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March 29, 2018

The following is a true account from one of our patients who recently received the O-Shot. Please note, names and details have been changed for confidentiality. 

It’s a gorgeous spring day in early March, and I am en route to Cherokee Women’s Woodstock office to get an O-Shot, a procedure that offers women treatment for urinary incontinence and sexual dysfunction. I am excited and a little nervous at the idea of this new procedure. However, I am hopeful after hearing other women’s success stories, and hope to have my own story add to the increasing number of women who have had remarkable results after getting the O-Shot.

When I heard that Cherokee Women’s was offering this procedure, I wanted to try it. I trust Dr. Litrel and his team, so much so that I’ve been a patient for over eight years. The practice has delivered both of my children, and I refer them to anyone looking for a patient, kind team of physicians.

Why am I particularly interested in the O-Shot? I have suffered from sexual dysfunction for a number of years.

While I know I am not alone in this (nearly half of women report suffering from some sort of sexual dysfunction in their life), this isn’t something most women are comfortable discussing with each other, their doctors, much less their husbands or anyone else.

As a woman in my early 30’s, the daily life of being a full-time working mother has pulled my libido to nearly nonexistent levels and has caused complications in my marriage. I’m happily married, but I feel guilt and shame surrounding my low libido and am curious to see if the O-Shot (in addition to careful communication with my husband) helps me at all.

When I get to the office, the girl at the front desk smiles at me as I sign in. She has a very memorable face and kind eyes that I remember from previous visits. It puts me at ease while I try not to think about what I’ve signed myself up for.

Cherokee Women's Health, sexual dysfunction, urinary incontinence, O-Shot

Getting Ready for the Procedure

I’m called back to the exam room and told to undress from the waist down and wrap myself with the crinkly white cover. A few minutes later, Dr. Litrel comes in and explains that he’s going to apply a very thick layer of Lidocaine gel. It will need to sit for at least 20 minutes, and a nurse would be coming in shortly to take my blood so they can run it through the centrifuge.

The Lidocaine is cold, but welcome when I consider the alternative. A nurse comes in and gathers the tools she needs to take my blood. We make small talk and she says she’s heard lots of wonderful things about the procedure. She gets my blood ready for the centrifuge, and Dr. Litrel comes back in and places the blood in the centrifuge for 10 minutes.

I continue to lay back on the exam table and wait for the Lidocaine to do its thing, scrolling through email and social media channels mindlessly. As a full-time working mom of two rowdy boys, I enjoy the quiet and stillness of the next few minutes.

Once the centrifuge was done separating the blood, I was amazed when it I saw the tube pulled out and it was in three separate layers.

I watched Dr. Litrel add calcium carbonate to the blood in two different syringes, one for my clitoris and the other for my vagina. It was time to start the procedure. I try to calm my nerves by making jokes, something I always do as a defense mechanism. “Well, I guess if you’re going to have a needle in your vagina, you want a female pelvic reconstructive surgeon in charge of it.” Dr. Litrel chuckles softly at my joke, reassuring me that the procedure will take just a few minutes and I’ll be out the door in no time.

First, I needed two Lidocaine injections to make sure I didn’t feel the larger needles. This is the part that is different for every patient, Dr. Litrel tells me. “Some women feel absolutely nothing at all, and others feel the tiniest prick.” I was in the second category, but it was slight discomfort. (I mean, I’ve had two children—this was nothing I couldn’t handle.)

After the Lidocaine injections, I felt nothing. I can feel pressure, but absolutely no pain. Wondering what was happening, I ask, “What are you doing now, exactly? And he responds, “We’re doing the first PLP (platelet-rich plasma) injection as we speak.”

Dr. Litrel and his team were very warm, and so conscientious. Throughout the procedure, they asked, “Are you comfortable? Feeling okay? You’re doing a great job, we’re almost done.”

In just a couple more minutes, the procedure was done. Dr. Litrel explained that I should wait 48 hours before any sexual activity, and that I may want to wear a panty liner for a day or two just in case I experienced any breakthrough bleeding.

They gave me a few minutes to get cleaned up and dressed, and I walked out feeling a rush of excitement that I had done this for myself, and I couldn’t wait to test it out. All in all, the procedure only took about 45 minutes, and the longest part was waiting for the Lidocaine gel to take full effect.

As I walked out of the office and down to my car, my satisfaction grew. I was glad I went through with it, and I couldn’t imagine doing this procedure with another physician’s group.

That evening, I felt the tiniest bit of discomfort while sitting in a hard chair. I took some ibuprofen and didn’t have any more discomfort after that. The next morning, I had very mild swelling, but no pain.

Giving the O-Shot a Try

I’d kept the procedure a secret from my husband, wanting the first experience to be authentic and free from expectations. After “giving it a go,” I can say that I’m impressed. Frankly, I’m more than impressed. I haven’t felt a distinct change in my sexual desire like this, ever. Two weeks after receiving the O-Shot, my desire has increased considerably. And not just when the timing is right and the candles are lit and my mind is empty—even during the middle of the day—something many women don’t have the pleasure of thinking about with small children.

And it is a pleasure. Women often come second when it comes to the importance of a healthy sex life (pun intended). But the truth is, physical enjoyment of sex matters greatly to most women, and we want to be sexually intimate with our partners. Women are challenged by a myriad of burdens every day, and so often trying to balance work and life can take a huge toll on a woman’s libido.

Would I recommend the O-Shot? Absolutely. So far, I know a couple of women who have gotten the procedure, and we’ve all had positive results. One has had her urinary incontinence issue treated completely. One has stronger, longer-lasting orgasms as a result. And me? I’m just an overtired, overworked mom who can now get excited about sexual intercourse with her husband. And that is worth a thousand O-Shots.

For more information about the O-Shot (including details and special pricing), please email oshot@cherokeewomenshealth.com or call 770-720-7733. 

March 13, 2018

Although our physicians at Cherokee Women’s Health Specialists are experienced in treating all pelvic issues unique to women, we do not concentrate solely on the physical aspects of your genitalia. We recognize that health issues can be comprised of overall physical, mental and social factors and take all that into account, offering holistic approaches to the many problems that have plagued women since the beginning of time. One of these holistic solutions is the O-Shot, also known as the Orgasm Shot.

Women have always suffered from a plethora of physical ailments unique to their gender-so much so that an entire branch of medicine, Gynecology, has been devoted to their exclusive issues. Painful intercourse, urinary incontinence, vaginal dryness, and sexual disinterest are only a few of the problems we see on a daily basis. Though medicinal and surgical intervention is always available, many women today prefer a gentler and more natural approach. The O-Shot has been known to alleviate or entirely correct many of these problems in a less invasive, natural and extremely effective way.

Below, Dr. Litrel offers more insight on the holistic approach to treatment urinary incontinence and sexual dysfunction with the O-Shot:

What is the O-Shot?

The O-Shot is a non-surgical injectable procedure administered in-office, using your own processed growth factor cells harvested from your blood. It is then re-injected into an area of the upper vagina and near the clitoris, resulting in healing regeneration of the orgasmic zone, triggering the power of your own body’s natural healing properties.

How is This Done? 

After a vial of blood is taken from you, it is centrifuged, separating concentrated plasma and platelets from the rest of the blood. This process produces platelet-rich plasma (PRP), to which your physician applies an additive to boost the activation of your growth factors. Then, the platelet-rich serum is reintroduced into your body after swabbing the area with a numbing anesthetic.

Platelets normally swim around in your blood vessels, always on guard for any disruption or damage. When they sense one, they rush to the injury site, join together in a chain to ‘hold down the fort’, by forming a clot or plug. Then, they send out a type of S.O.S.to healing stem cells to hurry over and start repairs in the form of collagen production.

The O-Shot mimics this sequence by introducing a multitude of platelets into the body. The additive mixed in earlier sends that signal a false alarm of sorts- to lure the stem cells over. Stem cells, recognizing so many of your own platelets in one place are fooled into thinking there’s an injury and immediately respond, doing what they’re designed to do, which is to begin producing collagen and new tissue, replenishing vital elasticity, skin cells, moisture, plumpness, sensitivity, and strength to the area. 

PRP is not a not a novelty or fad. This technique has been used for many years to heal wounds, to treat sports and other injuries— has even proven effective in dentistry.

What Can the O-Shot do for Me?

The O-Shot can benefit women a great deal. By spurring the area of the body where it has been injected into healing itself, the O-Shot immediately begins to work. It starts correcting different feminine issues that have developed over time due to aging, childbirth trauma, depleted collagen, tissue damage, skin cell death, etc., physical changes which can evolve into such problems as:

  • Sexual dysfunction
  • Sexual disinterest or low libido
  • Vaginal Dryness
  • Urinary Incontinence
  • Failure to achieve orgasm
  • Desensitization
  • Painful intercourse
  • Stress incontinence
  • Urge incontinence

The O-shot, in tandem with your own biological healing factors, can then ease or altogether eliminate these troubles, resulting in:

  • Accelerated desire for sex
  • More powerful orgasms
  • Corrected or minimized urinary incontinence leakage
  • More youthful and supple vaginal lip appearance
  • Increased tautness to the vaginal opening
  • Less or no need for artificial vaginal lubricant
  • More frequent and regular orgasms
  • Less or no pain during intercourse
  • More sensitivity and arousal during clitoral stimulation
  • More ease in attaining orgasm
  • Possibility of reducing or stopping previous drug intervention
  • Possibility of less frequent or complete cessation of pelvic-related infections

How Long do the Effects of the O-Shot Last?

Individual results vary, but often noticeable change begins immediately and can last up to 18 months. Depending on how severe your issue is, we may recommend a booster procedure in about 4 to 8 weeks, and a maintenance shot in about a year so that there is no diminishment of ongoing benefit. There is also no recovery period necessary. You can resume all normal activities immediately after leaving our office. Furthermore, the whole process will cause you little or no discomfort.

Who is a Good Candidate for the O-Shot?

Almost every woman between the ages of 25 to 65 is a good candidate. There are virtually no exceptions, but we can only recommend this procedure 100% after you disclose your full medical history so we can be sure there are no foreseeable problems exempting you. Usually, however, most women prove to be excellent candidates.

Why Should I Choose Cherokee Women’s Health Specialists for my O-Shot Treatment?

At our establishment, we pride ourselves on our holistic approach to female wellness. We treat you as a whole, taking into account any metabolic or hormonal problems you may have. Even diet and lifestyle can compromise or your body’s ability to heal or regenerate tissue. We address any psychological or emotional issues as well so that we can help restore your overall health, head to toe and inside and out. We do not just focus on your pelvic area. We examine all your alternatives and only recommend the best one for your unique situation.

Drs. Litrel and Haley have spent their entire medical careers striving to learn all there is to know about a woman’s anatomy and the myriad of factors that can affect its performance and functions. They are board certified, double accredited urologists with certification in OB-GYN and Female Pelvic Medicine and Reconstructive Surgery (FPMRS), the latter requiring years of study, training, hands-on experience, and meeting rigid proficiency demands specified by the American Board of Medicine (ABMS). Dr. Haley has been trained and licensed in Aesthetic Injectables for over a decade. Together and separately, these professionals are knowledgeable in every aspect of the problems exclusive to women throughout their lifetimes.

Administration of the O-Shot requires focused expertise, strict adherence to FDA guidelines, and astute knowledge of anatomy for optimum results. Our accomplished practitioners offer this skill on a daily basis. For more information on the O-Shot procedure, we invite you to email Oshot@cherokeewomenshealth.com or call our office at 770-720-7733.

February 19, 2018

Lack of sexual desire. The inability to become aroused or orgasm during intercourse. Painful or unpleasant sex. These are all symptoms of sexual dysfunction and if you’re experiencing any of them, you’re not alone. Nearly 43% of women report at least some degree of poor sexual function.

Sexual dysfunction affects women of all ages. However, it can be particularly brutal for women entering menopause thanks to hormonal imbalances. If you’re simply no longer interested in sex or have trouble staying lubricated before or during intercourse, you may want to consider the O-Shot.

Aptly named, the O-Shot or ‘Orgasm Shot’ works to improve overall sexual health so you can take your life back. It’s a simple minimally-invasive procedure that safely and effectively restores your ability to climax by improving lubrication and sensation.

How Does It Work? 

Before your O-Shot treatment, you’ll undergo a simple blood draw. One of our specialists will then spin, clean, and process the blood into platelet-rich plasma (PRP) while you wait in-office.

The PRP is then injected directly into the clitoris and inside the vagina. The process stimulates the growth of new cells and encourages the formation of new collagen, blood vessels, and nerves. In turn, the injection sites become more sensitive.

A topical numbing agent is placed on the injection sites prior to your treatment to minimize discomfort. There is no downtime associated with the O-Shot and patients are free to go about their daily activities immediately following the procedure, including intercourse.

Unlike other similar procedures, the O-Shot uses your own body’s natural healing process. Dermal fillers used for vaginal rejuvenation provide short-term results and are quickly absorbed and expelled from the body. Surgical methods are costly, time-consuming, and have longer recovery times.

What To Expect

Because the O-Shot uses a biologic process, some women may experience improvement almost immediately while it can take several weeks for other women to notice results. Once the O-Shot takes effect, you should experience better sexual function for up to a year or more.

After your Orgasm Shot, you can expect improved sexual desire, better lubrication, and the ability to climax more often. Stronger, longer-lasting orgasms can also be accomplished with O-Shot injections. Most women don’t need more than one O-Shot injection, however, you may want to consider an additional treatment 3-4 months if desired results are not achieved.

No significant side effects have been reported with the O-Shot. Some patients expressed temporary spotting, swelling, and hypersensitivity after their vaginal rejuvenation procedure. Any adverse side effects should dissipate within 1-3 days.

Am I A Good Candidate?

The ideal candidate for the O-Shot include women who are seeking a non-surgical way to improve their sexual health. With a short, in-office appointment women can achieve long-lasting results without the downtime.

You may be a good candidate if you have one or more of the following sexual concerns:

  • Vaginal Dryness
  • Urinary Incontinence
  • Lack of Sexual Desire
  • Inability to Become Aroused or Orgasm
  • Pain During Intercourse

Menopausal and post-menopausal women can especially benefit from the O-Shot. New collagen, blood vessels, and nerves that are formed help restore your sexual health to its previous good health.

Women who go into the procedure with realistic expectations are more likely to be happy with the results of their O-Shot procedure. During your consultation, your doctor will be able to explain the procedure in detail so you can make an informed decision about what’s right for you.

Ready to improve your sexual health with the O-Shot? Schedule a consultation with Cherokee Women’s Health today to inquire about getting the O-Shot for yourself. One of our friendly staff members will be happy to confidently answer any questions you have about how you can treat your sexual dysfunction

October 4, 2017

romantic couple photoLoss of sexual desire after fifty does not have to be the norm. If you find yourself uttering “not tonight” excuses more and more lately, Cherokee Women’s Health Specialists can provide treatment options so you can say goodbye to your low libido and get back to feeling “alive” again.

Many women after fifty weren’t raised talking about sexual health so it may be an uncomfortable topic to bring up to your GYN. However, after over forty years of combined specialized experience in women’s health, our providers can assure you that, although you are a unique individual, your struggle with a lowered libido is not unique at all. Nor is it something you should be embarrassed about.

Declining sex drive is often something older women keep to themselves. They may feel isolated and abnormal in a world of uninhibited sexual openness. Additionally, new libido medications for men increase the pressure for women to perform when desire is nonexistent. They avoid bedtime until their partner is fast asleep. Some fear their unresponsiveness may cause their significant other to seek gratification elsewhere. Others, wanting to please the person they love, dutifully ‘fake it’, which results in eventual resentment and even feelings of being violated.

Without intervention, waning desire can lead to a sense of inadequacy, self-loathing, insecurity and depression. It can cause misunderstandings and hurt feelings, sometimes ultimately leading to shattered relationships. None of this has to happen. For menopausal and post- menopausal women looking to recapture lost desire, help for the following problems is available:

• Dryness and pain: Dryness after menopause is common. The vaginal walls grow thinner, the opening can get smaller, and the canal shorter. Causes include a drop in the hormone, estrogen, which previously kept your lady parts firm, plump and moist. These changes can make intercourse unpleasant enough to embrace celibacy. We can recommend different hormonal therapies, topical creams and water based lubricants that have come a long way from the petroleum products and creams recommended by your grandmother.

• Sagging and loss of sensitivity:  Just as your body shows signs of aging, time can impact your genitals. Vaginal childbirth delivery can stretch and displace internal organs and tissue. Estrogen loss can leave your vulva and labia loose and flaccid. This can affect sexual pleasure attained through friction. Orgasms become harder to achieve.

Today, there are more options than ever to correct these problems. ThermiVa, a non-invasive, gentle warming laser treatment, can restore the youthful appearance and function of your vulva and vagina by tightening and treating their external and internal tissues.

Vaginal rejuvenation, which includes labiaplasty and vaginoplasty, reshapes, trims and alters the appearance of the vagina and labia. It not only offers aesthetic enhancement but can renew your self-confidence exponentially.Various reconstructive surgeries can secure genital organs back into their original position with a relatively short recovery period. We even have the technology now to transform your genitalia to a virginal state if you so choose.

• Incontinence: Fecal and bladder incontinence are usually a result of internal organ trauma from childbirth. If you’ve been avoiding sex because you’re worried about accidents or being seen in adult diapers, we offer solutions ranging from simple exercises to surgical repair.

• Post hysterectomy issues: Removal of reproductive parts does not mean the end of intimacy. In fact, a high percentage of women report that they enjoy sex even more after a hysterectomy so whether you’ve undergone a partial, total or radical procedure, sex doesn’t have to become a memory.

Your hormones may be out of whack for several weeks and depression, whether psychological or triggered by abrupt hormonal changes, may occur. The extent of your surgery will determine how your estrogen and testosterone levels will be affected. You may possibly enter menopause and experience hot flashes, insomnia, and other symptoms. These temporary after-effects should abate with time. If not, and you are still disinterested in sex, talk to us. Once we determine if hormonal levels, medication, scarring, or other problems are causing your low libido, our FPMRS urogynecologists can help determine treatment options.

If loss of sexual desire is a concern for you, call us to book an appointment at 770.720.7733.

August 9, 2017

Insecurities, Relationship Issues, and Pelvic Health

If you’re considering vaginoplasty, labiaplasty, or other pelvic surgeries, you probably have a lot of questions – and you should! Dr. Litrel has been performing these types of procedures for twenty years and even has a board certification in Female Pelvic Medicine and Reproductive Surgery in addition to his OB-GYN certification. He believes that the best patients are well informed, and does his best to answer all the questions that come his way.

Here are 10 recent questions he answered on an online forum.

1. I am very insecure about my vagina and the color of it. Is it normal? I’m afraid to have sex.

Your appearance is perfectly normal and does not have any issues that require intervention from a cosmetic surgeon. Your insecurity is normal as well to some degree.  Everyone has some fear about social rejection, the feeling that others will not like or love us. This is really a spiritual issue, learning to love ourselves and love others, growing daily in our abilities in this arena. This is what makes life meaningful and fulfills our purpose in life: love.

When it comes to sexuality –  the sharing of our bodies with another in a pleasurable and intimate manner – the insecurity that one feels can prevent us from extending ourselves in this way.  This is painful because sex and intimacy and pleasure are so important to enjoy life.

But as a doctor who specializes solely in the care of woman, the common problem that women experience is not that they can’t find sexual partners, but rather that they choose the wrong sexual partner. Or too many. For men, in many and most cases sex is the end. Sex and orgasm itself is the goal.

Women like sex and orgasm, too. But for women, sex is really the beginning – the beginning of a powerful and important relationship – and the beginning of New Life (pregnancy). This is why so often women are broken hearted by the way they are treated by men. Men get sex – and eventually leave for someone else.

Thus it’s important for women to choose a partner who is committed to not just his own orgasm and his own pleasure – but one who is committed to you and the future of the relationship that God willing may someday include children.

Bottom line is this: if insecurity about the appearance of your genitals is holding you back from “sex” – when you find the partner who is not just attractive physically but spiritually as well – one who will be committed to you and the future, that person will love you so you will not be so afraid.

So it’s okay to wait to have sex and indeed it’s usually better. It builds a better long term relationship. When a woman waits to have sex not only does the guy think that she’s special, he also thinks that he’s special. And thus the relationship becomes special.

2. Is there any way to make my vagina look new again?

Women sacrifice a lot. Pregnancy and delivery is difficult enough as is raising children.  But the changes that women experience to their bodies are just another painful thing that women must confront. There are office procedures and surgeries that can help you with both sexual function and appearance of your genitalia. As far as specifics are concerned that is something that is tailored to each patients desires and anatomy.

3. Suffering from some mild incontinence and loss of muscle tone in my vagina. Does the Apex M pelvic floor exerciser work?

There are three good things about the apex devices. One is that they can help improve the muscle tone on your pelvic floor and can help with incontinence. Two is that they are done in the privacy of your own home. Three they are safe and won’t hurt you. It’s reasonable to try this before surgery. It’s reasonable to use this afterwards as well.

4. Can any board certified surgeon do a labiaplasty?

I would strongly advise you to wait until you find a specialist surgeon who focuses on labiaplasty. This can be a cosmetic gynecologist or a plastic surgeon. But don’t see someone who does not do a lot of these surgeries. Board certification is about education and passing examinations. But the key is experience and skill rather than diplomas on the walls and initials after your name.

5. Vaginoplasty: Can this surgery be personalized based on size of husband? Do all “holes” end up the same after this surgery regardless of requests?

Your surgery should be tailored to the size of your husband. Sexual issues are usually top-of-mind for women considering vaginoplasty. Thus your experience with your sexual partner is an essential part of the interview, the examination and the performance of the surgery.

6. I recently had vaginal tightening surgery. Is it normal to have a lot of pain afterward?

Everyone responds to the pain of surgery in a different way. Our bodies are different. It’s important to get an examination by your surgeon to make sure that there are not issues. But assuming a normal exam, be assured that everyone will have a different response. Typically by seven to fourteen days patients feel alright. If the pain continues, pelvic floor physical therapy can help. Muscle relaxers can also help if the examination demonstrates tenderness on your pelvic muscles.

7. Would a perineoplasty help with some feelings during sex?

The quick answer is that it will help – some.  Your question shows a sophisticated knowledge of your body and the problems you are having.  Pelvic reconstruction is likely required along with vaginoplasty to give you the tightness you desire. and to correct the anatomic deformities and changes your eloquently describe. There are non-surgical modalities such as ThermiVa that can help. But that may be a waste – it will depend upon your anatomy and the findings on physical examination. Good luck!

8. Can I enjoy sex after my clitoris is removed?

This should not be done for any reason other than the rare presence of cancer.  In some parts of the world there is “female circumcision” where young girls suffer genital mutilation. This is cultural and often the clitoris is not injured in the process. If you are considering a procedure make sure you understand what is being done and why.

9. Is a partial labiaplasty possible?

This is a good question. The truth is that every labiaplasty has to be tailored to a patient’s anatomy and also her desire. So really, you should just receive what it is that you desire rather than a “one size fits all.” Likely you have excess skin adjacent to your clitoral hood or the hood itself is more pronounced than you desire. This is a common problem that can be handled during an office procedure.

10. What are the adverse effects from an overly aggressive labiaplasty?

The Labia Minora come in all sizes and shapes. Our bodies differ. Consider how noses and ears are different sizes and shapes. The main thing that troubles patients with a “botched labiaplasty” is emotional upset with appearance. This can cause issues with sex because if we are not comfortable with how we look then it is more difficult to be intimate with another. There are less common instances when an over-aggressive labiaplasty can cause pain with sex but I would not worry about this. The most important things for sexuality to go well is to be in a loving relationship. This is a loving relationship with another – and also with yourself.

Were you questions among the ones Dr. Litrel answered here? If not, let us know! Ask during your next appointment, or call the office. And you can always check Dr. Litrel’s RealSelf profile where he answers questions about several types of vaginal reconstructive surgery and female pelvic health.

June 22, 2017

cwhs officePatients travel from across the country to Canton, GA, in north metro Atlanta to have surgery with Dr. Michael Litrel at Cherokee Women’s Health Specialists.

We are committed to ensuring your experience with us is safe, comfortable and convenient so we have provided the following information to assist out of town patients with transportation, accommodation and what you can expect before and after your surgery. And because you may have some downtime between your pre-op appointment and your surgery, we’ve also included links to stores and activities in the Canton area.

Please follow the instructions to prepare for your surgery with Dr. Litrel if you live outside the Canton/Atlanta area.

Contact Our Office
The first step for out of town patients is to contact our office to schedule a phone consultation with Dr. Litrel. If you have photos to provide for the consultation, you’ll be given a secure designated e-mail address to send the photos so that Dr. Litrel can review and understand your surgical needs.

Following your consultation, you’ll be contacted by our scheduling team to set up a preoperative examination appointment and your surgical date. 

Traveling to Canton
If you are flying to Atlanta, we recommend that you fly into Hartsfield Jackson International Airport, located about one hour from our Canton office. Once you arrive, you may choose from several transportation options. We have provided helpful links for you below.

Car Rental
Shuttle / Limo Services
Uber / Lyft

hampton-inn-and-holiday-inn-photosYour Accommodations
While staying in Canton, we recommend Hampton Inn or the Holiday Express Inn, where you will receive a reduced rate on your room during your stay, as a patient of Cherokee Women’s Health. It’s conveniently located off I-575 and within just three miles of our office, Northside Hospital Cherokee, several restaurants, shopping areas and more.

Hampton Inn
710 Transit Avenue
Canton, GA 30114
770-345-7400

Holiday Inn Express
713 Transit Ave
Canton, GA 30114
770-479-7300

Your Pre-Op Appointment
Your pre-op appointment will typically take place the day before your surgery. During this appointment, Dr. Litrel will examine you, explain again what to expect during your surgery, discuss what your recovery will be like, and answer any questions you may have. Rest assured, you will be able to contact Dr. Litrel with any issues or questions before you arrive – and after you depart.

Checking Into Your Hotel After Your Pre-Op Appointment
The check-in time at both Hampton Inn and Holiday Inn Express is 3 pm. However, as a patient of Cherokee Women’s, they may be able to accommodate an earlier check-in. If desired, please give them a call.

When checking in, be sure to tell them that you are a patient of Cherokee Women’s and that you will be receiving surgery at either our office or at Northside Hospital Cherokee to ensure you receive the reduced rate.

If you’re unable to check-in immediately after your pre-op appointment, we’ve provided several links to restaurants, shopping and other nearby activities below.

After Your Surgery
We want you to be as comfortable as possible so after your surgery, you will return to your room where you can rest in private. If you have arrived for your surgery alone, a Medical Assistant will provide transport from our office to the hotel. That evening, our nurse will come by to check on you. The following morning, Dr. Litrel and his medical assistant will do a post-op visit to ensure everything is going well and answer any additional questions or concerns you might have.

Canton Restaurants, Shops and Activities
You may want to get out and explore during your downtime so we’ve provided the following list for your convenience.

Restaurants
A wide range of restaurants are located within a mile or two of your hotel. For upscale dining, Downtown Woodstock is just ten minutes away, featuring award winning restaurants such as Century House, Vingenzo’s and Salt Factory Pub. If you prefer to stay even closer to your home away from home, Cracker Barrel is a one-minute walk from the hotel.

outlet-shoppes at atlanta photoShopping – Target, Kohl’s, Belk and Publix are just a few of the stores that are minutes away from Hampton Inn. The Outlet Shoppes at Atlanta is a short 10-minute drive south on I-575, and Downtown Woodstock just beyond offers a pedestrian-friendly downtown district. There you’ll find unique galleries and shops nestled among outstanding restaurants, bars and eateries.

Parks and Attractions
Greenprints Trail in downtown Woodstock begins in Woodstock’s Sculpture Garden at Elm Street and takes you through tree-lined green space through “Woofstock” Dog Park and beyond to the scenic local Noonday Creek. Elm Street Cultural Arts Village offers award-winning musicals, concerts and local improv talent.

Heritage Park has beautiful, open walking trails and is located just past our office, next to the YMCA.

Tanglewood Farm is a 10-acre petting zoo with more than 150 rare, miniature and heritage breed farm animals in a Wild West Town setting.

Gibbs Garden is 220 acres of beautifully landscaped gardens surrounded by forest, ponds, streams, waterfalls and bridge crossings. It is located about 30 minutes from Hampton Inn in nearby Ball Ground.gibbs-gardens photo

For more activities and information about Canton and the surrounding areas, visit Georgia Tourism and Travel.

Thank you again for choosing Cherokee Women’s Health Specialists. Please call us at 770.720.7733 to let us know if there is anything further that we can assist you with.

May 9, 2017

postoperative careThe physicians at Cherokee Women’s Health Specialists are committed to ensuring that your experience after surgery is as comfortable as possible. The following information will help answer frequently asked questions and will help you understand some of the common experiences that may occur after your surgery. Please do not hesitate to call the office with any additional questions about your recovery.

  • Call the office to schedule a post-operative appointment two to four weeks after your surgery.
  • If an ER visit is necessary post-operatively, go to Northside Hospital Cherokee if possible, but if you are an out of town patient or live in another state, then your closest hospital is appropriate.

Call the office at 770-720-7733 right away if you experience:

  • Fever higher than 100.4 degrees
  • Shortness of breath
  • Dizziness
  • Heavy vaginal bleeding
  • Severe pain not relieved with your pain medication
  • Persistent nausea or vomiting
  • Increased pain, redness, or swelling at the incision

IF THE SYMPTOMS ARE SEVERE, GO TO THE EMERGENCY ROOM OR CALL 911 FOR AN AMBULANCE IF NECESSARY.

How Much Activity Can I Do After Surgery?

General – There are no standard limitations with regards to activity after gynecological surgery except for driving and sexual activity (see below). If you stayed in the hospital overnight, you should plan to rest with minimal activity for at least a week. If you were sent home the same day you should plan to rest with minimal activity for three days. If you had a procedure with no incisions (such as a D and C or endometrial ablation) then you probably only need to rest for a day. Use common sense and listen to your body. Every patient is different, and different patients will have differing degrees of recovery. Gradually advance your activity. If the activity you are doing increases your discomfort, then STOP. If you are feeling well during increased activity but have increased pain the next day you need to decrease your activity.

Adequate rest and nutrition is required to heal from surgery. LISTEN TO YOUR BODY.

Stairs – Apprehension about stairs or weakness in mobility may require help when climbing up and down stairs. You are allowed to use the stairs if you feel you are able. It’s a good idea to put both feet on each step to not lessen the strain on your body for a week or longer after surgery.

Exercise – If you had incisions on your body wait until you get clearance from your surgeon. Use common sense when starting an exercise routine after surgery. Start out slowly and gradually increase time, distance and speed. Once you are cleared to exercise a general recommendation is to start out at 25% of what you were doing before surgery for a week or two and increase by 25% at each one or two week interval.

Driving – Driving should only begin only after you have stopped taking narcotics, and if you feel strong enough to be able to stop the vehicle in an emergency. At this point you should be able to walk up and down stairs comfortably and sit down and stand up without experiencing discomfort. Have someone drive you if you are still experiencing discomfort.

What Should I Eat After Surgery?

After surgery, your body needs enough calories and nutrients to fully recover from the procedure. Eating the right foods after surgery can decrease risk of infection, speed healing of the incision and increase strength and energy. The best post-surgery foods to eat are packed full of vitamins and minerals.

Here are some foods and nutrients you should focus on in your post-surgery diet:

Fiber – A common complaint after surgery is constipation. To avoid this uncomfortable post-surgery complication, eat plenty of fiber. Some high-fiber foods include fresh fruit and vegetables. Whole grain breads and oatmeal are other great sources of fiber. To prevent constipation, avoid foods like dried or dehydrated foods, processed foods, cheese and dairy products, red meats and sweets.

Protein – The amino acids in protein help with wound healing and tissue regeneration. Protein can also help with strength and energy following surgery. Lean meats such as chicken, turkey, pork and seafood are excellent sources of protein. You can also get protein from eggs, nuts, beans and tofu. Dairy also contains protein, but if you’re struggling with constipation, go for the other sources of protein instead of dairy options. If you have trouble getting enough protein in your diet after surgery, try adding protein powder to drinks or smoothies. Several Physicians at Cherokee Women’s recommend a Vegan diet which is absence of animal products including meat, dairy and eggs. Eat to Live by Joel Furman MD gives excellent recipes and recommendations for those inclined.

Carbohydrates – Fatigue is common following any surgical procedure, but eating the right kinds of carbs can help restore your energy levels. Get carbs from high-fiber foods like whole grains, fruits and veggies, and beans and legumes. These foods will boost energy levels without causing constipation.

Fat – Healthy fats from olive oil, avocados, coconut oil, nuts and seeds will improve immune response and aid the body’s absorption of vitamins. Fat will also help increase energy levels after surgery.

Vitamins and Minerals – Perhaps the most important nutrients in your post-surgery diet are vitamins and minerals. Vitamin A (found in orange and dark green veggies like carrots, sweet potatoes, kale and spinach) and vitamin C (found in citrus fruits, berries, potatoes, tomatoes, melons, and sweet bell peppers) help with wound healing. Vitamin D (found in milk, fish, eggs, and fortified cereals) promotes bone health. Vitamin E (found in vegetable oils, nuts, beef liver, milk and eggs) protects the body from free radicals. Vitamin K (found in green leafy veggies, fish, liver and vegetable oils) is necessary for blood clotting.

Zinc – (found in meat, seafood, dairy and beans) and Iron (found in meat and poultry, beans, apricots, eggs, whole grains and iron-fortified cereals) are also helpful for wound healing and energy following surgery.

Water – In addition to eating foods that are rich in fiber, protein, healthy fats, carbohydrates, vitamins and minerals, you must stay hydrated after surgery. Proper hydration isn’t only necessary for healing, but may also be necessary to help your body absorb medications following surgery. Be sure to drink at least eight glasses of water every day after surgery to stay hydrated.

The foods you should and shouldn’t eat can vary depending on the type of surgery and any medications you may be on so speak with your surgeon about your specific post-surgery dietary questions.

When Can I Take a Shower?

You may take a shower the day after surgery. Baths are typically fine the day after surgery if you desire. Make sure you have someone around to help you should you need assistance. If you are experiencing discomfort a sponge bath is a fine substitute.

How Should I Care For My Incisions?

Keep your abdominal incisions clean and dry. No special creams or ointments are needed. Your incisions are closed with a suture underneath your skin, which will dissolve on its own. It is then covered with a surgical-grade liquid band-aid. This protects the incision and will stay in place for up to two weeks or longer. The glue can be removed after two weeks by applying some Vaseline to the glue for several minutes and then using soap and water and gentle scrubbing with a washcloth after two weeks. A small amount of bleeding at the incision sites is not uncommon. If it persists, call your doctor. Once the glue is removed it is OK to apply Neosporin to the incisions if they are red or inflamed. If you notice sutures poking through the skin you can trim them with nail clippers and/or see your surgeon.

How Long Will I Have Bleeding After Surgery?

Vaginal spotting may last for several weeks after gynecological surgery. Call the office if you have heavy bleeding, increasing bleeding, a foul odor, or if you have urinary or rectal bleeding. Removal of ovarian cysts or other gynecological procedures may cause your period to come within a few days after surgery.

I Have Large Bruise Near My Incision, Is That Normal?

Some patients will develop bruises at the incision sites. The incision sites are made by “trocars”, a plastic sleeve that is used for access during the surgery for the camera and for instruments. Sometimes these trocars cut tiny vessels just beneath the skin that cause limited bleeding. Even under the best of circumstances, it is sometimes impossible to see these small vessels. A bruise will develop that will resolve. Those patients with very large masses or fibroids may also develop bleeding at the incisions that can be more extensive due to longer manipulation of the trocar sites. Rarely, this bleeding can be very extensive, leading to a large bruise that tracts to the groin area. Please note that this type of bleeding almost always resolves. Pain or warmth may develop from the blood under the skin. Use Motrin 600 mg every six hours or 800 mg every eight hours to relieve the pain.

How Much Pain Will I Have After Surgery?

Incision – Pain around the incision sites is not uncommon, and will resolve over several days. Most patients describe pain as minimal or moderate, and will improve daily.

Pelvic and Rectal – Some patients describe pressure and pain with urination or with bowel movements. These symptoms resolve and are due to irritation to the rectum and bladder from the surgical procedure, and will resolve with time.

Chest and Shoulder – If you had laparoscopic surgery, the carbon dioxide gas used to insufflate the abdomen during the procedure (so the surgeon can see) will irritate the phrenic nerve in some patients, leading to mild to severe pain. This nerve tracks pain impulses from the lining of the chest cavity. The pain can occur during deep breaths. This resolves within two to three days, and is not worrisome. If the pain is extreme or does not resolve, a visit to the local ER is important to rule out other causes of chest pain, such as heart or lung issues.

Sore Throat – Some patients will have a sore throat from the tube that is placed during anesthesia. Throat lozenges or warm tea will help soothe the discomfort, and this will resolve within a few days.

General – Pain should resolve over time, and will get better every day. If pain persists or becomes worse, a visit to the ER at the hospital where the procedure was performed is recommended.

How Should I Manage My Pain After Surgery?

You will be given a prescription for Motrin and a narcotic (Percocet, Norco or Dilaudid) at the hospital prior to your discharge. To be effective, Motrin should be used in doses of 600 mg every six hours, or 800 mg every eight hours. Narcotics should be used sparingly since they will cause constipation. The first several days following surgery, most patients use mainly Motrin during the day, with use of a narcotic sometimes at night to help with sleep. Using a heating pad on the lower abdomen is safe. Coughing can be uncomfortable initially because of abdominal discomfort. Placing a pillow on the abdomen to support your abdomen while coughing can be helpful.

Is It Normal to Have Swelling?

Abdominal – Some degree of abdominal distension (swelling) is to be expected after surgery. This is due to distension of the intestines, and resolves over time. It is usually mild to moderate only.

Extremities – Swelling of the legs and sometimes arms is not uncommon after surgery. This is due to increased fluid given during the procedure. This will resolve over several days. If you notice persistent or increasing swelling, tenderness to the calf or calf pain, please call the office immediately. If one leg is more swollen and red than the other you should be evaluated by your surgeon or in the emergency room because of the risk of a blood clot in your leg (DVT) that can be life threatening.

I Have Constipation, What Should I Do?

Constipation is common after surgery and usually resolves with time and/or treatment. Constipation means that you do not have a bowel movement regularly or that stools are hard or difficult to pass. Constipation can be made worse by narcotic pain medications or decreased activity or decreased fluid intake.

If you are having vomiting in addition to constipation, or if your surgery involved the stomach or intestines, call your surgeon before using medications to treat constipation.

A common approach to constipation after surgery is to take a laxative (eg, magnesium hydroxide [milk of magnesia]) or fiber supplement (eg, psyllium [Metamucil, Hydrocil] or methylcellulose [Citrucel]); this can be taken with a stool softener (eg, docusate [Colace]).

If the initial treatment does not produce a bowel movement within 24 to 48 hours, the next step is to take a stimulant laxative that contains senna (e.g,, Black Draught, Ex-lax, Fletcher’s Castoria, Senokot) or bisacodyl (e.g,, Correctol, Doxidan, Dulcolax). Read the directions and precautions on the package before using these treatments.

If these treatments do not produce a bowel movement within 24 hours, you should call your healthcare provider for further advice.

Once the bowels begin to move, you may want to continue using a stool softener (e.g., docusate (Colace) or a non-stimulant laxative (e.g., MiraLAX/GlycoLax) on a daily basis to keep the stools soft. This treatment may be taken for as long as needed.

I Have Diarrhea, What Should I Do?

Diarrhea sometimes is caused by antibiotics and will resolve once the antibiotics are stopped. A probiotic such as lactobacillus can help with this process. Rarely, severe diarrhea can develop. Call your doctor if you have severe diarrhea, bloody diarrhea, or if your diarrhea is accompanied by fever or worsening pain.

I’m Nauseated, What Can I Do?

Anesthesia is the main cause for nausea immediately after surgery. After the first 24 hours, nausea is more likely caused by either your narcotic pain medication or your antibiotics. You will be sent home with nausea medication such as Phenergan or Zofran. If you are experiencing severe nausea, please call your doctor.

Will I Have Problems With My Bladder?

Is it normal if it hurts when I urinate? — If you have had vaginal surgery, you may feel a pulling sensation during urination or you may feel sore if the urine falls on vaginal stitches. It can be normal to urinate frequently after surgery. Call your surgeon if you have any of the following:

  • Burning with urination
  • Needing to urinate frequently or urgently and then urinating only a few drops
  • Temperature greater than 101ºF or 38ºC (measure with a thermometer)
  • Pain on one side of your upper back that continues for more than one hour or keeps coming back
  • Blood in your urine (you can check to see if this is just vaginal blood falling into the toilet by holding toilet tissue over your vagina)

What Should I Do if it is Difficult to Urinate?

Most women urinate at least every four to six hours, and sometimes more frequently. If you have not urinated for six or more hours (while you are awake) or if you feel the need to urinate and it will not come out, you should call your healthcare provider. Urinary retention is the inability to pass urine through the bladder.

A very small number of patients will develop this problem due to the anesthetic used for the surgery or if they had incontinence surgery. If you are sent home and are not able to pass urine, please go to a local emergency room. A catheter may be placed to allow the bladder to “rest” after the surgery, and will be removed several days later in the office. It is important to have this catheter placed to avoid injury to the bladder. If you have a self cath kit and instructions how to use it, you may do this instead of seeking medical care. (You can look at a video by Bard on Youtube called “Female Self-Cath Instructional video (animated) Magic3” or watch other available videos on cherokeewomenshealth.com or on YouTube.)

When Can I Resume Sex?

Intercourse should be avoided until cleared by your surgeon. If your surgery did not involve the vagina or cervix, intercourse can typically resume in two to three weeks. If you had a hysterectomy or surgery in the vagina, you should avoid intercourse for a minimum of eight weeks to allow the top of the vagina to fully heal. Make sure you are examined by your surgeon and cleared. Avoid deep penetration initially until you are completely comfortable. Clitoral orgasm (stimulating the clitoris without vaginal penetration) is typically fine after gynecological surgery if you desire unless you had surgery on your labia minora or majora (in which case you need to get clearance from your surgeon.)

January 31, 2017

woman with magnifying glass photoPhysical imperfections are usually visible to the naked eye. Flaws can range from minimal irregularities such as a receding hairline or having one eye slightly larger than the other. Others can be stark abnormalities such as a distorted limb or a blatant handicap. We base these deviations on our everyday observations of what we perceive as ‘normal’. However, when it comes to the more private area of our bodies, it may be more difficult to differentiate between normal and abnormal.

Pelvic appearance and health continue to remain private subjects for most. Typically, women don’t whip off their panties or take selfies of their lady parts in order to ask someone, “Am I normal down there?” In fact, a 2015 Australian study shows that 50% of women have no idea what a normal vagina looks like. 53% have never seen a real-life vagina other than their own, and 15% have only ever seen one in science videos.

The research continued to say that many women rely on pornographic material to compare their private parts to what they think might be the norm. Based on those often misconstrued observations, a staggering 1 in 7 women request labiaplasty because what they see on TV and elsewhere appears to be different from their own.

What Am I Supposed to Look Like? What is Considered ‘Normal’ Down There?
Unlike men, whose sexual organs are mostly external, the outer visible parts of your genitalia are limited to the vulva, which can be seen when facing a mirror standing up. Even those parts may be obscured by pubic hair unless you opt for a waxed or shaven appearance. The rest of your sexual organs are internal, and investigating them for possible problems can only be done by pulling back the labia or having your gynecologist discern any possible abnormalities during your annual checkup.

There are several parts to the vulva, but most women are concerned with the appearance of the following:

Mons pubis or mons veneris: The gently sloped shaven or unshaven mound you see when facing a mirror. The mound size depends on hormone levels and weight. The mons pubis enlarges at puberty and sinks at menopause due to estrogen levels. In some cases, sharp pains in this area can occur, sometimes during later stages of pregnancy or even after, and if this discomfort is excessive, you should consult your physician.

The appearance of the mons pubis is different from woman to woman and can fluctuate in size with weight, childbirth or during the aging process. If you find yours to be unsightly, monsplasty (a pubic lift) can reduce, lift or tighten sagging in this area, thus improving its size and appearance.

Labia majora: The two outer sides of the vulva called labia majora resemble pads or cheeks that are separated by lip-like tissue (pudendal cleft). These labia extend from the mons pubis all the way down to the base of the vulva and perineum. They consist of fatty tissue that contains oil and sweat glands.

A slight musty smell is normal, and you may even emit a somewhat metallic odor around menstruation. Foul smell or discharge should be checked. Labia majora size is different from one woman to the next. Just as you can have one foot bigger than the other, labial size varies and perfect symmetry is actually more unusual than the norm.

Color varies from a normal skin tone to a deep purple, just like your facial lips. However, should you develop cysts, new moles, lumps, ulcers, experience excessive pain, itching or any discomfort that is not eased by wearing looser or cotton lined underwear, consult your physician.
A prominent labia may sometimes result in what is referred to as ‘camel toe’, where the pudendal cleft of the labia can be seen through tighter clothing. You may find this extremely embarrassing, however, labiaplasty can correct this problem.

Labia minora: These are thinner inner lips that come into view when lightly spreading the labia majora apart. In some women, the labia minora can protrude from the labia majora and this is not an abnormality. As with labia majora, color differs from one woman to the next.

Clitoris: The small, knobby, sexually sensitive sponge-like tissue located on the anterior top of the vulva is your clitoris. The visible portion of the clitoris is about the size of a pencil eraser. It can either protrude or be nestled in tissue called a clitoral hood. Both are normal—much like belly buttons that vary from person to person. Some are embedded and referred to as innies while others, known as outies, may jut out. Sometimes, the clitoral hood may be too thick or protrude too much, causing chafing and discomfort. This may interfere with sexual pleasure and gratification. A procedure called clitoral hoodectomy can correct this, either for aesthetic purposes, for physical comfort or as a medical necessity.

Urethra: Located just below the clitoris and above the vagina, the urethra is the portal for urine to pass. It is about 1-½” long. Any swelling, discomfort, pain upon urination, lumps, abdominal pressure, blood in your urine, itching, discharge, discomfort during sex, or inflammation should be discussed with your doctor.

Vaginal opening (introitus): The channel leading to the vagina and its interior. Color varies and can range from a light pink hue to a deep wine color. Size and shape also differ from woman to woman. It can be cylindrical, round or oval. As with most of your genitalia, any discomfort, pain, difficulty with sex or urination, lumps, unusual bleeding, itching, discharge, foul smell, inflammation, visible protrusions of inner organs, or growths should be reported to your gynecologist.

Perineum: This is the small section of triangularly shaped fibro muscular tissue that begins at the base of the vulva and extends to the anus. The distance between the two can vary greatly from female to female. As with all lady parts, there are no set measurements that are considered ‘normal’ or ‘abnormal’.

The perineum serves as a structural support for several internal organs. It is also referred to as an erogenous zone.

The perineum may need to be surgically incised to allow for a safe delivery of a baby (episiotomy). It is then stitched and allowed to heal. Due to the trauma the perineum may suffer as a result of childbirth, women may experience complications (prolapse) later on that may require surgical intervention (perineoplasty). Should you experience bowel problems, incontinence, pain in the perineal area or in your thighs, back, abdomen or waist, speak to your doctor.

Anus: This is the end of the digestive tract and external opening that allows for fecal elimination. Depending on your skin tones, its color can range from pink to reddish brown. The opening is puckered and closed unless either eliminating fecal matter or inserting an object such as a finger or other probe.

If you experience pain, itching, difficulty or burning during a bowel movement, have uncontrollable bowel movements (fecal incontinence), notice blood, pus, swelling, a hard mass, any discharge or mucous, discuss this with your doctor.

I’ve Been Told I’m ‘Normal’ Down There But I Still Don’t Like the Way I Look. Do I Need to be ‘Abnormal’ to Qualify for Surgery?

Not at all. Mental health and physical health go hand in hand. If you’re not happy with your body and feel cosmetic GYN surgery can make you feel better about yourself and give you more confidence, there are a range of cosmetic procedures available to you. Dr. Michael Litrel (MD, FPMRS, FACOG) participates in RealSelf.com, an online forum on cosmetic treatments and aesthetic medicine. Not only is he highly skilled in performing cosmetic surgery, his expertise includes any necessary pelvic surgery you may require. He can answer your questions frankly and honestly. He’ll even look at any ‘selfies’ you may wish to provide on RealSelf.com to help ascertain whether you may benefit from a cosmetic GYN procedure. Of course, an in-person consultation with Dr. Litrel is required prior to final decision making.REAL SELF LOGO

Just as a regular breast examination is essential to your health and well-being, it’s a good idea to take a peek down there from time to time. By looking at your body and listening to cues, you may counteract an issue before it interferes with your pelvic health.

Typically, if you feel good, have a satisfying sex life, suffer no discomfort, experience no unpleasant leaks or odors, or don’t suddenly have bits and pieces poking out that don’t seem to belong, you are perfectly ‘normal’ down there. Maintain your annual gynecological checkups and pay attention to any changes that concern you. To schedule an appointment with one of our FPMRS doctors, call 770.720.7733.

January 2, 2017

cosmetic vs reconstructive surgery photoAt Cherokee Women’s Health Specialists, we offer women the most modern, up-to-date solutions to gynecological problems that were formerly considered almost impossible to treat. Our OB-GYNs, urogynecologists, and Female Pelvic Medicine and Reproductive Surgeons are trained and credentialed to perform the many highly specialized cosmetic and reconstructive procedures that can dramatically change women’s lives and boost their psychological outlook.

Since the beginning of time, women have strived for ultimate beauty, perfect body symmetry and feminine wellness. Similarly, the world of medicine has dedicated itself to studying and repairing human anatomy, and to provide and maintain optimum overall health. It was inevitable that this combination would ultimately lead to a branch of medicine focused solely on women’s unique medical and cosmetic pelvic health issues.

From the time of the misguided, but well-intentioned Hippocrates, who believed in using a pomegranate as a pessary to cure prolapse, doctors have dissected, analyzed, and tried to understand the all-important female reproductive system, not just to insure the future of mankind, but to alleviate and correct those gender-specific disorders.

Eventually, as medical knowledge evolved, specialties such as gynecology, obstetrics, and urogynecology emerged. However, it wasn’t until 2014 that cosmetic and reconstructive surgery combined into a recognized and accredited field called Female Pelvic Medicine and Reconstructive Surgery (FPMRS). This subspecialty satisfied women’s dual concerns of both repair and cosmetically improved genital appearance without the need to see several different doctors for each individual requirement.

Today, complete hysterectomies and other radical surgeries are no longer the all-in-one solution to many of the pelvic health problems women encounter throughout their lifetimes. The days of dangerous, invasive surgeries that resulted in disfiguring scars and months of recuperation and rehabilitation are slowly being left behind in the last century where they belong.

Yet many women, especially older ones, are unaware of the many options available to them today. They suffer needlessly, assuming their disorders are simply something they must learn to live with. They shyly excuse themselves to leave a room to change an adult diaper, or to push back something that might be peeking out from their private areas, not realizing that a simple surgery with minimal scarring and recovery time is available and can easily correct the problem. Others are hesitant to indulge in sexual intimacy because they’re concerned their partner may find a particular irregularity distasteful.

What is the Difference Between Pelvic Cosmetic and Pelvic Reconstructive Surgery?

Cosmetic surgery is usually an elective procedure to correct physical flaws, irregularities or deformities, and is not typically done out of necessity, but more to improve appearance and elevate self-confidence. It can also reverse many physical age-related effects, providing a more youthful rejuvenation to the area.

Reconstructive surgery is done for medical, and sometimes life threatening issues. It corrects damage to the pelvic area, and usually restores function, stability, sensation, and position, reverting the reproductive system to its pre-trauma state.

Can Pelvic Reconstructive Surgery Also be Cosmetically Beneficial?

It certainly can! While repairing damage that requires necessary tightening or trimming, reconstructive surgery can also automatically provide a more visually appealing and youthful look. Also, in many cases, as reconstructive surgery is being performed, an elective cosmetic procedure can be done simultaneously as well.

What are the Different Cosmetic Surgeries and Reconstructive Procedures you Offer?

There are a number of different procedures available to you for both physical wellness and aesthetic benefits.

Reconstructive Surgeries include:

  • Midurethral slings: This procedure quickly, easily and effectively corrects the problem of stress urinary incontinence, which is involuntary urine leakage when you cough, sneeze or laugh. Urinary incontinence may also occur during different activities. This is an outpatient procedure that can be completed in approximately 30 minutes.
  • Colposuspension: Used to treat stress urinary incontinence as well, colposuspension is a surgical procedure that requires restoring the shifted or fallen vagina to its original location. This can either be done by laparoscopic technique or via abdominal incision.
  • Posterior/anterior colporrhaphy: This vaginal wall defect repair corrects any protrusion of the bladder into the vagina (cystocele) or the rectum into the anus (rectocele). Both these problems are known as pelvic organ prolapse (POP), meaning organs are drooping from their regular place in the pelvic vault. POP can cause pelvic pain and pressure, vaginal bleeding, painful intercourse, back pain, bowel movement problems and incontinence.

Cosmetic Surgeries include:

  • Vaginal rejuvenation (Vaginoplasty): Vaginoplasty is a blanket term that encompasses several different procedures, both reconstructive and cosmetic. Cosmetically speaking, however, one of the procedures of vaginoplasty is vaginal rejuvenation which tightens, modifies, and/or reforms the shape of the vaginal tissue to achieve a younger appearance and ‘feel’. It can be described as a face lift of sorts for a woman’s genitals.
  • Labiaplasty: Labiaplasty reduces the size of the labia—usually the labia minora. If you have large or saggy labia, or are uncomfortable with any bulging that may show through tighter clothing, labiaplasty can give that area a trimmer appearance.

Cosmetic and Reconstructive Surgeries
ThermiVa: ThermiVa is a completely non-invasive, nonsurgical, drug and hormone- free vaginal rejuvenation treatment that restores vaginal health in many beneficial ways. Though it cannot actually be classified as ‘reconstructive’ in a surgical sense, temperature controlled heat administered via radio frequency energy rejuvenates interior and exterior vaginal tissue by stimulating new collagen growth. This process revitalizes the vagina to much of its former condition by reducing discomfort, providing lubrication, and eliminating laxity. ThermiVa can also correct incontinence and deliver support to the bladder, correcting many disorders caused by natural aging and childbirth, with added aesthetic advantages.

  • Perineoplasty: Though usually considered a reconstructive procedure, perineoplasty can also be cosmetic in the case of a deformed perineum. Perineoplasty corrects damage and defect in the perineum, the triangular section located between the anus and vagina, and serves an important role as a structural support for several reproductive organs. Typically, it can become impaired through childbirth, episiotomy, obesity or excess weight loss. Perineoplasty can correct issues such as scarring, excess skin, reduction in sexual pleasure, and can restore support to internal organs.
  • Hymenoplasty: Though this usually involves cosmetic restoration or creation of the ‘virginal’ tissue that may have been non-existent from birth, lost through trauma, sexual intercourse or other forms of rupture, hymenoplasty can also correct conditions such as imperforate, septate or microperforate hymen that can make intercourse, menstruation or tampon insertion difficult or impossible without surgical intervention.
  • Monsplasty (pubic lift): Reduces, tightens or lifts the pubic mound located just under your abdomen for a more feminine look.
  • Clitoral hood reduction: A thick or prominent clitoral hood may inhibit sensation and diminish sexual pleasure. A clitoral hood reduction can alleviate extreme discomfort, redness or irritation that can possibly lead to infection from constant chafing against clothing. Often, this procedure is accompanied by labiaplasty to shorten the vagina.
  • G-shot: G-shot is a treatment to enhance sexual pleasure, thus making it beneficial physically. G-shot can be administered by our pelvic health care providers.

Surgery Methods

  • Robotic surgery: This is a minimally invasive surgery that implements the use of a robotic arm to perform corrective surgery for such problems as pelvic cancerous tumors, fibroids, obstructions and masses. It is also used to ease pelvic pain and bleeding, and to rectify pelvic, rectal, vaginal vault and uterine prolapse. Today’s robotic surgery, under the practiced guidance of a specialist, can perform hysterectomies and endometrial excisions and resections. Due to its precision, robotic surgery offers wonderful benefits such as almost insignificant scarring, minimal discomfort or pain, rapid recovery, and less danger of infection.
  • Laparoscopic and single incision laparoscopic surgery: Apart from being a wonderful diagnostic tool, laparoscopy can correct many pelvic problems. A thin tube that is equipped with a light can be inserted into the body to probe for the cause of various problems within the reproductive system. It can also remove cysts, tumors, scarring (adhesions) and fibroids, as well as perform hysterectomies and tubal ligations. Laparoscopic surgery and can correct disorders such as incontinence and pelvic organ prolapse, leaves insignificant scarring, and allows for a much shorter recovery time with less risk of infection.

What is the Recovery Time for Most of These Surgeries You’ve Described?
Because of the less invasive methods we use today, like robotic and laser surgery, the recovery time is far shorter than most women may imagine. Some procedures only require one to three weeks of recuperation, others a little longer. Generally the longest recovery time is about three months. Your doctor will always provide you with aftercare instructions and any special precautions you may need to take.

The days of heavy handed scalpel wielding are becoming a thing of the past, giving way to treatments that were beyond our scope of imagination even 20 years ago. By today’s standards, yesterday’s methods seem almost barbaric in comparison. Yet many woman are still convinced that they are destined to endure the discomfort and changes Mother Nature sends their way, convinced that it is their destiny, or just a result of passing years.

In this day and age of open, frank, and honest dialogue, the word “vagina’ does not have to be whispered. Sex is no longer a marital ‘duty’ explained on the night prior to your wedding, but is a pleasurable experience you have every right to participate in and enjoy without discomfort or embarrassment. Nor is it a taboo subject to consider a lift, tuck, tightening or trim to an intimate zone if that change can allow you more self-confidence, less inhibition and additional ‘feel-good’ sensation.

We offer the physical, psychological, aesthetic and therapeutic means for you to achieve and maintain optimum pelvic health and confidence. At Cherokee Women’s Health Specialists, we not only listen and guide you in confidential privacy, but also communicate vital information regarding genital heath in public forums like Real Self, so that you can always be informed and make knowledgeable choices regarding your body.

The procedures covered in this article are only a partial and generalized list of the many various services we offer. The pelvic structure is a complicated myriad of bone, tissue, fiber, blood, organs, and cartilage, and the possible problems that can affect your wellness are equally complex. That is why we treat each person who comes to us with the individual attention their personal issues deserve.

If you have additional questions on cosmetic or reconstructive surgery, or to book an appointment, call 770.720.7733.

December 6, 2016

gspot-happy-woman-photoFor many women, the genital area and its many complicated parts still remain a mystery, often depriving them of the many delightful sensations they are capable of enjoying.

Our specialists at Cherokee Women’s Health are aware of the possible inhibitions you may have when it comes to asking what you might consider embarrassing questions. Simply admitting to exploring your own body may seem like a taboo subject, but to us, it’s a very natural and healthy practice, so we welcome any questions you may have regarding erogenous areas of your body such as the G-Spot.

What is the G-Spot and Where is It?
The G-Spot, or Gräfenberg spot, is an internal area located inside the entrance of a woman’s vagina. Named for a German gynecologist, Ernst Gräfenberg, who also invented the intrauterine device (IUD), the G-Spot is believed to be an extremely sensitive nerve bundle that, when aroused, can result in a profound, thrilling orgasm, sometimes culminating in female ejaculation.

Although the G-Spot varies slightly in location from one woman to the next, it is usually situated 2 to 3 inches upwards on the front wall inside the vagina. Some theorize that it is part of the prostate, while others believe it to be an extension of the clitoris, which extends up to four inches into the vagina.

Does Every Woman Have a G-Spot?
There is some controversy on the subject. Some sexologists and doctors say no, while others say with absolute certainly that, yes, it is present in all woman. If you’ve ever achieved G-Spot orgasm, you know it exists. It is likely that the reason for any doubt may be because of the G-Spot’s location in your body, which varies a little from woman to woman, making it tricky to pinpoint sometimes. As well, it cannot always be accessed and stimulated with normal penile penetration in the traditional missionary position. Rear entry vaginal penetration, or the woman on top, (‘cowgirl’) position are two examples you may wish to try. Sometimes, it just requires a little imagination, practice, and/or the introduction of oral, manual or artificial methods to achieve G-Spot gratification.

You Mentioned Female Ejaculation. Isn’t That Something Only Men Do?

No, some women are capable of ejaculating fluid during a G-Spot climax, and there is nothing harmful or unusual about it. It’s not known for certain if this happens because the G-Spot is an extension of the clitoris, which becomes engorged during sexual activity, or if the fluid is expelled by the woman’s prostatic-like glands that are situated in the urethral sponge, a part of the inner clitoral structure.

Am I Abnormal if I’ve Never Experienced This?
Absolutely not! It is still difficult for many women to achieve orgasm, whether it be through clitoral, vaginal or G-Spot stimulation. There are many factors that can prevent a woman from enjoying full and satisfying intimacy, and these can be both psychological and/or physical. It’s our job to determine which might be preventing you from doing so, and to help you in any way we can. If a pelvic examination shows no abnormalities, then some of the following reasons may be preventing you from enjoying the full, stirring benefits of G-Spot orgasm
Inhibitions such as nervousness or sexual taboo beliefs:

  • Insufficient lubrication
  • Improper positioning
  • Minimal or no foreplay
  • Rough manipulation
  • Lack of pressure during stimulation
  • Lack of candid verbal or manual guidance between partners.

Is There Anything Else You Can Do to Help Me Experience G-Spot Pleasure Regularly?
Yes, we can. If we find there are no physical or psychological reasons preventing you from achieving G-Spot satisfaction, a procedure called G-Spot amplification (also known as G-Shot or GSA) enhances sexual arousal and gratification.

Our experts are fully qualified to administer this quick, safe, and painless procedure which injects a harmless filler that allows the G-Spot to extend lower into the vagina, making it more accessible and easier to stimulate. The effects have proven to be highly successful, and can last anywhere from three to five months, allowing women to enjoy the delightful benefits and gratification of G-Spot orgasms.

Sexual pleasure is a personal experience with individual preferences. What impassions one woman may not necessarily excite another, and that includes attaining climax through G-Spot stimulation. We are always here to help you and to discuss your concerns regarding intimacy and other feminine health issues that you may be dealing with.

If you have any questions about your sexual health, call us today for an appointment at 770.720.7733.

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“Dr. Litrel was a fantastic doctor. I had my first exam with him, although at first I was skeptical about a male doctor for my GYN. But after I met him I’m glad I kept an open mind, and I couldn’t have dreamed up a better doctor. He cares about you as a person and not just a patient. The front desk ladies and nurses were very friendly and it’s a great office, very clean and not intimidating. I highly recommend Cherokee Women’s Health.”
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