The exit point is not through the abdomen but through the inner thigh. When a person strains, the bladder neck pushes onto the tape and closes, thus preventing leakage of urine. This tape is left permanently in the body.
The new technique has advantages over the older ones in that there is less risk of bleeding and injury to the bladder, and cystoscopy ( putting a TV system into the bladder ) to check for bladder damage and perforation need not be routinely done. This surgery can be done as a day procedure and the patient can be up and about the same day.
Complications, though minimal, include voiding problem ( less than 1% ), erosion of the mesh through the vagina, infection, bleeding, bladder injury and thigh pain.
In my personal series of the first 100 cases, the short-term success rate is 94%.
People with SUI should seek treatment early. A Screening ( to check if one is prone to or has SUI ) and Prevention Clinic for SUI is available so as to tackle the problem early in order to prevent progression to surgery. This is important as the more severe the condition, the lower the suceess rate from surgery.
There are many surgeries for SUI, ranging from 30 - 40% success rate for some old surgeries, to over 90% for some newer ones. Hence, it is very important to select the correct and best surgery for SUI. This is especially so as the success rate for SUI surgery fall with each subsequent surgery.
It is mandatory to perform a computer test of the baldder, called URODYNAMICS STUDIES, before any incontinence surgery in order to select the best and correct surgery for the patient. Life expectancy has gone up to 81 - 83 and people now have many more good years to live.
Ladies, do not suffer in silence for a lot can be done to improve or cure the problem of urinary leakage. On top of the" 5Cs " that people strive towards, we should add one more " C " . . . . . CONTINENCE.
A national survey on 3500 females in Singapore by Dr Christopher Chong revealed that 13.5% sufferred from SUI and a shocking 35.6%in the above 50 age group; that is more than 1 out of 3 females above 50 years old suffer from SUI. This equates to about 190 000 females in Singapore. It is estimated that less than 30 000 have seeked treatment for this problem. Also from the survey, the reasons for this low treatment level were that majority of the females were too embarassed to talk about it ( even with close friends or relatives ), did not know that it is a problem, did not know that it can be treated, and did not know where to seek treatment. Many, sadly, accepted it as part of growing old.
The Tension-free Vaginal Tape ( TVT ) is now the accepted surgery of choice in the treatment of SUI. The latest technique using the same tape is called TVT_O ( TVT-Obturator ) and has been used in Singapore for more than a year. It uses a polypropylene mesh tape placed around the middle part of the baldder neck ( " door " or outlet pipe of the bladder ) without any tension or stitches. The exit point is not through the abdomen but through the inner thigh. When a person strains, the bladder neck pushes onto the tape and closes, thus preventing leakage of urine. This tape is left permanently in the body.
The new technique has advantages over the older ones in that there is less risk of bleeding and injury to the bladder, and cystoscopy ( putting a TV system into the bladder ) to check for bladder damage and perforation need not be routinely done. This surgery can be done as a day procedure and the patient can be up and about the same day.
Complications, though minimal, include voiding problem ( less than 1% ), erosion of the mesh through the vagina, infection, bleeding, bladder injury and thigh pain.
In my personal series of the first 100 cases, the short-term success rate is 94%.
People with SUI should seek treatment early. A Screening ( to check if one is prone to or has SUI ) and Prevention Clinic for SUI is available so as to tackle the problem early in order to prevent progression to surgery. This is important as the more severe the condition, the lower the suceess rate from surgery.
There are many surgeries for SUI, ranging from 30 - 40% success rate for some old surgeries, to over 90% for some newer ones. Hence, it is very important to select the correct and best surgery for SUI. This is especially so as the success rate for SUI surgery fall with each subsequent surgery.
It is mandatory to perform a computer test of the baldder, called URODYNAMICS STUDIES, before any incontinence surgery in order to select the best and correct surgery for the patient. Life expectancy has gone up to 81 - 83 and people now have many more good years to live.
Ladies, do not suffer in silence for a lot can be done to improve or cure the problem of urinary leakage. On top of the" 5Cs " that people strive towards, we should add one more " C " . . . . . CONTINENCE.
A Story to Share
I always love telling this true story : When i was working and subspecialising in Urogynaecology in Australia, a patient turned up at my clinic 3 weeks after surgery by my colleague. She had a tape inserted through the vagina for treatment of her urine leakage.She complained that the tape had eroded through the vagina as her husband felt the pain while having sex with her the night before. On examination, she was found to be absolutely right. I snipped of the tape and gave her vaginal hormones to thicken the vaginal skin over the cut surface and her husband was happy ever after.
Now, the story i want to tell is that she was 76 and her husband was 80 years of age. In the public hospital where i practised, we usually review our patients 6 weeks after surgery to give them the go-ahead to resume normal activities. This elderly couple could not wait and were having at 3 weeks after the operation! It is really so nice to see an elderly couple still so intimate and so in love. Isn't this a beautiful story?
To reiterate, it is not uncommon for people not being bale to enjoy sex. Fortunately, there are many ways to help them, including the use of sexual tools / toys. Couples should make it a point to set aside themselves even though they have a busy work schedule. It is useful to have the correct environment and ambiance. Those with kids may want to consider going off for a " dirty weekend " once in a while. Foreplay is of utmost importance and one should not jump straight into coitus. Change of position, medication and a positive and correct outlook towards sex will help in achieving sexual satisfaction.
Life is short and unpredictable - the journey will be wonderful if we can have a great emotional and sexual relationship with someone we love . .. . . . . . . . . .
Now, the story i want to tell is that she was 76 and her husband was 80 years of age. In the public hospital where i practised, we usually review our patients 6 weeks after surgery to give them the go-ahead to resume normal activities. This elderly couple could not wait and were having at 3 weeks after the operation! It is really so nice to see an elderly couple still so intimate and so in love. Isn't this a beautiful story?
To reiterate, it is not uncommon for people not being bale to enjoy sex. Fortunately, there are many ways to help them, including the use of sexual tools / toys. Couples should make it a point to set aside themselves even though they have a busy work schedule. It is useful to have the correct environment and ambiance. Those with kids may want to consider going off for a " dirty weekend " once in a while. Foreplay is of utmost importance and one should not jump straight into coitus. Change of position, medication and a positive and correct outlook towards sex will help in achieving sexual satisfaction.
Life is short and unpredictable - the journey will be wonderful if we can have a great emotional and sexual relationship with someone we love . .. . . . . . . . . .
From last title
FEAR
Fear of intercourse, especially the first time round, may affect one's outlook towards one's future sex life. If the first penetration proves to be extremely painful and traumatic, phobia of intercourse may result. Fear can also be of pregnancy, infection and guilt to name a few.
SUGGESTION : A couple should try to find out more about sex before starting, especially concerning contraception, hygiene and prevention of infection. Enough foreplay and lubrication is important.
TIGHT INTROITUS ( VAGINA )
Some people are born with tight pelvic bone and vagina. While one cannot do much about bones, a tight vagina can be treated easily. Many such patients have a thickened band on the floor of the vagina, giving rise to pain during intercourse, resulting in the female refusing penetration ( Vaginimus ).
SUGGESTION : A simple surgery, which can be done as a day procedure, can be done to either release the tight band ( using laser or burning called diathermy ), or to make a small cut to widen the outlet of the vagina ( called Fenton's operation ).
RETROVERTED UTERUS
Retroverted uterus ( womb ) occurs in about 10 to 15 % of patients, naturally. In such cases, the womb rests on the back or the spine area. Some will complain of pain during intercourse.
SUGGESTION : A change in the sexual position may be all that is needed. The rear entry ( doggy style ) tends to move the womb away from the spine and relieve much of the backache. Surgery is available to correct this problem but this is a major surgery and is used only as a last resort.
ENDOMETRIOSIS
This is when menstrual blood back flow out of the lining of the womb to implant on the ovaries, womb or outside the womb. Endometriosis is associated with painful periods, painful intercourse, heavy periods and subfertility.
SUGGESTION : Please consult your gynae regarding further management. A laparoscopy ( key-hole surgery ) where a scope ( TV ) is put through the naval to look at the womb may be necessary for diagnosis. Treatment can be with medication or keyhole surgery depending on the severity.
VAGINAL INFECTION
This often presents with vaginal discharge which could be white and curdy ( fungal infection ) or yellow / green ( bacteria or parasite infection ). If left untreated, the patient may experience lower abdominal pain and of course painful sex.
SUGGESTION : See your gynae to clean off the infection, send the discharge for examination and for medication.
MENOPAUSE
This covers one large group of patients. In my practice, i routinely ask my patients about their sexual health. It may be due to the Asian culture, but the sad truth is that many menopaused women will divulge that they have little or no sex after menopause. There are many reasons , but a common one given is that of feeling old and tired. This may one reason for us reading reports of older men going over to Batam in search of sex. This has led some to believe that " WOMEN MENOPAUSE, MEN NO PAUSE ". Well, men actually has andropause, but this comes much later than women's menopause. The menopause is associated with loss of hormones called Oestrogen as the ovaries stop working and stop producing hormones when a patient is menopaused. This results in vaginal dryness, clitoris losing its protective covering, loss of tissues elasticity and the vaginal lining becomes thin. There is also a decrease in sexual responsivity and decreased libido. All these will lead to painful sex.
SUGGESTION : Vaginal hormones will help to improve vaginal dryness, thicken vaginal tissues and improving the elasticity of the vagina. The men have Vigra, Levitra and Cialis. Now a product approved for use in females in the USA, has been brought to Singapore. This is " ZESTRA ", a cream manufactured to help in lubrication and increasing libido in females. Application of Zestra to the vulva and vagina area 5 to 10 minutes before intercourse can leak to improving sexual arousal for the females.
Fear of intercourse, especially the first time round, may affect one's outlook towards one's future sex life. If the first penetration proves to be extremely painful and traumatic, phobia of intercourse may result. Fear can also be of pregnancy, infection and guilt to name a few.
SUGGESTION : A couple should try to find out more about sex before starting, especially concerning contraception, hygiene and prevention of infection. Enough foreplay and lubrication is important.
TIGHT INTROITUS ( VAGINA )
Some people are born with tight pelvic bone and vagina. While one cannot do much about bones, a tight vagina can be treated easily. Many such patients have a thickened band on the floor of the vagina, giving rise to pain during intercourse, resulting in the female refusing penetration ( Vaginimus ).
SUGGESTION : A simple surgery, which can be done as a day procedure, can be done to either release the tight band ( using laser or burning called diathermy ), or to make a small cut to widen the outlet of the vagina ( called Fenton's operation ).
RETROVERTED UTERUS
Retroverted uterus ( womb ) occurs in about 10 to 15 % of patients, naturally. In such cases, the womb rests on the back or the spine area. Some will complain of pain during intercourse.
SUGGESTION : A change in the sexual position may be all that is needed. The rear entry ( doggy style ) tends to move the womb away from the spine and relieve much of the backache. Surgery is available to correct this problem but this is a major surgery and is used only as a last resort.
ENDOMETRIOSIS
This is when menstrual blood back flow out of the lining of the womb to implant on the ovaries, womb or outside the womb. Endometriosis is associated with painful periods, painful intercourse, heavy periods and subfertility.
SUGGESTION : Please consult your gynae regarding further management. A laparoscopy ( key-hole surgery ) where a scope ( TV ) is put through the naval to look at the womb may be necessary for diagnosis. Treatment can be with medication or keyhole surgery depending on the severity.
VAGINAL INFECTION
This often presents with vaginal discharge which could be white and curdy ( fungal infection ) or yellow / green ( bacteria or parasite infection ). If left untreated, the patient may experience lower abdominal pain and of course painful sex.
SUGGESTION : See your gynae to clean off the infection, send the discharge for examination and for medication.
MENOPAUSE
This covers one large group of patients. In my practice, i routinely ask my patients about their sexual health. It may be due to the Asian culture, but the sad truth is that many menopaused women will divulge that they have little or no sex after menopause. There are many reasons , but a common one given is that of feeling old and tired. This may one reason for us reading reports of older men going over to Batam in search of sex. This has led some to believe that " WOMEN MENOPAUSE, MEN NO PAUSE ". Well, men actually has andropause, but this comes much later than women's menopause. The menopause is associated with loss of hormones called Oestrogen as the ovaries stop working and stop producing hormones when a patient is menopaused. This results in vaginal dryness, clitoris losing its protective covering, loss of tissues elasticity and the vaginal lining becomes thin. There is also a decrease in sexual responsivity and decreased libido. All these will lead to painful sex.
SUGGESTION : Vaginal hormones will help to improve vaginal dryness, thicken vaginal tissues and improving the elasticity of the vagina. The men have Vigra, Levitra and Cialis. Now a product approved for use in females in the USA, has been brought to Singapore. This is " ZESTRA ", a cream manufactured to help in lubrication and increasing libido in females. Application of Zestra to the vulva and vagina area 5 to 10 minutes before intercourse can leak to improving sexual arousal for the females.
From Last Title
STRESS
This is probably the most common complaint, especially for the younger and pre-menopausal age group, as the greatest sex organ lies between the ears. It is not uncommon for my patients to reveal that they have sex at most once a month. The stress is mainly from working and over-working. Of course the home environment plays a part as well. It is absolutely unnatural to tell your partner that it is a safe period or the time of the month to have sex rather than it happening spontaneously.
SUGGESTION : Try to set aside certain days to relax, even when work is heavy. A good ambiance, dim lighting, light sexy music, aroma therapy will all help in setting the stage right. Give each other sensual massages, a longer period of foreplay and enough lubrication ( natural or applied ) such that both parties are absolutely wet before penetration usually gets the desired effects and results.
This is probably the most common complaint, especially for the younger and pre-menopausal age group, as the greatest sex organ lies between the ears. It is not uncommon for my patients to reveal that they have sex at most once a month. The stress is mainly from working and over-working. Of course the home environment plays a part as well. It is absolutely unnatural to tell your partner that it is a safe period or the time of the month to have sex rather than it happening spontaneously.
SUGGESTION : Try to set aside certain days to relax, even when work is heavy. A good ambiance, dim lighting, light sexy music, aroma therapy will all help in setting the stage right. Give each other sensual massages, a longer period of foreplay and enough lubrication ( natural or applied ) such that both parties are absolutely wet before penetration usually gets the desired effects and results.
WHY DON'T I ENJOY SEX? - IN FEMALES
Sexual intercourse is one of the simple pleasures in life. To be able to have pleasurable sex and achieve orgasm is the aim of all couples. It is often said that a healthy sex life is essential in a couple's relationship and emotional growth. Sexual intercourse unfortunately is not simply about penetration of the penis into the vagina. Many factors are involved in pleasurable sex and orgasm. We will now embark on a journey to examine the more common reasons as to why some people do not enjoy sex.
Labioplasty
Apart from vaginoplasty, I'm seeing more patients requesting for Labioplasty (reduction of the labia). Some patients, especially those below 40 years old, are very upset by their enlarged labia. Some complained that penetration was more difficult and they felt a pain when their partner searched for the point of entry.
Others felt depressed when their partners looked at their vulva and got turned off by the sight. Labioplasty is a simple surgery involving the excess labia skin being cut away using a straight or a zigzag interlocking cut. Stitching is done using very fine sutures and these are removed within a week. Labioplasty can be done as a day procedure with excellent results.
Others felt depressed when their partners looked at their vulva and got turned off by the sight. Labioplasty is a simple surgery involving the excess labia skin being cut away using a straight or a zigzag interlocking cut. Stitching is done using very fine sutures and these are removed within a week. Labioplasty can be done as a day procedure with excellent results.
A Tight Fit
Standfirst:
Vaginoplasty, a surgery done to tighten the vagina, has made medicine cross over to the realm of aesthetics in recent years. Dr Christopher Chong gives you an insight on this trend. I'm certainly seeing more patients requesting for vaginoplasty these days.
Some of them do it for themselves, while others do it for their partners. Understandably, if sex reaches the "no fun" stage, their relationship can be affected. Many of these patients have prolapsed pelvic organ.
Let me share with you an interesting finding: a search on "vaginal cosmetic surgery" on internet portals Yahoo and Google revealed hundreds of websites dedicated to this topic. Yet, a similar search on Medline – for online medical journals and research – turned up none. This may simply be a matter of different terminologies, but the objective and outcome are likely to be the same.
Before you learn how vaginoplasty is done, you need to know what drives it. The pelvic floor muscles in women control the three organ systems – namely the bladder, womb and bowel, which are lined up in this order. When one organ system is damaged, it's likely that the neighbouring organs are affected as well. The three main culprits behind damaged pelvis floor muscles are pregnancy /childbirth, menopause and obesity. On the other hand, some women are born with weak collagen muscle tissues and have a lax vagina even at a young age and without having gone through childbirth.
Culprit:
Childbirth The usual damage is, of course, from pregnancy and childbirth. The baby's head going through the vagina can cause overstretching and tearing of the pelvic floor muscles. It's even worse for patients who do not do Kegel's exercise during pregnancy and post delivery. Many women are unaware that this exercise can reduce or prevent pelvic floor damage. To find out if damage has been done, a doctor may put an index finger into the vagina and a thumb into the anus, and pinch them together. If there's a hollow in between, it's likely to be due to the damage in the pelvic floor muscles and in the "perineal body" tissue located in the region. This is a common problem caused by poorly healed or poorly cut (episiotomy) vagina after childbirth. It gives that open vulva/vagina feeling to the patient and her partner, which is why complaints like "looseness", "no strength", "no sensation" and "no fun" are often heard.
Relatively safe In Vaginoplasty, I repair the perineal body tissue and join the pelvic floor muscles with sutures. The vaginal skin will be fashioned according to preferred tightness of the pelvic floor muscles. This surgery can be done as a day procedure, with minimal pain and complications, and with a good success rate under skilled hands.
Generally, I do not cut away vaginal skin unless it's excessive, because the complication that comes after it is that of painful intercourse. Any prolapsed problem must be corrected at the same time. This is an attempt at achieving "a tight fit" to improve stimulation of the vulval and vaginal tissues. It's not far fetched to get her partner to go for "fitting", but very often, he's not willing to do so. Vaginoplasty can be done with or without the use of laser but the principles of surgery remain the same. Complications like bleeding and infection are rare. Some women may get scarred, and coupled with the over tightening or cutting of the vaginal skin, sex can end up becoming a nightmare instead of a pleasure.
Measuring success
The success of vaginoplasty is personal and subjective – to the surgeon, the patient or her partner. The true measure of success would be the three parties are happy. I always abide by my teacher's wisdom of treating a patient as "a whole, not a hole". It's important to be sensitive to the psychological and emotional aspects of the patient and her partner. It helps manage expectations and improve the chances of a successful outcome. The majority of my patients, who have sought vaginoplasty, are in the pre-menopausal stage and a significant number is in their 30s. They have certainly reported better sexual satisfaction – and relationship – after the surgery.
But the greatest sex organ is truly what's between the ears – the brain. Stimulation of the clitoris and vulva, which can be achieved through foreplay, sends positive signals to the brain, which in turn gives sexual satisfaction. However, a satisfactory vulval/vaginal stimulation still requires a "good fit". While vaginoplasty is not the one-size-fits-all solution to enhancing sex life, it cannot be denied that a proper fit does matter in bed.
Vaginoplasty, a surgery done to tighten the vagina, has made medicine cross over to the realm of aesthetics in recent years. Dr Christopher Chong gives you an insight on this trend. I'm certainly seeing more patients requesting for vaginoplasty these days.
Some of them do it for themselves, while others do it for their partners. Understandably, if sex reaches the "no fun" stage, their relationship can be affected. Many of these patients have prolapsed pelvic organ.
Let me share with you an interesting finding: a search on "vaginal cosmetic surgery" on internet portals Yahoo and Google revealed hundreds of websites dedicated to this topic. Yet, a similar search on Medline – for online medical journals and research – turned up none. This may simply be a matter of different terminologies, but the objective and outcome are likely to be the same.
Before you learn how vaginoplasty is done, you need to know what drives it. The pelvic floor muscles in women control the three organ systems – namely the bladder, womb and bowel, which are lined up in this order. When one organ system is damaged, it's likely that the neighbouring organs are affected as well. The three main culprits behind damaged pelvis floor muscles are pregnancy /childbirth, menopause and obesity. On the other hand, some women are born with weak collagen muscle tissues and have a lax vagina even at a young age and without having gone through childbirth.
Culprit:
Childbirth The usual damage is, of course, from pregnancy and childbirth. The baby's head going through the vagina can cause overstretching and tearing of the pelvic floor muscles. It's even worse for patients who do not do Kegel's exercise during pregnancy and post delivery. Many women are unaware that this exercise can reduce or prevent pelvic floor damage. To find out if damage has been done, a doctor may put an index finger into the vagina and a thumb into the anus, and pinch them together. If there's a hollow in between, it's likely to be due to the damage in the pelvic floor muscles and in the "perineal body" tissue located in the region. This is a common problem caused by poorly healed or poorly cut (episiotomy) vagina after childbirth. It gives that open vulva/vagina feeling to the patient and her partner, which is why complaints like "looseness", "no strength", "no sensation" and "no fun" are often heard.
Relatively safe In Vaginoplasty, I repair the perineal body tissue and join the pelvic floor muscles with sutures. The vaginal skin will be fashioned according to preferred tightness of the pelvic floor muscles. This surgery can be done as a day procedure, with minimal pain and complications, and with a good success rate under skilled hands.
Generally, I do not cut away vaginal skin unless it's excessive, because the complication that comes after it is that of painful intercourse. Any prolapsed problem must be corrected at the same time. This is an attempt at achieving "a tight fit" to improve stimulation of the vulval and vaginal tissues. It's not far fetched to get her partner to go for "fitting", but very often, he's not willing to do so. Vaginoplasty can be done with or without the use of laser but the principles of surgery remain the same. Complications like bleeding and infection are rare. Some women may get scarred, and coupled with the over tightening or cutting of the vaginal skin, sex can end up becoming a nightmare instead of a pleasure.
Measuring success
The success of vaginoplasty is personal and subjective – to the surgeon, the patient or her partner. The true measure of success would be the three parties are happy. I always abide by my teacher's wisdom of treating a patient as "a whole, not a hole". It's important to be sensitive to the psychological and emotional aspects of the patient and her partner. It helps manage expectations and improve the chances of a successful outcome. The majority of my patients, who have sought vaginoplasty, are in the pre-menopausal stage and a significant number is in their 30s. They have certainly reported better sexual satisfaction – and relationship – after the surgery.
But the greatest sex organ is truly what's between the ears – the brain. Stimulation of the clitoris and vulva, which can be achieved through foreplay, sends positive signals to the brain, which in turn gives sexual satisfaction. However, a satisfactory vulval/vaginal stimulation still requires a "good fit". While vaginoplasty is not the one-size-fits-all solution to enhancing sex life, it cannot be denied that a proper fit does matter in bed.
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