Author: runels

  • The Gap

  • O-Shot® (Orchid Shot®) Could Decrease Chances of Cancer

    O-Shot® (Orchid Shot®) Could Decrease Chances of Cancer

    The following research showed that our O-Shot® techniques using PRP could decrease the chances of the development of squamous cell carcinoma in women suffering from lichen sclerosus.

    Over a period of about nine years, none of the 319 women followed developed squamous cell carcinoma after treatment with PRP.

    =>Here’s the research to read as a pdf<–

    =>Where to find a physician offering the procedure in your area<–

    -> Where your physician can find more information (click) about the procedure (the web page you are reading now is only for education; your physician (in consultation with you) can best determine your treatment.

    -> Here’s where you can calculate your Female Sexual Function Index (free online test)<–

    Here’s more research about PRP and it’s benefit for lichen sclerosus…

    • Casabona, Francesco, Ilaria Gambelli, Federica Casabona, Pierluigi Santi, Gregorio Santori, and Ilaria Baldelli. “Autologous Platelet-Rich Plasma (PRP) in Chronic Penile Lichen Sclerosus: The Impact on Tissue Repair and Patient Quality of Life.” International Urology and Nephrology 49, no. 4 (April 2017): 573–80. https://doi.org/10.1007/s11255-017-1523-0.
    • Casabona, Francesco, Virginia Priano, Valerio Vallerino, Angela Cogliandro, and Giorgio Lavagnino. “New Surgical Approach to Lichen Sclerosus of the Vulva: The Role of Adipose-Derived Mesenchymal Cells and Platelet-Rich Plasma in Tissue Regeneration.” Plastic and Reconstructive Surgery 126, no. 4 (2010): 210e–11.
    • Cattaneo, A., P. Carli, A. De Marco, L. Sonni, G. Bracco, A. De Magnis, and G. L. Taddei. “Testosterone Maintenance Therapy. Effects on Vulvar Lichen Sclerosus Treated with Clobetasol Propionate.” The Journal of Reproductive Medicine 41, no. 2 (February 1996): 99–102.
    • Chin, Simone, James Scurry, Jennifer Bradford, Geoffrey Lee, and Gayle Fischer. “Association of Topical Corticosteroids With Reduced Vulvar Squamous Cell Carcinoma Recurrence in Patients With Vulvar Lichen Sclerosus.” JAMA Dermatology 156, no. 7 (July 1, 2020): 813–14. https://doi.org/10.1001/jamadermatol.2020.1074.
    • Franic, D., Z. Iternička, and M. Franić-Ivanišević. “Platelet-Rich Plasma (PRP) for the Treatment of Vulvar Lichen Sclerosus in a Premenopausal Woman: A Case Report.” Case Reports in Women’s Health 18 (April 2018): e00062. https://doi.org/10.1016/j.crwh.2018.e00062.
    • Garrido-Colmenero, Cristina, Carmen María Martínez-Peinado, Manuel Galán-Gutiérrez, Virginia Barranco-Millán, and Ricardo Ruiz-Villaverde. “Successful Response of Vulvar Lichen Sclerosus with NB-UVB.” Dermatologic Therapy 34, no. 2 (2021): e14801. https://doi.org/10.1111/dth.14801.
    • Goldstein, Andrew T., Michelle King, Charles Runels, Meghan Gloth, and Richard Pfau. “Intradermal Injection of Autologous Platelet-Rich Plasma for the Treatment of Vulvar Lichen Sclerosus.” Journal of the American Academy of Dermatology 76, no. 1 (January 2017): 158–60. https://doi.org/10.1016/j.jaad.2016.07.037.
    • Goldstein, Andrew T., Leia Mitchell, Vaishnavi Govind, and Debra Heller. “A Randomized Double-Blind Placebo Controlled Trial of Autologous Platelet Rich Plasma Intradermal Injections for the Treatment of Vulvar Lichen Sclerosus.” Journal of the American Academy of Dermatology, January 2019. https://doi.org/10.1016/j.jaad.2018.12.060.
    • Goodchild, Sophie. “How Kim Kardashian’s Vampire Facial Could Provide Relief to 1m Women.” Mail Online, November 5, 2022. https://www.dailymail.co.uk/health/article-11393613/How-Kim-
    • Kardashians-vampire-facial-provide-relief-1m-British-women.html.
    • Gulin, Sandra Jerkovic, Filippa Lundin, and Oliver Seifert. “Comorbidity in Patients with Lichen Sclerosus: A Retrospective Cohort Study.” European Journal of Medical Research 28, no. 1 (September 11, 2023): 338. https://doi.org/10.1186/s40001-023-01335-9.
    • Gunthert, A.R., K. Duclos, B.G. Jahns, and et al. “Clinical Scoring System for Vulvar Lichen Sclerosus.” J Sex Med 9 (2012): 2342–50.
    • Gutierrez-Ontalvilla, P., F. Giner, L. Vidal, and M. Iborra. “The Effect of Lipofilling and Platelet-Rich Plasma on Patients with Moderate-Severe Vulvar Lichen Sclerosus Who Were Non-Responders to Topical Clobetasol Propionate: A Randomized Pilot Study.” Aesthetic Plastic Surgery 46, no. 5 (October 2022): 2469–79. https://doi.org/10.1007/s00266-021-02718-1.
    • Krogh, G von, K Dahlman-Ghozlan, and S Syrjänen. “Potential Human Papillomavirus Reactivation Following Topical Corticosteroid Therapy of Genital Lichen Sclerosus and Erosive Lichen Planus.” Journal of the European Academy of Dermatology and Venereology : JEADV 16, no. 2 (March 2002): 130–33. http://www.ncbi.nlm.nih.gov/pubmed/12046814.
    • Lee, A., J. Bradford, and G. Fischer. “Long-Term Management of Adult Vulvar Lichen Sclerosus: A Prospective Cohort Study of 507 Women.” JAMA Dermatol 151 (2015): 1061–67.
    • Marnach, Mary L., and Rochelle R. Torgerson. “Therapeutic Interventions for Challenging Cases of Vulvar Lichen Sclerosus and Lichen Planus.” Obstetrics & Gynecology 138, no. 3 (September 2021): 374–78. https://doi.org/10.1097/AOG.0000000000004498.
    • Mitchell, Leia, Andrew T. Goldstein, Debra Heller, Theodora Mautz, Chelsea Thorne, So Yeon Joyce Kong, Maria E. Sophocles, Hillary Tolson, and Jill M. Krapf. “Fractionated Carbon Dioxide Laser for the Treatment of Vulvar Lichen Sclerosus: A Randomized Controlled Trial.” Obstetrics & Gynecology 137, no. 6 (June 2021): 979–87. https://doi.org/10.1097/AOG.0000000000004409.
    • “New Surgical Approach to Lichen Sclerosus of the Vulva: The Role of Adipose-Derived Mesenchymal Cells and Platelet-Rich Plasma in Tissue Regeneration. Casabona F1, Priano V.” Plast Reconstr Surg., n.d.
    • Origoni, M., D. Ferrari, M. Rossi, F. Gandini, M. Sideri, and A. Ferrari. “Topical Oxatomide: An Alternative Approach for the Treatment of Vulvar Lichen Sclerosus.” International Journal of Gynecology & Obstetrics 55, no. 3 (December 1996): 259–64. https://doi.org/10.1016/S0020-7292(96)02768-3.
    • Pensato, Rosita, and Simone La Padula. “The Effect of Lipofilling and Platelet-Rich Plasma on Patients with Moderate–Severe Vulvar Lichen Sclerosus Who Were Non-Responders to Topical Clobetasol Propionate: A Randomized Pilot Study.” Aesthetic Plastic Surgery, May 31, 2022. https://doi.org/10.1007/s00266-022-02947-y.
    • Posey, Kathleen, and Charles Runels. “In-Office Surgery and Use of Platelet Rich Plasma for Treatment of Vulvar Lichen Sclerosus to Alleviate Painful Sexual Intercourse.” Journal of Lower Genital Tract Disease 19, no. 3 (July 2015): S1–25. https://doi.org/10.1097/lgt.0000000000000121.
    • Qing, Chun, Xiaoyong Mao, Gaoqing Liu, Yibin Deng, and Xiaokun Yang. “The Efficacy and Safety of 5-Aminolevulinic Acid Photodynamic Therapy for Lichen Sclerosus: A Meta Analysis.” Indian Journal of Dermatology 68, no. 1 (2023): 1–7. https://doi.org/10.4103/ijd.ijd_925_21.
    • Tedesco, M., G. Pranteda, G. Chichierchia, and et al. “The Use of PRP (Platelet-Rich Plasma) in Patients Affected by Genital Lichen Sclerosus: Clinical Analysis and Results.” J Eur Acad Dermatol Venereol 33 (2019): e58–59.
    • Vittrup, G., L. Mørup, T. Heilesen, D. Jensen, S. Westmark, and D. Melgaard. “The Quality of Life and Sexuality in Women with Lichen Sclerosus – A Cross Sectional Study.” Clinical and Experimental Dermatology n/a, no. n/a. Accessed August 31, 2021. https://doi.org/10.1111/ced.14893.
  • Female Sex Muscles Part 2

    Find the nearest provider of the O-Shot® combined with an Emsella treatment<–

    Physicians apply for training to provide the O-Shot® procedure<–

    More about Emsella<–

    References

    Brækken, Ingeborg H., Memona Majida, Marie Ellström Engh, and Kari Bø. “Can Pelvic Floor Muscle Training Improve Sexual Function in Women with Pelvic Organ Prolapse? A Randomized Controlled Trial.” The Journal of Sexual Medicine 12, no. 2 (February 1, 2015): 470–80. https://doi.org/10.1111/jsm.12746.
    Celenay, Seyda Toprak, Yasemin Karaaslan, and Enver Ozdemir. “Effects of Pelvic Floor Muscle Training on Sexual Dysfunction, Sexual Satisfaction of Partners, Urinary Symptoms, and Pelvic Floor Muscle Strength in Women with Overactive Bladder: A Randomized Controlled Study.” The Journal of Sexual Medicine 19, no. 9 (September 1, 2022): 1421–30. https://doi.org/10.1016/j.jsxm.2022.07.003.
    Edenfield, Autumn L., Pamela J. Levin, Alexis A. Dieter, Cindy L. Amundsen, and Nazema Y. Siddiqui. “Sexual Activity and Vaginal Topography in Women with Symptomatic Pelvic Floor Disorders.” The Journal of Sexual Medicine 12, no. 2 (February 1, 2015): 416–23. https://doi.org/10.1111/jsm.12716.
    Ferreira, Clicia Raiane Galvão, Wenderk Martins Soares, Caren Heloise da Costa Priante, Natália de Souza Duarte, Cleuma Oliveira Soares, Kayonne Campos Bittencourt, Giovana Salomão Melo, et al. “Strength and Bioelectrical Activity of the Pelvic Floor Muscles and Sexual Function in Women with and without Stress Urinary Incontinence: An Observational Cross-Sectional Study.” Healthcare (Basel, Switzerland) 11, no. 2 (January 6, 2023): 181. https://doi.org/10.3390/healthcare11020181.
    Lutz, Robert H., Justin E. King, Timothy C. Sell, Charlotte L. Early, and Emma M. Nguyen. “Platelet-Rich Plasma Treatment of a Quadriceps Tendon Tear in a Collegiate Basketball Athlete.” Current Sports Medicine Reports 22, no. 11 (November 2023): 370–74. https://doi.org/10.1249/JSR.0000000000001115.
    Omodei, Michelle Sako, Lucia Regina Marques Gomes Delmanto, Eduardo Carvalho-Pessoa, Eneida Boteon Schmitt, Georgia Petri Nahas, and Eliana Aguiar Petri Nahas. “Association Between Pelvic Floor Muscle Strength and Sexual Function in Postmenopausal Women.” The Journal of Sexual Medicine 16, no. 12 (December 1, 2019): 1938–46. https://doi.org/10.1016/j.jsxm.2019.09.014.

    Regarding PRP for Muscle Strength & Repair

    Agarwal, Varsha, Ambika Gupta, Harneet Singh, Mala Kamboj, Harsha Popli, and Suman Saroha. “Comparative Efficacy of Platelet-Rich Plasma and Dry Needling for Management of Trigger Points in Masseter Muscle in Myofascial Pain Syndrome Patients: A Randomized Controlled Trial.” Journal of Oral & Facial Pain and Headache, November 28, 2022. https://doi.org/10.11607/ofph.3188.
    Aguilar-García, Daniel, J. Andrés Fernández-Sarmiento, María del Mar Granados Machuca, Juan Morgaz Rodríguez, Pilar Muñoz Rascón, Rocío Navarrete Calvo, Yolanda Millán Ruiz, et al. “Histological and Biochemical Evaluation of Plasma Rich in Growth Factors Treatment for Grade II Muscle Injuries in Sheep.” BMC Veterinary Research 18, no. 1 (November 12, 2022): 400. https://doi.org/10.1186/s12917-022-03491-2.
    Bernuzzi, Gino, Federica Petraglia, Martina Francesca Pedrini, Massimo De Filippo, Francesco Pogliacomi, Michele Arcangelo Verdano, and Cosimo Costantino. “Use of Platelet-Rich Plasma in the Care of Sports Injuries: Our Experience with Ultrasound-Guided Injection.” Blood Transfusion 12, no. Suppl 1 (January 2014): s229–34. https://doi.org/10.2450/2013.0293-12.
    Bubnov, Rostyslav, Viacheslav Yevseenko, and Igor Semeniv. “Ultrasound Guided Injections of Platelets Rich Plasma for Muscle Injury in Professional Athletes. Comparative Study.,” n.d., 5.
    Graca, Flavia A., Anna Stephan, Benjamin A. Minden-Birkenmaier, Abbas Shirinifard, Yong-Dong Wang, Fabio Demontis, and Myriam Labelle. “Platelet-Derived Chemokines Promote Skeletal Muscle Regeneration by Guiding Neutrophil Recruitment to Injured Muscles.” Nature Communications 14, no. 1 (May 22, 2023): 2900. https://doi.org/10.1038/s41467-023-38624-0.
    Le, Adrian D.K., Lawrence Enweze, Malcolm R. DeBaun, and Jason L. Dragoo. “Platelet-Rich Plasma.” Clinics in Sports Medicine 38, no. 1 (January 2019): 17–44. https://doi.org/10.1016/j.csm.2018.08.001.
    Middleton, Kellie K, Victor Barro, Bart Muller, Satosha Terada, and Freddie H Fu. “Evaluation of the Effects of Platelet-Rich Plasma (PRP) Therapy Involved in the Healing of Sports-Related Soft Tissue Injuries.” The Iowa Orthopaedic Journal 32 (2012): 150–63. http://www.ncbi.nlm.nih.gov/pubmed/23576936.
    Moraes, Vinícius Y, Mário Lenza, Marcel Jun Tamaoki, Flávio Faloppa, and João Carlos Belloti. “Platelet-Rich Therapies for Musculoskeletal Soft Tissue Injuries.” The Cochrane Database of Systematic Reviews 12 (January 2013): CD010071. https://doi.org/10.1002/14651858.CD010071.pub2.

    Regarding Emsella

    Azparren, Javier, and Judson Brandeis. “HIFEM PROCEDURE ENHANCES QUALITY OF LIFE OF ELDERLY MEN WITH POST-PROSTATECTOMY INCONTINENCE,” n.d., 6.
    Evans, Kimberly, and Julene B Samuels. “FEMALE URINARY INCONTINENCE AND SEXUAL FUNCTION AFTER THE HIFEM® PROCEDURE,” n.d., 2.
    Gözlersüzer, Özlem, Bestami Yalvaç, and Basri Çakıroğlu. “Investigation of the Effectiveness of Magnetic Field Therapy in Women with Urinary Incontinence: Literature Review.” Urologia Journal, January 9, 2022, 03915603211069010. https://doi.org/10.1177/03915603211069010.
    He, Qing, Kaiwen Xiao, Liao Peng, Junyu Lai, Hong Li, Deyi Luo, and Kunjie Wang. “An Effective Meta-Analysis of Magnetic Stimulation Therapy for Urinary Incontinence.” Scientific Reports 9 (June 24, 2019): 9077. https://doi.org/10.1038/s41598-019-45330-9.
    Hwang, Ui-Jae, Min-Seok Lee, and Oh-Yun Kwon. “Effect of Pelvic Floor Muscle Electrical Stimulation on Lumbopelvic Control in Women with Stress Urinary Incontinence: Randomized Controlled Trial.” Physiotherapy Theory and Practice 0, no. 0 (April 18, 2022): 1–10. https://doi.org/10.1080/09593985.2022.2067508.
    Samuels, Julene B. “HIFEM TECHNOLOGY – THE NON-INVASIVE TREATMENT OF URINARY INCONTINENCE,” n.d., 7.
    Samuels, Julene B, and Kimberly Evans. “FEMALE SEXUAL FUNCTION AND URINARY INCONTINENCE AFTER HIFEM® PROCEDURE,” n.d., 1.
    Samuels, Julene B., Andrea Pezzella, Joseph Berenholz, and Red Alinsod. “Safety and Efficacy of a Non‐Invasive High‐Intensity Focused Electromagnetic Field (HIFEM) Device for Treatment of Urinary Incontinence and Enhancement of Quality of Life.” Lasers in Surgery and Medicine 51, no. 9 (November 2019): 760–66. https://doi.org/10.1002/lsm.23106.
    ———. “Safety and Efficacy of a Non‐Invasive High‐Intensity Focused Electromagnetic Field (HIFEM) Device for Treatment of Urinary Incontinence and Enhancement of Quality of Life.” Lasers in Surgery and Medicine 51, no. 9 (November 2019): 760–66. https://doi.org/10.1002/lsm.23106.
    Silantyeva, Elena, Dragana Zarkovic, Evgeniia Astafeva, Ramina Soldatskaia, Mekan Orazov, Marina Belkovskaya, Mark Kurtser, and Academician of the Russian Academy of Sciences. “A Comparative Study on the Effects of High-Intensity Focused Electromagnetic Technology and Electrostimulation for the Treatment of Pelvic Floor Muscles and Urinary Incontinence in Parous Women: Analysis of Posttreatment Data.” Female Pelvic Medicine & Reconstructive Surgery 27, no. 4 (April 2021): 269–73. https://doi.org/10.1097/SPV.0000000000000807.
    ———. “A Comparative Study on the Effects of High-Intensity Focused Electromagnetic Technology and Electrostimulation for the Treatment of Pelvic Floor Muscles and Urinary Incontinence in Parous Women: Analysis of Posttreatment Data.” Female Pelvic Medicine & Reconstructive Surgery 27, no. 4 (April 2021): 269–73. https://doi.org/10.1097/SPV.0000000000000807.

    Regarding O-Shot® Procedure for Sexual Function

    Cardozo, Linda, and David Staskin, eds. Textbook of Female Urology and Urogynecology. Fourth edition. Boca Raton: CRC Press, Taylor & Francis Group, 2017.
    Handy, Ariel B., Amelia M. Stanton, and Cindy M. Meston. “Understanding Women’s Subjective Sexual Arousal Within the Laboratory: Definition, Measurement, and Manipulation.” Sexual Medicine Reviews 6, no. 2 (2018): 201–16. https://doi.org/10.1016/j.sxmr.2017.11.001.
    Hersant, Barbara, Mounia SidAhmed-Mezi, Yazid Belkacemi, Franklin Darmon, Sylvie Bastuji-Garin, Gabrielle Werkoff, Romain Bosc, et al. “Efficacy of Injecting Platelet Concentrate Combined with Hyaluronic Acid for the Treatment of Vulvovaginal Atrophy in Postmenopausal Women with History of Breast Cancer.” Menopause 25, no. 10 (2018): 1. https://doi.org/10.1097/GME.0000000000001122.
    Jb, Neto. “O-Shot: Platelets Rich Plasma in Intimate Female Treatment,” 2017, 4.
    Jhang, Jia-Fong, Shu-Yu Wu, Teng-Yi Lin, and Hann-Chorng Kuo. “Repeated Intravesical Injections of Platelet-Rich Plasma Are Effective in the Treatment of Interstitial Cystitis: A Case Control Pilot Study.” LUTS: Lower Urinary Tract Symptoms 11, no. 2 (2019): O42–47. https://doi.org/10.1111/luts.12212.
    Long, Cheng-Yu. “A Pilot Study: Effectiveness of Local Injection of Autologous Platelet-Rich Plasma in Treating Women with Stress Urinary Incontinence.” Scientific Reports, 2021, 9.
    Matz, Ethan L, Amy M Pearlman, and Ryan P Terlecki. “Safety and Feasibility of Platelet Rich Fibrin Matrix Injections for Treatment of Common Urologic Conditions.” Investigative and Clinical Urology 59, no. 1 (January 2018): 61–65. https://doi.org/10.4111/icu.2018.59.1.61.
    Merhi, Zaher, Serin Seckin, and Marco Mouanness. “REPRODUCTIVE ENDOCRINOLOGY: CASE STUDY Intraovarian PRP Injection Improved Hot Flashes in a Woman With Very Low Ovarian Reserve.” Accessed July 7, 2021. https://doi.org/10.1007/s43032-021-00655-7.
    Moccia, Felice, Paola Pentangelo, Alessandra Ceccaroni, Antonio Raffone, Luigi Losco, and Carmine Alfano. “Injection Treatments for Vulvovaginal Atrophy of Menopause: A Systematic Review.” Aesthetic Plastic Surgery, August 14, 2023. https://doi.org/10.1007/s00266-023-03550-5.
    Nikolopoulos, Kostis I., Vasilios Pergialiotis, Despina Perrea, and Stergios K. Doumouchtsis. “Restoration of the Pubourethral Ligament with Platelet Rich Plasma for the Treatment of Stress Urinary Incontinence.” Medical Hypotheses 90 (May 1, 2016): 29–31. https://doi.org/10.1016/j.mehy.2016.02.019.
    Prodromidou, Anastasia, Themos Grigoriadis, and Stavros Athanasiou. “Platelet Rich Plasma for the Management of Urogynecological Disorders: The Current Evidence.” Current Opinion in Obstetrics & Gynecology Publish Ahead of Print (August 18, 2022). https://doi.org/10.1097/GCO.0000000000000820.
    Prodromidou, Anastasia, Dimitrios Zacharakis, Stavros Athanasiou, Athanasios Protopapas, Lina Michala, Nikolaos Kathopoulis, and Themos Grigoriadis. “The Emerging Role on the Use of Platelet-Rich Plasma Products in the Management of Urogynaecological Disorders.” Surgical Innovation, April 28, 2021, 15533506211014848. https://doi.org/10.1177/15533506211014848.
    Runels, Charles. “A Pilot Study of the Effect of Localized Injections of Autologous Platelet Rich Plasma (PRP) for the Treatment of Female Sexual Dysfunction.” Journal of Women’s Health Care 03, no. 04 (2014). https://doi.org/10.4172/2167-0420.1000169.
    Sanoulis, Vasileios, Nikolaos Nikolettos, and Nikolaos Vlahos. “The Use of Platelet-Rich Plasma in the Gynaecological Clinical Setting. A Review.” 18, no. 3 (2019): 11.
    ———. “The Use of Platelet-Rich Plasma in the Gynaecological Clinical Setting. A Review.” Hellenic Journal of Obstetrics and Gynecology 18, no. 3 (July 3, 2019): 55–65. https://doi.org/10.33574/hjog.1766.
    Sharp, Gemma, Pascale Maynard, Christine A Hamori, Jayson Oates, David B Sarwer, and Jayashri Kulkarni. “Measuring Quality of Life in Female Genital Cosmetic Procedure Patients: A Systematic Review of Patient-Reported Outcome Measures.” Aesthetic Surgery Journal 40, no. 3 (February 17, 2020): 311–18. https://doi.org/10.1093/asj/sjz325.
    Zheng, Zhifang. “Materials Selection for the Injection into Vaginal Wall for Treatment of Vaginal Atrophy,” 2021, 11.
    Liu, Zhaoxue, Yuan Tang, Jiaojiao Liu, Ruting Shi, Michael Houston, Alvaro Munoz, Yingchun Zhang, and Xuhong Li. “Platelet-Rich Plasma Promotes Restoration of The Anterior Vaginal Wall for The Treatment of Pelvic Floor Dysfunction in Rats.” Journal of Minimally Invasive Gynecology, October 2022, S1553465022009463. https://doi.org/10.1016/j.jmig.2022.10.004.

  • The O-Shot® after Breast Cancer–a Sampling of Research

    Fat, when used for reconstruction, is usually mixed with PRP to improve survival. The following two articles show that when fat is used for reconstruction post-breast cancer, there is a trend toward fewer recurrences.


    Eichler, C., C. Baucks, J. Üner, C. Pahmeyer, D. Ratiu, B. Gruettner, W. Malter, and M. Warm. “Platelet-Rich Plasma (PRP) in Breast Cancer Patients: An Application Analysis of 163 Sentinel Lymph Node Biopsies.” Edited by Xin-yuan Guan. BioMed Research International 2020 (October 22, 2020): 1–7. https://doi.org/10.1155/2020/3432987.
    Kaoutzanis, Christodoulos, Minqiang Xin, Tiffany N.S. Ballard, Kathleen B. Welch, Adeyiza O. Momoh, Jeffrey H. Kozlow, David L. Brown, Paul S. Cederna, and Edwin G. Wilkins. “Autologous Fat Grafting After Breast Reconstruction in Postmastectomy Patients: Complications, Biopsy Rates, and Locoregional Cancer Recurrence Rates.” Annals of Plastic Surgery 76, no. 3 (March 2016): 270–75. https://doi.org/10.1097/SAP.0000000000000561.

    Kronowitz, Steven J., Cosman Camilo Mandujano, Jun Liu, Henry M. Kuerer, Benjamin Smith, Patrick Garvey, Reshma Jagsi, Limin Hsu, Summer Hanson, and Vicente Valero. “Lipofilling of the Breast Does Not Increase the Risk of Recurrence of Breast Cancer: A Matched Controlled Study.” Plastic and Reconstructive Surgery 137, no. 2 (February 2016): 385–93. https://doi.org/10.1097/01.prs.0000475741.32563.50.

    Eichler, Christian, Jens Üner, Fabinshy Thangarajah, Julia Radosa, Max Zinser, Lotta Ada Fischer, Julian Puppe, Matthias Warm, Wolfram Malter, and Caroline Lenz. “Platelet-Rich Plasma (PRP) in Oncological Patients: Long-Term Oncological Outcome Analysis of the Treatment of Subcutaneous Venous Access Device Scars in 89 Breast Cancer Patients.” Archives of Gynecology and Obstetrics, April 4, 2022. https://doi.org/10.1007/s00404-022-06416-4.

    Since PRP has strong antibacterial qualities, and since those with breast cancer present a more inflammatory microbiota, the anti-bacterial effects may be partly responsible for the trend toward fewer recurrences.


    Urbaniak, Camilla, Gregory B. Gloor, Muriel Brackstone, Leslie Scott, Mark Tangney, and Gregor Reid. “The Microbiota of Breast Tissue and Its Association with Breast Cancer.” Edited by H. Goodrich-Blair. Applied and Environmental Microbiology 82, no. 16 (August 15, 2016): 5039–48. https://doi.org/10.1128/AEM.01235-16.


    More research regarding the O-Shot® procedure and dryness

    Saleh, Doaa M., and Rania Abdelghani. “Clinical Evaluation of Autologous Platelet Rich Plasma Injection in Postmenopausal Vulvovaginal Atrophy: A Pilot Study.” Journal of Cosmetic Dermatology n/a, no. n/a. Accessed March 9, 2022. https://doi.org/10.1111/jocd.14873.
    Samaie Nouroozi, Atefeh, Ashraf Alyasin, Ashraf Malek Mohammadi, Nili Mehrdad, Seyed Asadollah Mossavi, Mohammad Vaezi, atoosa Gharib, Ardeshir Ghavamzadeh, and Saeed Mohammadi. “Autologous Platelet-Released Growth Factor and Sexual Dysfunction Amendment: A Pilot Clinical Trial of Successful Improvement Sexual Dysfunction after Pelvic Irradiation.” Asian Pacific Journal of Cancer Prevention 20, no. 3 (March 1, 2019): 817–23. https://doi.org/10.31557/APJCP.2019.20.3.817.

    Zheng, Zhifang, Junfeiyang Yin, Biao Cheng, and Wenhua Huang. “Materials Selection for the Injection into Vaginal Wall for Treatment of Vaginal Atrophy.” Aesthetic Plastic Surgery 45, no. 3 (June 1, 2021): 1231–41. https://doi.org/10.1007/s00266-020-02054-w.


    Antibacterial Qualities of PRP

    Aggour, Reham L., and Lina Gamil. “Antimicrobial Effects of Platelet-Rich Plasma against Selected Oral and Periodontal Pathogens.” Polish Journal of Microbiology 66, no. 1 (April 3, 2017): 31–37. https://doi.org/10.5604/17331331.1235227.
    Cieslik-Bielecka, A., D. M. Dohan Ehrenfest, A. Lubkowska, and T. Bielecki. “Microbicidal Properties of Leukocyte- and Platelet-Rich Plasma/Fibrin (L-PRP/L-PRF): New Perspectives.” Journal of Biological Regulators and Homeostatic Agents 26, no. 2 Suppl 1 (2012).
    Sethi, Dalip, Kimberly E. Martin, Sangeeta Shrotriya, and Bethany L. Brown. “Systematic Literature Review Evaluating Evidence and Mechanisms of Action for Platelet-Rich Plasma as an Antibacterial Agent.” Journal of Cardiothoracic Surgery 16, no. 1 (September 28, 2021): 277. https://doi.org/10.1186/s13019-021-01652-2.
    Zhang, Wenhai, Yue Guo, Mitchell Kuss, Wen Shi, Amy L. Aldrich, Jason Untrauer, Tammy Kielian, and Bin Duan. “Platelet-Rich Plasma for the Treatment of Tissue Infection: Preparation and Clinical Evaluation.” Tissue Engineering. Part B, Reviews 25, no. 3 (June 1, 2019): 225–36. https://doi.org/10.1089/ten.teb.2018.0309


    Providers of the O-Shot® procedure<–

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    Apply for online training to provide the O-Shot® procedure<–

  • Female Genital Mutilation (FGM) Helped by the O-Shot® Procedure

    Gynecologist from Geneva Show That the O-Shot® Procedure Helps Women Suffering from Female Genital Mutilation

    News provided by
    Cellular Medicine Association
    April 14, 2023
    FAIRHOPE, AL, April 14, 2023 /PRNewswire/ — In March of 2023, Dr. E. Toganazzo, et. al, gynecologists from Geneva, Switzerland, published (in the Aesthetic Surgery Journal) their observations in a study treating women suffering sexual dysfunction following female genital mutilation (FGM). All five women were treated with surgical exposure of the clitoris followed by direct injection of the clitoris with Platelet Rich Plasma (PRP) using O-Shot® procedure injection techniques.

    After the treatment, all five women experienced “easier access and stimulation of their clitoris as well as improved sexual arousal, lubrication, and pleasure and claimed to be satisfied with their restored body image.”

    Platelet rich plasma has been known for at least two decades to help with the repair and restoration of nerve tissue. This is the most recent of other research papers showing the benefit of PRP for women suffering from FGM.

    Dr. Charles Runels (the inventor of the O-Shot® procedure) said, “These brilliant researchers made use of the power of what the body normally uses to heal—the growth factors in platelets, or PRP. Combining their expert surgical skills to restructure the scarring from FGM with injected PRP to restore nerve function and promote healing of the tissue is a very powerful combination that I think will bring hope to many women.”

    “When there is no encasing scar tissue to remove, other studies have shown that simply injecting the remnant clitoris (post-FGM) with PRP can help restore sexual function in some women. Nothing works all the time for all women, and there is still much work to be done to perfect the combination techniques, but our O-Shot® procedure is changing the lives of thousands of women who were without hope. I look forward to more physicians contributing to the much-needed research,” said Dr. Runels.

    Dr. Runels and his colleagues of the Cellular Medicine Association conduct and consult regarding research in the areas of esthetics, erectile dysfunction, urinary incontinence, orgasmic dysfunction, lichen sclerosus, & the treatment of scaring using blood-derived growth factors.

    Contact:
    Charles Runels, MD
    Medical Director
    Cellular Medicine Association

    888-920-5311 phone
    251-650-1251 fax
    DrRunels@Runels.com

    Find the nearest O-Shot® provider here<–

    Physicians apply for training for the O-Shot® procedure here<–

    https://CellularMedicineAssociation.org

    Further References Related to Platelet Rich Plasma (PRP) to Help Women Suffering from Female Genital Mutilation

    Regarding PRP to help women suffering from female genital mutilation…

    1. Birge, Özer, Aliye Nigar Serin, and Mehmet Sait Bakır. “Female Genital Mutilation/Cutting in Sudan and Subsequent Pelvic Floor Dysfunction.” BMC Women’s Health 21 (December 28, 2021): 430. https://doi.org/10.1186/s12905-021-01576-y.
    2. Botter, C, D Sawan, and M Sidahmed-Mezi. “Clitoral Reconstructive Surgery After Female Genital Mutilation/Cutting: Anatomy, Technical Innovations and Updates of the Initial Technique.” AJO-DO Clinical Companion 18 (2021): 996–1008. https://doi.org/10.1016/j.jsxm.2021.02.010.
    3. Dardeer, H.H.M., M.L. Mohamed, A.M. Elshahat, G.F. Mohammed, and A.M. Gadallah. “Platelet-Rich Plasma: An Effective Modality to Improve Sexuality in FGM/C.” Sexologies, June 2022, S1158136022000457. https://doi.org/10.1016/j.sexol.2022.05.002.
    4. Manin, Emily, Gianmarco Taraschi, Sarah Berndt, Begoña Martinez de Tejada, and Jasmine Abdulcadir. “Autologous Platelet-Rich Plasma for Clitoral Reconstruction: A Case Study.” Archives of Sexual Behavior, November 15, 2021. https://doi.org/10.1007/s10508-021-02172-9.
    5. Sadat Seidu, Anwar, Haruna Danamiji Osman, Kingsley Appiah Bimpong, and Kwame Afriyie. “Case Report Female Genital Mutilation/Cutting Resulting in Genital Tract Obstruction and Sexual Dysfunction: A Case Report and Literature Review,” 2021. https://doi.org/10.1155/2021/9986542.
    6. Sharif Mohamed, Fatima, Verina Wild, Brian D Earp, Crista Johnson-Agbakwu, and Jasmine Abdulcadir. “Clitoral Reconstruction After Female Genital Mutilation/Cutting: A&nbsp;Review of Surgical Techniques and Ethical Debate,” 2020. https://doi.org/10.1016/j.jsxm.2019.12.004.

    Regarding PRP to help to regrow nerve tissue…

    1. Chung, Eric. “Regenerative Technology to Restore and Preserve Erectile Function in Men Following Prostate Cancer Treatment: Evidence for Penile Rehabilitation in the Context of Prostate Cancer Survivorship.” Therapeutic Advances in Urology 13 (January 1, 2021): 17562872211026420. https://doi.org/10.1177/17562872211026421.
    2. Foy, Christian A., William F. Micheo, and Damien P. Kuffler. “Functional Recovery Following Repair of Long Nerve Gaps in Senior Patient 2.6 Years Posttrauma.” Plastic and Reconstructive Surgery. Global Open 9, no. 9 (September 2021): e3831. https://doi.org/10.1097/GOX.0000000000003831.
    3. Kuffler, Damien P. “Platelet-Rich Plasma and the Elimination of Neuropathic Pain.” Molecular Neurobiology 48, no. 2 (October 2013): 315–32. https://doi.org/10.1007/s12035-013-8494-7.
    4. Pandunugrahadi, Muhammad, Komang Agung Irianto, and Oen Sindrawati. “The Optimal Timing of Platelet-Rich Plasma (PRP) Injection for Nerve Lesion Recovery: A Preliminary Study.” International Journal of Biomaterials 2022 (2022): 9601547. https://doi.org/10.1155/2022/9601547.
    5. Sánchez, Mikel, Eduardo Anitua, Diego Delgado, Peio Sanchez, Roberto Prado, Gorka Orive, and Sabino Padilla. “Platelet-Rich Plasma, a Source of Autologous Growth Factors and Biomimetic Scaffold for Peripheral Nerve Regeneration.” Expert Opinion on Biological Therapy 17, no. 2 (February 1, 2017): 197–212. https://doi.org/10.1080/14712598.2017.1259409.
    6. Wu, Yi-No, Chun-Hou Liao, Kuo-Chiang Chen, and Han-Sun Chiang. “Dual Effect of Chitosan Activated Platelet Rich Plasma (CPRP) Improved Erectile Function after Cavernous Nerve Injury.” Journal of the Formosan Medical Association, March 27, 2021. https://doi.org/10.1016/j.jfma.2021.01.019.
    7. Yasak, Tuğçe, Özay Özkaya, Ayça Ergan Şahin, and Özlem Çolak. “Electromyographic and Clinical Investigation of the Effect of Platelet-Rich Plasma on Peripheral Nerve Regeneration in Patients with Diabetes after Surgery for Carpal Tunnel Syndrome.” Archives of Plastic Surgery 49, no. 02 (March 2022): 200–206. https://doi.org/10.1055/s-0042-1744410.
  • Every physician read…

    It’s not just about pretty, it’s about love organs working! In one study of women presenting to the doctor’s office, 54% were not having sex and 64% were suffering sexual dysfunction (which by definition means they are experiencing psychological distress from their sexual problems).

    This book goes a long way toward correcting that problem…

  • G-Spot Support Muscle (GSSM) Enhancement with VaginaLab™

     

    Find a provider who lives close to you<–(look for those who do both Emsella & the O-Shot® procedure)<–

    G-Spot Support Muscles

    The Research & What You Get…

    1. Some of the Research

    Kato, Mayumi Kobayashi, Satoru Muro, Tomoyasu Kato, Naoyuki Miyasaka, and Keiichi Akita. “Spatial Distribution of Smooth Muscle Tissue in the Female Pelvic Floor and Surrounding the Urethra and Vagina.” Anatomical Science International 95, no. 4 (September 2020): 516–22. https://doi.org/10.1007/s12565-020-00549-9.
    Tsonis, O., F. Gkrozou, E. Harrison, K. Stefanidis, N. Vrachnis, and M. Paschopoulos. “Female Genital Tract Microbiota Affecting the Risk of Preterm Birth: What Do We Know so Far? A Review.” European Journal of Obstetrics & Gynecology and Reproductive Biology 0, no. 0 (December 2019). https://doi.org/10.1016/j.ejogrb.2019.12.005.
    Faubion, Stephanie S, Lynne T Shuster, and Adil E Bharucha. “Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction.” Mayo Clinic Proceedings 87, no. 2 (February 2012): 187–93. https://doi.org/10.1016/j.mayocp.2011.09.004.
    Agar, N. S., and T. Stephens. “Reduced Glutathione–a Comparative Study of Erythrocytes from Various Species of Marsupials in Australia.” Comparative Biochemistry and Physiology. A, Comparative Physiology 52, no. 4 (December 1, 1975): 605–6. https://doi.org/10.1016/s0300-9629(75)80008-9.
    Handy, Ariel B., Amelia M. Stanton, and Cindy M. Meston. “Understanding Women’s Subjective Sexual Arousal Within the Laboratory: Definition, Measurement, and Manipulation.” Sexual Medicine Reviews 6, no. 2 (2018): 201–16. https://doi.org/10.1016/j.sxmr.2017.11.001.
    Hersant, Barbara, Mounia SidAhmed-Mezi, Yazid Belkacemi, Franklin Darmon, Sylvie Bastuji-Garin, Gabrielle Werkoff, Romain Bosc, et al. “Efficacy of Injecting Platelet Concentrate Combined with Hyaluronic Acid for the Treatment of Vulvovaginal Atrophy in Postmenopausal Women with History of Breast Cancer.” Menopause 25, no. 10 (2018): 1. https://doi.org/10.1097/GME.0000000000001122.
    Jb, Neto. “O-Shot: Platelets Rich Plasma in Intimate Female Treatment,” 2017, 4.
    Jhang, Jia-Fong, Shu-Yu Wu, Teng-Yi Lin, and Hann-Chorng Kuo. “Repeated Intravesical Injections of Platelet-Rich Plasma Are Effective in the Treatment of Interstitial Cystitis: A Case Control Pilot Study.” LUTS: Lower Urinary Tract Symptoms 11, no. 2 (2019): O42–47. https://doi.org/10.1111/luts.12212.
    ———. “Repeated Intravesical Injections of Platelet-Rich Plasma Are Effective in the Treatment of Interstitial Cystitis: A Case Control Pilot Study.” LUTS: Lower Urinary Tract Symptoms 11, no. 2 (2019): O42–47. https://doi.org/10.1111/luts.12212.
    Long, Cheng-Yu. “A Pilot Study: Effectiveness of Local Injection of Autologous Platelet-Rich Plasma in Treating Women with Stress Urinary Incontinence.” Scientific Reports, 2021, 9.
    Malabarey, Ola, and Jens-Erik Walter. “Collagenoma and Voiding Dysfunction as Complications of Periurethral Bulking.” International Urogynecology Journal 26, no. 7 (July 2015): 1077–78. https://doi.org/10.1007/s00192-015-2649-1.
    Matz, Ethan L, Amy M Pearlman, and Ryan P Terlecki. “Safety and Feasibility of Platelet Rich Fibrin Matrix Injections for Treatment of Common Urologic Conditions.” Investigative and Clinical Urology 59, no. 1 (January 2018): 61–65. https://doi.org/10.4111/icu.2018.59.1.61.
    Merhi, Zaher, Serin Seckin, and Marco Mouanness. “REPRODUCTIVE ENDOCRINOLOGY: CASE STUDY Intraovarian PRP Injection Improved Hot Flashes in a Woman With Very Low Ovarian Reserve.” Accessed July 7, 2021. https://doi.org/10.1007/s43032-021-00655-7.
    Nikolopoulos, Kostis I., Vasilios Pergialiotis, Despina Perrea, and Stergios K. Doumouchtsis. “Restoration of the Pubourethral Ligament with Platelet Rich Plasma for the Treatment of Stress Urinary Incontinence.” Medical Hypotheses 90 (May 1, 2016): 29–31. https://doi.org/10.1016/j.mehy.2016.02.019.
    Prodromidou, Anastasia, Dimitrios Zacharakis, and Stavros Athanasiou. “The Emerging Role on the Use of Platelet-Rich Plasma Products in the Management of Urogynaecological Disorders,” 2021. https://doi.org/10.1177/15533506211014848.
    Runels, Charles. “A Pilot Study of the Effect of Localized Injections of Autologous Platelet Rich Plasma (PRP) for the Treatment of Female Sexual Dysfunction.” Journal of Women’s Health Care 03, no. 04 (2014). https://doi.org/10.4172/2167-0420.1000169.
    Sanoulis, Vasileios, Nikolaos Nikolettos, and Nikolaos Vlahos. “The Use of Platelet-Rich Plasma in the Gynaecological Clinical Setting. A Review.” 18, no. 3 (2019): 11.
    Share, J. B. “Review of Drug Treatment for Down’s Syndrome Persons.” American Journal of Mental Deficiency 80, no. 4 (January 1976): 388–93.
    Sills, Eric Scott, Xiang Li, Natalie S Rickers, Samuel H Wood, and Gianpiero D Palermo. “Metabolic and Neurobehavioral Response Following Intraovarian Administration of Autologous Activated Platelet Rich Plasma: First Qualitative Data.” Neuro Endocrinology Letters 39, no. 6 (January 2019): 427–33. http://www.ncbi.nlm.nih.gov/pubmed/30796792.
    Zheng, Zhifang. “Materials Selection for the Injection into Vaginal Wall for Treatment of Vaginal Atrophy,” 2021, 11.
    Azparren, Javier, and Judson Brandeis. “HIFEM PROCEDURE ENHANCES QUALITY OF LIFE OF ELDERLY MEN WITH POST-PROSTATECTOMY INCONTINENCE,” n.d., 6.
    Evans, Kimberly, and Julene B Samuels. “FEMALE URINARY INCONTINENCE AND SEXUAL FUNCTION AFTER THE HIFEM® PROCEDURE,” n.d., 2.
    Samuels, Julene B. “HIFEM TECHNOLOGY – THE NON-INVASIVE TREATMENT OF URINARY INCONTINENCE,” n.d., 7.
    Samuels, Julene B., Andrea Pezzella, Joseph Berenholz, and Red Alinsod. “Safety and Efficacy of a Non‐Invasive High‐Intensity Focused Electromagnetic Field (HIFEM) Device for Treatment of Urinary Incontinence and Enhancement of Quality of Life.” Lasers in Surgery and Medicine 51, no. 9 (November 2019): 760–66. https://doi.org/10.1002/lsm.23106.
    Silantyeva, Elena, Dragana Zarkovic, Evgeniia Astafeva, Ramina Soldatskaia, Mekan Orazov, Marina Belkovskaya, Mark Kurtser, and Academician of the Russian Academy of Sciences. “A Comparative Study on the Effects of High-Intensity Focused Electromagnetic Technology and Electrostimulation for the Treatment of Pelvic Floor Muscles and Urinary Incontinence in Parous Women: Analysis of Posttreatment Data.” Female Pelvic Medicine & Reconstructive Surgery 27, no. 4 (April 2021): 269–73. https://doi.org/10.1097/SPV.0000000000000807.
    Mardinoglu, A., and J. Nielsen. “Systems Medicine and Metabolic Modelling.” Journal of Internal Medicine 271, no. 2 (February 1, 2012): 142–54. https://doi.org/10.1111/j.1365-2796.2011.02493.x.
    Sayin, Umit. “Doors of Female Orgasmic Consciousness: New Theories on the Peak Experience and Mechanisms of Female Orgasm and Expanded Sexual Response.” NeuroQuantology 10, no. 4 (November 29, 2012). https://doi.org/10.14704/nq.2012.10.4.627.
    Stromberg, Joseph. “This Is What Your Brain Looks like during an Orgasm.” Vox, April 1, 2015. https://www.vox.com/2015/4/1/8325483/orgasms-science.
    “Systems Medicine: A New Approach to Clinical Practice | Elsevier Enhanced Reader.” Accessed August 30, 2021. https://doi.org/10.1016/j.arbr.2014.09.001.
    Bernuzzi, Gino, Federica Petraglia, Martina Francesca Pedrini, Massimo De Filippo, Francesco Pogliacomi, Michele Arcangelo Verdano, and Cosimo Costantino. “Use of Platelet-Rich Plasma in the Care of Sports Injuries: Our Experience with Ultrasound-Guided Injection.” Blood Transfusion 12, no. Suppl 1 (January 2014): s229–34. https://doi.org/10.2450/2013.0293-12.
    Bubnov, Rostyslav, Viacheslav Yevseenko, and Igor Semeniv. “Ultrasound Guided Injections of Platelets Rich Plasma for Muscle Injury in Professional Athletes. Comparative Study.,” n.d., 5.
    Middleton, Kellie K, Victor Barro, Bart Muller, Satosha Terada, and Freddie H Fu. “Evaluation of the Effects of Platelet-Rich Plasma (PRP) Therapy Involved in the Healing of Sports-Related Soft Tissue Injuries.” The Iowa Orthopaedic Journal 32 (2012): 150–63. http://www.ncbi.nlm.nih.gov/pubmed/23576936.
    Alves, Rubina, and Ramon Grimalt. “A Review of Platelet-Rich Plasma: History, Biology, Mechanism of Action, and Classification.” Skin Appendage Disorders 4, no. 1 (January 2018): 18–24. https://doi.org/10.1159/000477353.
    Number 5, STL Volume 24. “Platelet-Rich Plasma (PRP): Current Applications in Dermatology.” Accessed August 26, 2021. https://www.skintherapyletter.com/dermatology/platelet-rich-plasma-prp/.
    Sánchez, Mikel, Eduardo Anitua, Diego Delgado, Peio Sanchez, Roberto Prado, Gorka Orive, and Sabino Padilla. “Platelet-Rich Plasma, a Source of Autologous Growth Factors and Biomimetic Scaffold for Peripheral Nerve Regeneration.” Expert Opinion on Biological Therapy 17, no. 2 (February 1, 2017): 197–212. https://doi.org/10.1080/14712598.2017.1259409.
    Chicharro-Alcántara, Deborah, Mónica Rubio-Zaragoza, Elena Damiá-Giménez, José M. Carrillo-Poveda, Belén Cuervo-Serrato, Pau Peláez-Gorrea, and Joaquín J. Sopena-Juncosa. “Platelet Rich Plasma: New Insights for Cutaneous Wound Healing Management.” Journal of Functional Biomaterials 9, no. 1 (January 18, 2018): 10. https://doi.org/10.3390/jfb9010010.
    “Platelet-Rich Plasma as an Additional Therapeutic Option for Infected Wounds with Multi-Drug Resistant Bacteria: In Vitro Antibacterial Activity Study – Art%3A10.1007%2Fs00068-018-0957-0,” n.d.
    Spanò, Raffaele, Anita Muraglia, Maria R. Todeschi, Marta Nardini, Paolo Strada, Ranieri Cancedda, and Maddalena Mastrogiacomo. “Platelet-Rich Plasma-Based Bioactive Membrane as a New Advanced Wound Care Tool.” Journal of Tissue Engineering and Regenerative Medicine 12, no. 1 (2018): e82–96. https://doi.org/10.1002/term.2357.
    Chung, Eric. “Regenerative Technology to Restore and Preserve Erectile Function in Men Following Prostate Cancer Treatment: Evidence for Penile Rehabilitation in the Context of Prostate Cancer Survivorship.” Therapeutic Advances in Urology 13 (January 1, 2021): 17562872211026420. https://doi.org/10.1177/17562872211026421.
    Foy, Christian A., William F. Micheo, and Damien P. Kuffler. “Functional Recovery Following Repair of Long Nerve Gaps in Senior Patient 2.6 Years Posttrauma.” Plastic and Reconstructive Surgery. Global Open 9, no. 9 (September 2021): e3831. https://doi.org/10.1097/GOX.0000000000003831.
    Kuffler, Damien P. “Platelet-Rich Plasma and the Elimination of Neuropathic Pain.” Molecular Neurobiology 48, no. 2 (October 2013): 315–32. https://doi.org/10.1007/s12035-013-8494-7.
    Sánchez, Mikel, Eduardo Anitua, Diego Delgado, Peio Sanchez, Roberto Prado, Gorka Orive, and Sabino Padilla. “Platelet-Rich Plasma, a Source of Autologous Growth Factors and Biomimetic Scaffold for Peripheral Nerve Regeneration.” Expert Opinion on Biological Therapy 17, no. 2 (February 1, 2017): 197–212. https://doi.org/10.1080/14712598.2017.1259409.
    Wu, Yi-No, Chun-Hou Liao, Kuo-Chiang Chen, and Han-Sun Chiang. “Dual Effect of Chitosan Activated Platelet Rich Plasma (CPRP) Improved Erectile Function after Cavernous Nerve Injury.” Journal of the Formosan Medical Association, March 27, 2021. https://doi.org/10.1016/j.jfma.2021.01.019.
    O-Shot® Arousal Oil
    Chicharro-Alcántara, Deborah, Mónica Rubio-Zaragoza, Elena Damiá-Giménez, José M. Carrillo-Poveda, Belén Cuervo-Serrato, Pau Peláez-Gorrea, and Joaquín J. Sopena-Juncosa. “Platelet Rich Plasma: New Insights for Cutaneous Wound Healing Management.” Journal of Functional Biomaterials 9, no. 1 (January 18, 2018): 10. https://doi.org/10.3390/jfb9010010.
    “Platelet-Rich Plasma as an Additional Therapeutic Option for Infected Wounds with Multi-Drug Resistant Bacteria: In Vitro Antibacterial Activity Study – Art%3A10.1007%2Fs00068-018-0957-0,” n.d.
    Spanò, Raffaele, Anita Muraglia, Maria R. Todeschi, Marta Nardini, Paolo Strada, Ranieri Cancedda, and Maddalena Mastrogiacomo. “Platelet-Rich Plasma-Based Bioactive Membrane as a New Advanced Wound Care Tool.” Journal of Tissue Engineering and Regenerative Medicine 12, no. 1 (2018): e82–96. https://doi.org/10.1002/term.2357.
    Bernuzzi, Gino, Federica Petraglia, Martina Francesca Pedrini, Massimo De Filippo, Francesco Pogliacomi, Michele Arcangelo Verdano, and Cosimo Costantino. “Use of Platelet-Rich Plasma in the Care of Sports Injuries: Our Experience with Ultrasound-Guided Injection.” Blood Transfusion 12, no. Suppl 1 (January 2014): s229–34. https://doi.org/10.2450/2013.0293-12.
    Bubnov, Rostyslav, Viacheslav Yevseenko, and Igor Semeniv. “Ultrasound Guided Injections of Platelets Rich Plasma for Muscle Injury in Professional Athletes. Comparative Study.,” n.d., 5.
    Middleton, Kellie K, Victor Barro, Bart Muller, Satosha Terada, and Freddie H Fu. “Evaluation of the Effects of Platelet-Rich Plasma (PRP) Therapy Involved in the Healing of Sports-Related Soft Tissue Injuries.” The Iowa Orthopaedic Journal 32 (2012): 150–63. http://www.ncbi.nlm.nih.gov/pubmed/23576936.
    Bernuzzi, Gino, Federica Petraglia, Martina Francesca Pedrini, Massimo De Filippo, Francesco Pogliacomi, Michele Arcangelo Verdano, and Cosimo Costantino. “Use of Platelet-Rich Plasma in the Care of Sports Injuries: Our Experience with Ultrasound-Guided Injection.” Blood Transfusion 12, no. Suppl 1 (January 2014): s229–34. https://doi.org/10.2450/2013.0293-12.
    Bubnov, Rostyslav, Viacheslav Yevseenko, and Igor Semeniv. “Ultrasound Guided Injections of Platelets Rich Plasma for Muscle Injury in Professional Athletes. Comparative Study.,” n.d., 5.
    Middleton, Kellie K, Victor Barro, Bart Muller, Satosha Terada, and Freddie H Fu. “Evaluation of the Effects of Platelet-Rich Plasma (PRP) Therapy Involved in the Healing of Sports-Related Soft Tissue Injuries.” The Iowa Orthopaedic Journal 32 (2012): 150–63. http://www.ncbi.nlm.nih.gov/pubmed/23576936.
    Moraes, Vinícius Y, Mário Lenza, Marcel Jun Tamaoki, Flávio Faloppa, and João Carlos Belloti. “Platelet-Rich Therapies for Musculoskeletal Soft Tissue Injuries.” The Cochrane Database of Systematic Reviews 12 (January 2013): CD010071. https://doi.org/10.1002/14651858.CD010071.pub2.

    2. “What you Get” with the VaginaLab™ Program…

    Ten years ago, there were zero drugs approved by the FDA for the treatment of female sexual dysfunction. Thankfully, in the decade since I first designed the O-Shot® procedure, a noticeable number of new therapies have appeared.

    In an effort to combine the best of therapies for a noticeable result, I put together a package that strategically brings a woman to her best sexual health, pleasure, and connection.  There are no magic bullets in medicine–the body is so complicated that almost always best health requires a thoughtful, informed combination of therapies that consider the whole system and how it works together.

    Though there are no magic formulas, there’s a certain basic combination of ideas that can help almost everyone. For example, almost everyone will see an improvement in thought, emotions, cardiovascular health, and digestion, and sexual function if they walk or jog daily. But, walking alone will not make all sexual problems go away.

    In thinking about what I would want almost every woman to do to see her best sexual health, I came up with the following ultimate-best combination of therapies (of course, each component would need to be approved by your own physician based on your own individual sexual health goals):

    1. Daily walking. It’s difficult to be healthy if you’re sedentary.  Ideally, you work up to 21-25 miles of comfortable walking per week.
    2. Good sleep. Most require 7-8 hours. Some of us function on 5 with an afternoon nap.  But, whatever your quota, you need that and you need it with a regular go-to-bed time and a regular wake-up time most of the time.
    3. Hormonal optimization. This can be tricky. For example, it’s a known side effect of birth control pills that they lower testosterone in women–causing many women to experience a multitude of problems including weight gain, loss of sex drive, migraines, and even chronic pain with sex that does not go away when you stop the birth control pills. Some women cannot use any hormonal replacement but most women do benefit from a careful measurement and adjustment of hormones based on symptoms and previous history.
    4. O-Shot® procedure. Improving the health (blood flow, nerve conduction, and collagen structure) in the vagina, peri-urethral, and clitoral area is not everything but it sure does help many women: this improvement in tissue health is exactly what the O-Shot® procedure can do in most women–this one procedure can change lives.
    5. Emsella treatments (though first brought to market for urinary incontinence, it does wonderful things for sex). No one seems to doubt the usefulness of Kegel exercises in both men and women; so, it’s not surprising that many find the amazing benefits from doing 15,000 Kegel contractions in 21 minutes with more strength than can be done on your own.  A series of sessions back to back followed by a maintenance plan can be life-changing. Nothing I know of can strengthen the G-Spot Support Muscles (GSSM) 
    6. A strong program of appropriate supplements: a probiotic, a libido enhancer, vitamin E, Vitamin C, and a good B-Complex.
    7. Sex education/counseling for the woman and her lover. Most people don’t know what they don’t know. A combination of book education and in-person counseling goes a long way.
    8. A good arousal oil. Yes, we know good lubrication happens with good sexual health; but a little extra lubrication with the proper ingredients can create a real improvement in response for both partners.
    9. Thoughtful consideration of various classes of vibrators/self stimulators. These aids can both help with discovery and response.
    10. Prescription medications designed for sex like Vyleesi and knowledge about how to best integrate them into your love-making.
    11. Various laser and radio-frequency devices (like the Diva and the Thermi-Va) when needed.
    12. And of course, the right person in your bed (which can mean, just falling in love with yourself)

    As for how to implement all of this, here’s a suggested plan:

    Day 0
    A detailed discussion with the physician about hormone levels, overall health and health practices, and relationships. O-Shot® procedure. Emsella Treatment.  Begin supplements and walking program.

    Days 1-21 
    6 Emsella treatments. Couple practices sexual exercises as per sex therapist/educator. Hormones are adjusted. Medications are adjusted as needed. Medications for improving sex may be started.

    Month 2
    Another O-Shot

    Months 3-6
    Two Emsella treatments per month

    The doctor is seen as needed but at least on Day 0 and with the second O-Shot® and on the phone 3 times over the first 2 months.

    Cost for the above treatments at full price:
    O-Shot® procedure x 2 ($1,500 each)…… $3,000
    Emsella treatments x 14 (6 in first 3 weeks then 2 per month for months 4, 5, and 6 @ $300 each)………………………………$4,200
    Arousal Oil, Probiotic, & Libido Pills (1 month supply x 6)….. $660
    Total Cost…..$7,860

    Bought as a package, discounted $1,000 for a total price of $6,860. Can be purchased with payments of $1,800 to find the nearest provider (someone who does both O-Shot and Emsella)
    then $5,060 divided over 6 payments of $843.33 each.
    Or, the package can be paid in full for a further discounted price of $6,487

     

    Charles Runels, MD

    P.S. You can also book an O-Shot® alone (find the nearest provider here),

  • Stress Urinary Incontinence in Young Female Athletes

    Read the research mentioned in the video here<–

    Here’s where to find the nearest O-Shot® provider<–

    Some of the research supporting the O-Shot® procedure as a treatment for female stress incontinence<–

    Physicians apply for training to offer the O-Shot® procedure to your patients<–

    Transcript

    Hello, I’m Charles Runels. I’m an internist down in the Gulf Coast. I’ve been taking care of women’s health problems for the past 30 years. And one of the problems that really is serious and can limit women at a time when they’re developing is stress and continence.

    Now, the definition of stress incontinence is leaking enough urine that it affects your hygiene (you have to wear a pad) or it’s interfering with your social activities, like sports.

    So imagine you’re a young teenager and you’re trying to practice sports, but you can’t do your cheerleading or your volleyball because you’re leaking urine in front of your friends. It can have a profound effect (especially in a developing social young, fragile 13 year old, she’s not as tough as her mother is emotionally, perhaps).

    And so that sort of embarrassment can be traumatic enough to limit the things that she should do. And so, instead of doing sports, she’s playing more video games. It’s not something trivial. Okay, it’s not cancer. But it’s not trivial.

    Well, there’s been this wrong concept that urinary incontinence to the point that you have to do something to keep from soiling your clothing is a problem that happens after you deliver children. But the truth is that there have been multiple studies showing that, especially young women that have impact sports, like running, volleyball, cheerleading, gymnastics, will develop incontinence to a great degree. One study showed that in Olympic trampoline athletes, all have incontinence.

    Well, this was just published this past month where some physicians looked at all the research out there, the significant research involving incontinence in young women who have not had children to see, well, how prevalent is it? And they found that depending on the sport, anywhere from 30 to near a hundred percent of the women participating, had incontinence.

    Well, they go through some of the things that people try to make that go away. In reality, what often happens is the young girl just quits doing the sport. But it’s everything from surgeries to medications wearing pads. And it often has to do with the levator muscle, but there are also muscles. The pelvic floor only accounts for about 20% of the common mechanism and there are sphincter muscles around the urethra that are not even technically part of the pelvic floor. So even if you teach the girl to do Kegels, perhaps this is going to help. Doctors aren’t a great help.

    And by the way, I’ll put a link to this research below the video so you can see here are the different options. Conservative have to do with voiding before the workout. Well yeah, really? And wearing dark-shaded garments so if you pee on yourself, nobody notices. It doesn’t sound like a very good answer, does it? And you got pelvic floor training, you got Kegels exercises. But again, the pelvic floor is what’s supporting the organs, but it’s not actually technically part of the sphincter mechanism. Biofeedback. Really, you’re going to sign your 13-year-old for biofeedback? And then you have surgery, so there’s not a lot of great options.

    And I’m really disappointed that, but not surprised that, because we have something new called the O-Shot® procedure, it wasn’t included in this article. If you go to our website oshot.com, you’ll see, there’s a research page, and I’ll just go ahead and take you there so you can see, there’s a research page because we do have some research showing that using platelet-rich plasma, as it’s done in athletes, will cause the tissue to become more, the muscles to become stronger and restored and the new nerve to grow. I mean, just think about it for a second.

    Why should an NFL athlete get better treatment for his knee than your teenage daughter for her incontinence? It’s the same tissue. It’s the blood in her body. You just get the platelets out of it, just like they would for an NFL athlete instead of squirting it in. Here’s some of the research, instead of squirting it into a joint though, it’s placed around the urethra. And if she’s a virgin, it could be done very, very easily without a lot of trauma and emotional upset. It’s pain-free for most people and helps restore that.

    Now, of course, it works for mamas too. And the research we’ve done has been in mostly grown women, but just realize there’s another option. I’ll put a link to the research below the video, and also a link to where you can find providers. We’re in 50 something countries and a number of providers. And hopefully, this will be a help to you or someone that you love.

  • Functional Clitoral Anatomy

    Topics Discussed Include the Following…

    *Materials for Injection Into the Vaginal Wall
    *What are we injecting: G-Spot or O-Spot (what’s the difference)?
    *The change in FSFI and FSD-R after the O-Shot® procedure
    *Dr. Elizabeth Owings discusses the Functional Clitoral Anatomy

    Video/Recording of CMA Journal Club, Pearl Exchange, & Marketing Tips

    Transcript (relevant links at the bottom of the page)

    Review of Materials for Injection into the Vaginal Wall

    Charles Runels, MD (00:03):
    Thank you guys for being here at the Journal Club with Pearls & Marketing (JCPM). And we have a very special guest tonight, Dr. Elizabeth Owings, who wrote a… She just clicked to me and said she got the wrong link. Okay. Let me send her another link or we’re not going to lose her. Hold on one second. Yeah. Okay. Just sent it to her again. Hopefully she’ll show up. Okay.

    Charles Runels, MD (00:35):
    So Dr. Owings, amazing, amazing physician who spent several months just studying the anatomy of the clitoris. It’s hard to believe it was actually left out of Grey’s Anatomy for a while. So Dr. Owings will be coming on in about 10 minutes. I’ve been spending a lot of time thinking about the functional anatomy, the way things that are and how we might improve our O-Shot®. Well, this paper just happened to come out, and it was actually brought to my attention by my fiance Alexandra, who’s a gynecologist out there in San Antonio. So thank you Alex, for showing me this.

    Charles Runels, MD (01:11):
    This came out, as you can see, it was come out in the past month and it was a nice review article that was published in Aesthetic Plastic Surgery about all the different materials that are being squirted into the vagina. Some of it you’ve seen, but having it all fit together in one paper with a very, I think, balanced view of it is helpful. I wanted to point out a couple of things, and you can download it. I’ve put it in the handout section. You just click on the little yellow flower it’ll pop up, and if you open it now, it’ll be still open when the webinar’s over. If not, it’s going to disappear.

    Charles Runels, MD (01:55):
    So here’s a couple of things that I noticed about this that I’d like to bring to your attention. First of all, this first little review paragraph just lists the things that have been published, and I’d like to point out that maybe multiple injections, I’m being a little picky here, but aren’t always needed. And when they talk about emboli, [inaudible 00:02:19] emboli, that happens, but it happens with HA, and that happens… Pulmonary embolism happens with fat. We haven’t had a pulmonary embolism. We’ve had one episode of blindness from PRP, and that was when it was injected near the eye. And so, except for that one episode, no one’s ever gone blind by injecting in the vagina, although pulmonary emboli have happened injecting fat and HA around the vagina.

    Charles Runels, MD (02:51):
    So anyway, there’s a nice little overview. I’m just going through it here, and you guys can point out, I’ll unmute the mic if you want to throw something in here. But they do point out that vaginal atrophy happens with estrogen levels being a main cause. Definitely a cause, it’s debatable how much, because there’s definitely a contribution from testosterone, as you guys know, not just estrogen. Many of you have discovered with testosterone creams also help the problem.

    Charles Runels, MD (03:27):
    And they’re about to quote one of the articles that are published together with some of the other people in our group. But one other thing before we get to that. On page 1232, they mentioned that… They started talking about the G-spot, and this becomes almost like a religion or a belief system more than science, I think. And although there was this study that came out in… Where this fellow, I can’t say his name. I met him. Really nice guy, at one of the [inaudible 00:04:04] courses, he did a series of dissections on cadavers and totally dissected out the G-spot. The reason I’m bringing this out is most people think that maybe it still hasn’t really been shown because there’s no specific tissue that anyone else has been able to find.

    What are we injecting: G-Spot or O-Spot?

    Charles Runels, MD (04:26):
    The only reason I bring it out is that I think technically we’re not injecting the G-spot, and I want to make sure that we’re clear on that because… Hey, I see you, Elizabeth, thank you for jumping on. Because the G-spot, in my opinion, is a functional thing. That if you look at what Dr. Grafenberg talked about back in the fifties, and you really should do a Wikipedia read and then read all the references about Dr. Grafenberg. Amazing, amazing man, amazing story that I won’t get into now. But he thought the whole urethra was the most arousing erotic part of a woman’s body. The spot became more of a later idea. And I think it’s less established. I think most people were tending to talk more about the clitoral urethral complex, which is what Dr. Owings is about to talk about here shortly.

    Charles Runels, MD (05:23):
    But the G-spot is something that I think you find in the bedroom, I think it varies from woman to woman, and in the same woman, sometimes from moment to moment. But it’s in theory the place where the woman’s most aroused. And I think to point to it on an anatomy chart, it could be how you define it. You can decide that. You can decide your left ear lobe’s the G-spot if you want to, but I think the way Dr. Grafenberg talked about it, it was the most arousing place of the most arousing place. The most arousing spot along the path of the urethra, but really it’s nebulous.

    Charles Runels, MD (05:58):
    And that’s why with the G-Shot that was out and popular in the US a number of years ago, you had to quote map the vagina and find that place by stimulating the woman’s vagina. And in Europe, this is still done. In some of our offices it’s still done, but this is frowned upon by ACOG now, and you’re putting, I think, your license at risk if you do this in the United States with an HA in the anterior vaginal wall, because of the risk of granuloma. 1 in 40 in one study, that can cause obstruction, necessitating surgery to correct it.

    Charles Runels, MD (06:34):
    So the O-spot, we need a place to call our place where we put it. You can call it whatever. You can call it the Florida spot. I don’t really care, but calling it the most distal place in the peri-urethral area, between the anterior vaginal wall and the urethra most distal from the bladder, it’s a long-winded thing. So that is the description of it. I like calling it the O-spot. Nobody’s name’s involved, so there’s no ego.

    Charles Runels, MD (07:09):
    It’s just where we put our shot, and that you can point to on a map. So if you’re going to do the G-Shot, in my opinion, you need to spread the lady’s legs and find where she moans the most, which is… I’m saying it purposefully in a very offensive way, because some people think of it as offensive, even when you say it in a not offensive way. So I like to talk about, we don’t really map out the vagina when we do the O-Shot®, and we’re not looking for the G-spot when we do that. Okay. Now I just wanted to bring that out. Go read about Dr. Grafenberg. Couple of the things. I’m trying to keep to the schedule here. I’ve got about two minutes and I’m going to turn it over to Dr. Owings. There’s a lot more here. Let’s see.

    The change in FSFI and FSD-R after the O-Shot® procedure

    Charles Runels, MD (07:55):
    If you go down to this little graph where they talk about the research we did, and just a couple of things to point out. It’s not apparent from this is that we published this little study. And what I did was I had a patient who used to work in getting universities ready for inspection by the FDA. After she retired from the FDA, where she was an inspector of research projects done by universities, after she retired, then she worked as a consultant on the other side to help people get ready for what she would have done when she worked for the FDA. I loved her, love her still. I saved her life with some stuff I was doing, and so she felt obligated. So I said, okay, let’s go through my charts. I don’t want to even touch the charts. And find women for whom we have a female sexual function index and a female sexual distress scale revised that was filled out plus or minus a few weeks around the 12 week mark. As you can see, 12 to 16 weeks. And we have one before and we have one at that time, because I think that’s when it probably maxes out. And just add it all up and let me see what it shows. My hands are going to be off.

    Charles Runels, MD (09:10):
    And she did it as meticulously as only an FDA person might do. And thankfully, it showed benefit. You realize I wasn’t even seeking people who were distressed. And ironically, of the two that showed increased distress on the distress scale, I called one of them because her distress scale had gone up, I think from a one to a two. It just bumped from zero distress, basically, to a little bit more distress. And when I asked her why her distress went up, she said, well, I’m having great sex, and now my boyfriend can’t keep up with her. So that was, that was her distress.

    Charles Runels, MD (09:51):
    The other woman had a divorce right after the shot, and her whole life was distressed. But the bottom line is that we showed some benefit. Obviously there was no placebo, and rightly so, he points that out. But I want you to know how those numbers were generated.

    Charles Runels, MD (10:08):
    This one, I think very well done. I think it’s complicating it. If you notice the people who were doing the procedures, like the recent one that made the cover of the journal Sexual Medicine, the people who were doing the sex procedures, who have never done this in the face, in my opinion, are complicating it. If you ever squirt PRP in the face, you’ll see, it’s like filling up a sponge. You wouldn’t feel obligated to stick the sponge, if it were small, in three or four different places. You would just put the needle in the sponge and it would fill without lots of sticks, which is what you see when you see PRP spread through the face.

    Charles Runels, MD (10:47):
    But not having witnessed that, I think some people complicate it, just my opinion. I may be proven to be wrong, but I don’t think you have to put multiple sticks. And I think most of what happens does go along, especially when you’re treating for stress urinary incontinence, but even when you’re treating for sex, because of the sensitivity of the urethra, I think anything away from 12:00 for sure, by the time you get to 2:00 and 10:00, perhaps benefits are rapidly declining. I’ve seen lectures about hyaluronic acid when I lectured in Europe, and many of you on the call now or listening later will know about this, because you live in Europe. We don’t have as yet an HA that’s approved for the vaginal space. The guy who invented [inaudible 00:11:42] came out with one that is, but the recommendation is that it only be used in the posterior vaginal wall for the same reason, I just mentioned. The G-Shot is not recommended, it’s condemned by ACOG, because when you put the HA in the anterior vaginal wall, some not happy things can happen. Where it’s safer in the posterior vaginal wall.

    Charles Runels, MD (12:06):
    The end point is often pH, which is interesting to us in the States. And you can see people are mixing it with PRP as we are doing in our wing lift. This, again, I think is something that hopefully will eventually be something we’re able to do here. There’s a region kit that comes with an HA as an activator that’s not cross-linked, that is supposed to be available here eventually.

    Charles Runels, MD (12:34):
    And then the collagen botulinum toxin, I’ll get back to fat as it does lead to embolism. When you get to stem cells, I don’t even like saying that on a microphone now because the FDA is so rambunctious about making sure we don’t talk about stem cells too much. So that’s it. Let’s see if there’s any other notes and we’ll turn this over to Elizabeth. Anyway, hopefully you guys will think about that, and… Oh, I know what else was going to show you. This last little part in the summary, and then I’ll shut this down. The references here are crazy good. So you might want to go through those when you have a Sunday afternoon. This part.

    Charles Runels, MD (13:24):
    Well, the bottom line is that instead of having one tool, the idea of combining tools is important. We definitely need to standardize it. The double-blind placebo needs to happen, but I think it might need to be a positive control, because saline is not a placebo. If you think about what happens when you power wash your driveway, I’m afraid there may be some disruption of tissue that makes it not a placebo. So in fact, our procedure is part biological by activating pluripotent stem cells with PRP-derived growth factors and cytokines. It’s partly a physical procedure when you’re hydrodissecting tissue. So it’s a little tricky doing a placebo-controlled trial, unless maybe you just stick the needle there. Anyway, I’m playing around with that. I actually stopped one study when I saw another study where the saline placebo worked almost as good as PRP and much better than you would have expected a placebo to work in a histological study.

    Charles Runels, MD (14:30):
    So I think now let’s unmute Dr. Owings and I have her beautiful pictures that she’s accumulated to help explain some of the function of the anatomy and how it relates to what we just talked about. Let’s see, I see two microphones, Elizabeth. I’m going to unmute them both. There you go. Should be live now.

    Elizabeth Owings, MD (14:57):
    Okay.

    Dr. Elizabeth Owings discusses the Functional Clitoral Anatomy

    Dr. Elizabeth Owings, MD

    Charles Runels, MD (14:59):
    You’re there. There’s something that’s causing an echo. So while she’s flipping that off, just to let you guys know, Dr. Owings is really a… I meet lots of smart people, but she’s one of those Renaissance ladies who has a music degree and plays the piano like Liberace or something, and she’s got so many fricking specialty trainings I can’t track them, and still looking for the new thing to think about. So thankfully some of those new things that she wanted to think about included our procedure. So let me see if I can make this… Yep. There it is. And I’ll just run through this whenever you tell me to, Elizabeth, and we can hear you now beautifully.

    Elizabeth Owings, MD (15:47):
    Okay. Terrific. Glad you can hear me. Just had two mics, because I didn’t know which one was going to link up right.

    Charles Runels, MD (15:53):
    [inaudible 00:15:53]. We got it now.

    Elizabeth Owings, MD (15:55):
    Perfect. So I guess I have been thinking about this. I’ve been thinking about this a lot. Any of you heard me give this talk, my third patient after I was trained in the O-Shot®… And I’ve got general surgery training and we do gynecology rotations and you learn about it in medical school. The third patient had lichen sclerosis. I had never seen it before to recognize it. Yes. Thank you, Charles. But this is a condition where the, the tissues just sort of adhesed together over the clitoris. You can actually feel it underneath there, but you can’t see it. And when you think about how to do an O-Shot®, it’s a bit perplexing and not something that you want to walk into.

    Elizabeth Owings, MD (16:36):
    My assistant had applied the lidocaine and I just came in to do the procedure. Very straightforward procedure, only it wasn’t. But it prompted me, I realized, I didn’t know nearly what I needed to know about the clitoris. I spent the next month, basically, downloading articles. I didn’t go back to the anatomy textbooks, because I’d already looked at them and they really weren’t helpful to me to really understand what was going on behind the scenes underneath the small, external portion of the clitoris, which is what anatomists tell us that the clitoris is, is just this tiny, external portion. And they’re thinking about… Do I have a pointer?

    Charles Runels, MD (17:22):
    I can give you the pointer. Hold on a second. Let me see if I can do that.

    Elizabeth Owings, MD (17:26):
    But just when they, in your anatomy books, they think of the clitoris is… Oh, there you are. Just this, the glans in the shaft. That’s all they think of as the clitoris. You may just want to point, Charles.

    Charles Runels, MD (17:51):
    Okay, I’ll point for you. All right. Let’s do that.

    Elizabeth Owings, MD (17:54):
    Okay.

    Charles Runels, MD (17:54):
    Take it back. Hold on one second. Got it. Okay. I’ll be your pointer.

    Elizabeth Owings, MD (17:55):
    Okay. Be my pointer. So the glans in the shaft is all it would be pointing at. That’s just that top, just the very, very, part of the glans and the shaft, but not the deep part is what they thought. So the deep part would be the legs of the clitoris that Charles is pointing to now. And you can’t see that from the outside. And so modern anatomists and ancient anatomists don’t really think of that as part of the clitoris. So it’s the easiest for me to understand it is starting with the sameness, the things that are the same about the female anatomy and the male anatomy.

    Find Nearest O-Shot® Provider

    Elizabeth Owings, MD (18:32):
    And so the male anatomy, almost everybody has seen an erect penis, an erect phallus. You’re familiar with the fact that it’s firm. It’s supposed to be firm when it’s erect, and what makes it from are these two tubes that fill with blood. When it happens normally, that’s wonderful. And then sometimes people have to take medications to make that blood flow happen. And then sometimes of course, people actually have to take an injection. It’s injected into the tube to make the blood flow in there to make the penis hard. If a man has a penile prosthesis, it’s basically implanted where these tubes are to make it erect.

    Elizabeth Owings, MD (19:15):
    Well, females have those same tubes. They’re just mostly on the inside. So this is the male, that Charles has pulled up for us. There we go. The big circles on the top, when I was in a microanatomy histology class, they told us to think of the cross section of the penis as looking like a monkey. Two big eyes, and those are those tubes that get hard. And then the part down at the bottom is the part that surrounds the urethra.

    Elizabeth Owings, MD (19:43):
    And so in the female… And there it is, there we go. That’s a nice picture of how these tubes are very wide open, ready to fill with blood, ready to become engorged. And they actually are joined and are one space towards the end of the penis, towards where the glans of the penis is. And they separate down at the base and in the deep parts of the penis. There’s another picture of it. You got that up at the top, there’s this combined space, there’s a septum, but it’s got a lot of space in there where fluid can flow back and forth. That’s why when you do a Trimix injection for the penis to become erect, you only have to inject in one spot. And that fluid in the medication is active throughout that whole space. When we do our PRP injections, very shortly after it’s injected, it becomes a platelet-rich fiber matrix. It turns into a clot, basically, on the inside, but not the bad kind, not the kind that causes problems. This is the kind that’s basically generating those healing factors so that the function is going to improve.

    Elizabeth Owings, MD (20:54):
    I just always like to include this slide, because you can see that even in the glans penis, you don’t think of it as a tube. And you’re looking at the microscopic section. There are these big spaces in it. And when you did your Priapus shot, when you did that injection in the tip of the penis, which is a completely separate space from those two tubes that become erect. But when you do that injection in the tip, it doesn’t raise a bleb, it doesn’t raise a wheel. This is a great picture so you can understand that there’s the spongy part that surrounds the urethra, that leads up to the glans, and it’s spongy, even in a very erect penis, the glans will have some give to it. Where the shaft of the penis will not. That’s that those tubes that I was talking about that become erect.

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    Elizabeth Owings, MD (21:41):
    The same thing happens in the clitoris. Those same tissues are all present. I love this picture, because this shows perfectly well where to put that shot. As soon as you see those side to side rugae in the vagina, just inside the hymen, even if you’re not sure if you’re looking at the hymen or not, if you see those lines going side to side, that’s the place where you put your O-Shot®. That is the O-spot.

    Elizabeth Owings, MD (22:10):
    The same thing on that right picture. You have a really good view now of where that O-Shot® goes, and then all of the deep tissues of the female that are all part of that clitoris. It’s all part of that clitoris complex. So it’s not just the tip, not just [inaudible 00:22:28]. So I just included this picture of me and my son out in front of a [Glendonhall 00:22:32] glacier, and there’s an iceberg down there. So just like they taught us about iceberg, most of it is under the surface. The same is true for the clitoris. Most of it is deep. The part that we see is a very, very small part of it. So go ahead into the next one.

    Elizabeth Owings, MD (22:46):
    And you can see this pretty well on the slide here. And if you think of this, what you’re looking at is maybe just a longitudinal section of the penis with a foreskin or prepuce surrounding the glans. Then that’s exactly what you’re looking at with the clitoris. And there are those two tubes that are going to make the clitoris hard just like the penis. It doesn’t stand up because of the way it’s constructed. A penis will stand up. The clitoris does not. It will become full and engorged, but it doesn’t stand up, just because of the way it’s constructed. We don’t need to look at that one. I like that next one though.

    Elizabeth Owings, MD (23:25):
    To just point out, this is a two year old child. This is fully developed. Just exactly like you would see in an adult. Go ahead to that next one. Again, great anatomical picture. The tip of the clitoris with the glans is what you would expect to see on the outside, with little shaft that’s going up. You might see that. But the vast majority of it is deep. So when you put an injection, not in the glans, but just behind the glans, you’re going into that tube, and the fluid will go all the way down. We’ve proven this on ultrasound. The fluid will go all the way down to the deep parts of the clitoris.

    Elizabeth Owings, MD (24:04):
    This is an MRI. This is a picture closest to the outside, and that’s why we call it the introitus and not the vagina on the line drawing right to the right. So these are 18 year old women who’ve never had a baby. And you can see where the vagina is. I love this MRI picture. Very clearly, you can see where the legs of the clitoris are deep, the glans and the urethral meatus right there with the introitus. That’s good. Just like that. Go ahead. There it goes.

    Elizabeth Owings, MD (24:38):
    A little bit deeper, the body of the clitoris they’ve got mapped out right there for you. And then the crura coming down side by side, and there’s the bulb of the clitoris. That is analogous to the corpus spongiosum in the male penis. And it’s there. I don’t think I’ve got the photomicrographs, but it exists all the way up to the glans of the penis, just like it does surrounding the urethra to the male. The urethra in the female just comes directly to the outside. It doesn’t have to track up to the glans like it does in the man.

    Elizabeth Owings, MD (25:17):
    There we go. And then deeper still, at the very top, you’ve got the mons. Right under that is the pubic symphysis, and right under that is the crus of the clitoris, and then the urethra. Under that, sort of with the transverse shape here, is the vagina itself. Go ahead to that next one.

    Elizabeth Owings, MD (25:43):
    This is one of my favorite views, because you really get an idea… They tilted it, it’s not exactly anterior to posterior. It’s tilted just a little bit so that you can see the entire body of the clitoris. You just get an idea of the glans at the tip, and then these deeper structures, all part of the clitoris that are surrounding the urethra and the vagina. And when you look at this picture, I think that’s when I realized anything that we do that makes those tissues more healthy and lens support to them… You expect your face to sag a little bit after 50 or 60 years, and probably every other tissue in your body is as well. So if you’re lending any support at all to these tissues, it’s going to support the urinary continence mechanism. It doesn’t make the muscle any tighter. It’s just lending support to these structures. They’re going to become not necessarily more engorged, but there’s just going to be more just basic tissue tone. Go ahead.

    Charles Runels, MD (26:47):
    Let me just throw one thing in there, Elizabeth.

    Elizabeth Owings, MD (26:50):
    Yes.

    Dr. Owings’ book to explain the clitoris. A great educational/marketing tool for physicians.

    Charles Runels, MD (26:51):
    We have an MRI study that’s listed on the reference page of the O-Shot® that showed where a female radiologist, she did MRIs just like this of women who have trouble with orgasm and women who easily orgasm, and there was a correlation with the size of the clitoris and the distance of the clitoris to the vagina. So the bigger the clitoris, and the closer to the vagina, the more it correlated directly with ability to orgasm. So just stressing I like this picture as well, because the idea of anatomy just being for surgeons maybe isn’t right, because we all have to think about how the parts work together. I think that this picture explains why just talking about a spot maybe as the main thing isn’t exactly so accurate.

    Charles Runels, MD (27:47):
    It shows where this clitoral urethral complex, it also points out why the answer to, if you’re going to treat urinary incontinence, do you still treat the clitoris? I think there’s two reasons why you do. One is, as you’ll see in these upcoming micrographs, but especially the one that Elizabeth just pointed out, there was some contribution to the clitoris to the continence mechanism. And then of course if you’re going to treat sex, do you still treat around the urethra, because of what we just talked about with Dr. Grafenberg. Of course you do that as well. So I always treat both, whether the complaint’s sex or incontinence. And I think, as you just pointed out, Dr. Owings, that picture tells a lot.

    Elizabeth Owings, MD (28:36):
    The other thing that I’ve noticed is even if people don’t complain, if something improves, when they see you again, they will let you know. So maybe urinary incontinence wasn’t the chief complaint, but when they come back in six weeks or six months or a year, maybe it’s time for another one, or maybe I had more than one patient that said, “Well, I thought I knew how good sex could be, but it was never as good as this. And I don’t know how good it can be. Let’s do it again. Let’s have another O-Shot®.” More than one, and not all young, healthy people. One of my earliest clients was a 65 year old woman, and she was just really excited with how positive her sex life could be. Thanks for moving me on here.

    Charles Runels, MD (29:28):
    That was an accident, actually. Finish your story. That was an accident.

    Elizabeth Owings, MD (29:33):
    That was the end of it. She did not have a lot of complaints. She just wanted some improvements in the sexual function characteristic, but urinary continence got better, and sex got a lot better. And when she came back, I actually treated her nipples, because at that point, I didn’t know if it would be beneficial or not. She did not have any problems with her nipples. She had normal sensation, had never had surgery on her nipples, but she had better sexual arousal from nipple stimulation. It was not just a part of her sexual response. In her words, it was off the chart. The party line for PRP is going to be two or three weeks for the start, and then three months for full effect. She hunted me down in the gym at six weeks, because we went to the same gym, and said, “That nipple thing is amazing. I had no idea that was possible.”

    Charles Runels, MD (30:28):
    Wonderful. It’s good [inaudible 00:30:29] that. And you and I can go all night, I love it, with stories, but I’ve had some men want their nipples done. And second point is that if someone comes in and talks about, I just want it for urinary incontinence, we all know it, but I think it’s worth bringing it out in the light that can we all agree that sometimes people lie about sex, or they’re embarrassed to talk about sex, and they might use it incontinence as a ticket to be there as we often have our patients do, but they’re just embarrassed to say about the sex part. So it’s another reason why I always treat the clitoris, even if they’re there for incontinence.

    Elizabeth Owings, MD (31:08):
    Well, exactly. And this is my slide of the title Why Girls Don’t Compare Parts. It’s just that the clitoris, which is the part that’s external is so small and so deeply hidden between the labia minora and the labia majora, there’s a prepuce there. It’s just hard to see. But the truth is, if you look at it, if this is what you do for a living and actually you are paying attention, it looks exactly like a little penis. How do you make it bigger? You give the woman testosterone. And that’s the sex change. Surgeons taught us that. I think it’s probably a slide later on.

    Elizabeth Owings, MD (31:48):
    I went ahead and looked at the gross anatomy. What do the surgeons who were doing the dissections, what are they seeing? What does it really look like underneath the skin? And so you can see there’s the glans of the clitoris and the clitoral body, which we’re used to seeing on the outside. And then those deeper structures that crus, the bulb, and the way they wrap around. Wrap around the urethra with the vaginal vestibule right underneath it. They’re just right there together. Go ahead. Same thing here, a little bit kind of from the side, the crus is sort of coming down. This long, long leg that comes down straight.

    Charles Runels, MD (32:24):
    I really like this picture. It really I think shows how everything’s laid on top of each other.

    Elizabeth Owings, MD (32:28):
    And the bulb actually comes a little bit forward, and the vaginal introitus is sort of all the way on the right side of the screen there with the bulb in the middle, and then the clitoral crus on the side there. That bulb is wrapped right around the vagina with the crus just outside of it.

    Charles Runels, MD (32:49):
    Beautiful.

    Elizabeth Owings, MD (32:51):
    It’s the same picture. They’ve just turned it a little bit further.

    Charles Runels, MD (32:58):
    So I just want to rant shortly. How many of our colleagues think about the vagina as just a simple tube that leads to the cervix where you can deposit some semen? And how many people are taught all the way through college that that’s kind of what it is. And yet, when you see the elegance of the functional anatomy and what’s happening when there’s a penis here or what’s happening when various sexual or non-sexual activities go on. Obviously we all know it’s much more complicated than that, but I think showing and talking about this with our patients is very helpful. And with our colleagues.

    Elizabeth Owings, MD (33:41):
    Right. So again, it’s just a little bit of a different view, but the same concept. These pictures, I like, because you really get an idea. If you take the urethra and you look at the tissues around it, what are you looking at? And the answer is, so the urethra is kind of that hole in the middle. It’s got a U in it, and around it, you may see this. It’s erectile tissues around it. That’s where the deep areas of the clitoris are directly overlying the urethra. And then on top of that is the layer of muscle. And when that muscle is what’s responsible for our urinary… Well, that, and all the other structures. There’s no muscle that wraps all the way around the urethra like there is in the man. I’ve got a slide about that later. In the woman it’s just this band of muscle that’s listed up at the top and this… Go ahead to the next one. There we go.

    Elizabeth Owings, MD (34:38):
    SM is muscle. That’s it. And I counted it, because I’m that person. It’s about 30 cell layers thick. It’s not very thick. If you buy broccoli, that’s got that big thick, rubber band around it, it’s about that width, and about that thickness. It’s very thin, it’s not nearly as strong as that rubber band is, but it’s just not a very big muscle. And that is responsible for sort of pinching off the urethra against the anterior vaginal wall. So anything that you’re doing that’s going to lend some support to those structures on the on the inside, whether it’s the anterior vaginal wall, placing a platelet-rich fiber matrix right in between those tissues, that’s what you did with that deeper injection and the O-Shot®, when you can even actually feel it. It feels like a Walnut in there. That is going to support those structures for urinary continence. And I believe that that’s why the effects for continence are almost immediate.

    Charles Runels, MD (35:44):
    Elizabeth, something that I haven’t talked about that I’ve been trying to find more reasoning and a clearer picture about is that if you go to the sports medicine literature, PRP has been talked about quite a bit. It’s still debated about how effective it is, but when you injure muscle, as you know from your many surgery residencies, that it can turn to atrophy, it can be infiltrated with adipocytes or scar tissue. And instead of growing new muscle back, you’re left with this weaker structure. But you have a lot of research now showing that PRP can activate these stem cells that live within the muscle, mostly in the periphery of the muscle, that are just waiting to be activated to regenerate when there’s injury or stress.

    Charles Runels, MD (36:42):
    I’ve started to wonder if perhaps some of what we’re seeing with our great results with incontinence in my person is both the bulk that you just talked about and perhaps that we’re actually making these intricate muscles that we’ve just lumped together as the pelvic floor, but actually there’s all these different intricacies that are almost like the mast of a ship or something, with ropes going lots of different directions and lots of different opinions about which is pulling what. But the fun thing is when you just flood the whole area with PRP, and then you do your kegels or not, or you do your [inaudible 00:37:23] or not, we could be doing sports medicine in this muscle inadvertently, and without maybe thinking about it except when you show us these pictures and we say, “Oh yeah. Well, the erectile tissue’s important, the muscles are important. The blood flow is important. The nerves are important in both stress and urge incontinence.” And thankfully we have a material that makes all those things better.

    Elizabeth Owings, MD (37:50):
    It’s true. I’ve been blown away from the very beginning about what’s possible with platelet-rich plasma, and you can go back and forth about platelet-rich, platelet-poor, activated, not activated, leukocyte-rich and leukocyte-poor. It doesn’t matter. Ultimately, I find myself asking, can a human being, various functions, various portions be made better than they were with this as an adjunct? And I think the answer is very often yes. It’s not necessarily predictable who or where, but very often, yes. And I’ve had this more than once. “It’s never been like this before.” And that’s a happy thing for me.

    Elizabeth Owings, MD (38:30):
    This picture, this line drawing is my line drawing of the… The cross section is through the urethra that you just looked at the slides of just a minute ago, so that you can see there’s a spot right in between where the urethra is. The one big blob on your left is sort of the bladder. Ureter is behind that, and the vagina sort of underneath that. And then there’s this tract in between, and Charles talked about hydrodissection and we know that when we put our PRP in there, there is going to be some hydrodissection just based on where that is. I don’t think that alone would explain any urinary continence improvement, but I don’t know. I definitely don’t have the data on that.

    Elizabeth Owings, MD (39:12):
    But what this picture is just shows the darker area of the urethra is where all that erectile tissue is that I tried to show you in the cross section. And then a little bit further than that, a little bit closer to the end of the urethra is where that muscle is. Now, a lot of people have proven this. Going further back in there with your platelet-rich plasma does not make a better continence procedure. You still want your O-Shot® to go in the O-spot. That’s where you want your PRP to go, is just inside the most distal portion of the urethra, underneath the urethra just inside the vagina, just at that most distal point. Climbing in deeper does not do you any good. It does not help the patient.

    Elizabeth Owings, MD (40:09):
    It’s a beautiful artistic rendition that my friend Kent Rush did for the book. There’s some good pictures, but you just get the idea again. The clitoral legs are on the outside, and the bulbs are right there around the vagina itself. Go ahead to the next one. Same song. Second verse. Keep going.

    Elizabeth Owings, MD (40:31):
    This is the male sphincter. There’s really a sphincter. That’s that deep magenta thing marked SS around the urethra that’s marked U. It is truly a sphincter. It’s a band of muscle that goes all the way around the urethra. Women don’t have that. And the good news for men though, the P-Shot®, it can actually help that work better as well. I’ve helped a lot of people with, they’re just not functioning well, especially after prostate surgery. I’m not sure these men are getting what I would consider informed consent, but I don’t know. Anyway, the problems I think are much more common than people are led to believe. You may say that the incidence of this or that side effect is only 20%, but if it happens to you, it’s a hundred percent. So anyway, next slide.

    Charles Runels, MD (41:21):
    [crosstalk 00:41:21] placebo controlled study that I pushed out in another email with rats. And of course, with rats, you don’t have to worry about a placebo effect, and you can harvest the penis. But this is the third one I’ve seen where they looked at that, or they tried to model prostate surgery with nerve injury and injected the penis with PRP, and the other group got saline and then harvested the penis, and they saw repair. So anyway, I’m hoping one day, at least by the time my grandkids are grown, that PRP will be routinely part of the rehabilitation protocol [inaudible 00:42:03] prostate surgery.

    Elizabeth Owings, MD (42:04):
    I agree. So this female corpus spongiosum, let me just tell you why I included this slide. There is still a pervasive myth. It’s been in the medical literature for decades, for well over 50 years, that there’s no corpus spongiosum, but the glans of the clitoris comes off the corpus cavernosum because there is no corpus spongiosum. Once you know what the deeper structures are, and you’ve seen some of these photomicrographs, that’s obviously not true.

    Elizabeth Owings, MD (42:40):
    Somehow, Charles, this is… It’s slid off sideways.

    Charles Runels, MD (42:48):
    Oh, I did something wrong. I don’t know what I did.

    Elizabeth Owings, MD (42:52):
    So what they’ve done is given this woman testosterone and all portions of the clitoris have hypertrophied, including the corpus spongiosum. So the glans is pulled up by a suture at the very, very top. Point it up at the top. That’s it, right there. And the long strand right there would be what in a male would be surrounding the urethra. That would be the corpus spongiosum. This is a photo micrograph. It’s hard, I wish I had the pointer, but the bottom line is the corpus cavernosum are these two big round things, but the corpus spongiosum is there through the entire length of the clitoris all the way up. It’s submucosal, meaning if you’re looking at the outside of the vulva, you won’t know it’s there. You would have to do a dissection, but it’s there. The whole way.

    Elizabeth Owings, MD (43:51):
    Go ahead with the next one. This is [Ashazinsky 00:43:55], the guy with the hardest name to say, who said he dissected these out. I think you can probably only do this in Poland. Eight consecutive cadavers. And he dissected out this thing he called the G-spot. There’s an ongoing debate. If you go to PubMed.org, and just put in G-spot and anatomy probably it’ll come up. Helena O’Connell, the lady who did, I think, some of the gross anatomy dissections, and maybe the MRIs too, I can’t remember. I think she was also a partner on that study. Has gone through and done all these dissections and said there’s no such thing as the G-spot. But the debate rages on.

    Elizabeth Owings, MD (44:39):
    So if you look at this nice picture he gave us, because this thing that he found, which looks sort of like a thrombosed hemorrhoid, it is deep inside the vagina and right near the bladder. And so that might make you think, well, this is going to work better for sex if I go really, really deep with my O-Shot®. And again, it doesn’t. It doesn’t work for sex, and it doesn’t work better for incontinence. I don’t know why.

    Elizabeth Owings, MD (45:06):
    There you go. Those were those pictures for the lichen sclerosis. You won’t harm anyone by putting PRP in that. That is actually the treatment. I thought I could learn this, and I really think they belong in a center of excellence. I refer everybody to Kathleen Posey in Mandeville, Louisiana on the north shore above New Orleans. Someone once listened to my lecture, what you’ve heard so far, and said, “Well, we know why women have urinary incontinence. It’s because when they have a baby that this is torn and that is torn.” Which it set my teeth on edge because it’s obvious to me that there are plenty of women who’ve never had a baby that have urinary incontinence. And if I go to PubMed and just type in urinary incontinence, and nulliparous, I get a whole couple of… I don’t even remember how many. You should go look at it. Articles about where people have looked at this.

    Elizabeth Owings, MD (46:07):
    So anyway, we’re biased. We think that if you’ve haven’t had a baby, then you shouldn’t have as much incontinence as if you have had a baby. If you’re in shape, then you should not have incontinence. And if you’re out of shape, then that’s more likely. And if you’re old, then you should have more than young. And that’s not quite what we found at all, if you look at all these reviews from 1% to 42%, depending on various factors. Heavy women seem to have it worse. Childhood bed wetters and people who engage in high-impact exercise are more likely to. Even women without babies who’ve had… Go ahead to the next one. So even we find that women 18 to 40 who’ve never had a baby, are active and have a low BMI may have up to 23% urinary incontinence. Go ahead.

    Elizabeth Owings, MD (47:01):
    30% in athletes versus 13% in controls. These are young women, roughly median age, 19. 372 athletes and 372 age match controls. Their risk factors were high-level sport, a history of urinary tract infections, had family history of urinary incontinence, and constipation. And I think the family history of urinary incontinence goes along with maybe some anatomic features. History of constipation, I think probably as well as high impact exercise goes along with increased abdominal pressure. You’ve got all this pressure. Just think about jumping on a trampoline, just like jogging. A woman with urinary incontinence may never jog again. She may just walk. So that’s something that you can use to reach people and reach their pain. If they’re changing their lifestyle because of urinary incontinence, that’s a big deal. Go ahead.

    Charles Runels, MD (47:56):
    I think you just made a big point. How much leaking do you have to have before it counts as incontinence? Sort of like the question, how big does a boat need to be before it’s a ship? It has to be so big you cannot carry it across land. Now it’s a ship, not a boat. And the answer to how much leaking before you have incontinence… For you guys on the call, I haven’t tried to define that… Is if it interferes with your hygiene or your lifestyle. So you have to start wearing a pad or change your clothes, obviously, hygiene. If you stop something that you normally like to do, like your gymnastics or cheerleading as a teenager, which is 1 in 20 teenagers, in college people, or you can’t sit through your meeting at work, you’re changing your lifestyle. That’s incontinence.

    Elizabeth Owings, MD (48:44):
    Yeah. So many of these are similar. Go ahead and see if you can find a sister study. It’s not too much further ahead. Yeah, sisters. I love this. So they took post-menopausal women, and one sister had never had a baby and one sister had had a baby, and they found that the incidence was exactly the same. 47 versus 49%. That is not statistically significantly different.

    Charles Runels, MD (49:08):
    Totally unsurprising, huh?

    Elizabeth Owings, MD (49:11):
    Yeah. And then sisters had a high concordance. They were very likely to have the same situation. If one had normal continence, then the other one probably did. And the same thing for incontinence. Go ahead. And then the elite trampolinists. So this was fun. So 80% of the… These were 12 to 22 year olds. Mean age was 15. 80% during training, they would leak about an ounce. Started after two and a half years of training.

    Elizabeth Owings, MD (49:41):
    And if they put a pad in and tested, they found that it was a hundred percent over the age of 15 were leaking during their training event. So it’s not a sphincter, that urinary incontinence mechanism. There are a lot of parts to it. It’s much more sort of like a siphon, like a valve and not a sphincter. Because it can be overcome, just like the valves and the veins in your leg can be overcome if there’s enough pressure. So that’s what I wanted to say there.

    Elizabeth Owings, MD (50:12):
    Thinking about this in the future and how to teach this and how to think about this, I’ve been thinking about models. I think that’s where I’m going to be going. The direction I’m going to be taking is making a form of model where some of these parts can be snapped together and then unsnapped so that you’ve got not just a visual, but you can actually hold things in your hand and go, “Oh, this is how this goes together.” With perhaps various stages in, because it’s the same, maybe at eight weeks gestation, it’s exactly the same. You can’t tell the difference, whether it’s a male or a female. They are the same at that point, from the standpoint of what the tissues look like. And these changes come over time. Lots and lots of influences, and over the weeks, between 7, 10 weeks or so, things are changing so that eventually you can tell the difference, which is a boy and which is a girl. Usually. Those ultrasound people get it wrong sometimes.

    Charles Runels, MD (51:20):
    I’ve never seen such a low dropout rate. You’ve held everybody’s attention. I think this is the best clitoral anatomy… and I’ve heard others… lecture I’ve ever heard. And could I just have an email that people could contact, because I know that you teach classes. Dr. Owings will do a one-off class if someone wants to go follow her around and see how she thinks about her business. She’s in several different cities with her practice, so there’s some menu there to choose from. Could I just type an email address into the chat box so they can reach out to you?

    Elizabeth Owings, MD (51:55):
    Sure. That’d be great. E as in Elizabeth, P as in Patricia, Owings, O-W-I-N-G-S @gmail.com.

    Charles Runels, MD (52:03):
    Okay.

    Elizabeth Owings, MD (52:03):
    Am I supposed to do that or are you going to do that?

    Charles Runels, MD (52:06):
    I just typed it in. It’s all there. Thank you so much for being on the call. Anything else you want to throw out there before I shut it down?

    Elizabeth Owings, MD (52:12):
    No. No. Just looking forward to hearing from everybody. Thank you so much for your attention.

    Charles Runels, MD (52:16):
    Thank you, Elizabeth. You have a wonderful night.

    Elizabeth Owings, MD (52:22):
    You too.

    
    

    Relevant Links

    Zheng Z, Yin J, Cheng B, Huang W. Materials Selection for the Injection into Vaginal Wall for Treatment of Vaginal Atrophy. Aesthetic Plast Surg. 2021;45(3):1231-1241. doi:10.1007/s00266-020-02054-w<-click-to-read<–
    Runels CE, Melnick H, DeBourbon E., A Pilot Study of the Effect of Localized Injections of Autologous Platelet Rich Plasma (PRP) for the Treatment of Female Sexual Dysfunction. J Women’s Health Care 2014, 3:4
    —>>>Click here to read. The introduction explains the science of the O-Shot®<–click<—


    Cellular Medicine Association
    1-888-920-5311

  • Los Angeles Magazine Reports that “Women’s Sexual Wellness is Booming”

    The June 22 issue of Los Angeles Magazine reported that sexual wellness for women is growing dramatically. Here are a few of the tools that seem to be used more often that did not exist even 10 or 12 years ago.

    O-Shot® research<–

  • Sexual Wellness (free on Kindle):Optimize Your Relationship, Pleasure & Sexual Health

    This book provides the wisdom and practical advice of seven separate physicians who not only understand the most up-to-date science of sex but also bring to that science more than 200 years of collective experience in taking care of people seeking to make sex better.

    Each of the following seven contributing authors actively practices medicine (not just talk about it) and have collectively cared for thousands of people both well and not well to help them find better sex and a better life…

    1. Dr. Jean Luc Le Provost describes powerful but simple daily routines that can be used to improve overall health in such a way to specifically improve sexual wellness and pleasure.

    2. Dr. Prabhat Soni uses his vast experience as a pulmonologist and sleep specialist to show you ways to optimize sleep and why poor sleep can kill your sex life. You need a functioning brain to have sex. But, just as importantly, the pituitary gland is literally attached to that brain, controls all the other glands, and is profoundly affected by sleep.

    3. Dr. Cristyn Watkins discusses her personal battles and how out of those battles she became an expert in cellular therapies that improve sexual wellness from the level of tissue and histology. Healthy tissue makes for healthy, fully functioning genitalia.

    4. Dr. Bill Song discusses a number of options to help increase the size of the penis—for improved confidence in men and enhanced pleasure for their lovers. Multiple modalities can be used. He helps you sort the options.

    5. Dr. Dan Botha discusses extremely helpful new technology that helps with a more exact treatment of erectile dysfunction and of Peyronie’s disease. No more guessing where the problem is or if and how things might be improving after treatment.

    6. Dr. Kimberly Evans describes how in her practice of gynecology she improves sexual wellness and pleasure by expertly micromanaging the hormones of women and their partners. Hormones affect the growth and function of everybody tissue; so there’s no finding your best sexual wellness without this step.

    7. Dr. Ramesh Kumar draws from his decades of experience as a radiation oncologist to describe ways to recover sexual desire, health, and pleasure after cancer—especially after prostate cancer.

    Dr. Charles Runels, as the producer of the book, and inventor of the Vampire Facelift®, O-Shot®, and P-Shot® procedures, uses his 30 plus years as a physician to build a utilitarian framework on which to organize the wisdom of the above seven authors with his description of systems analysis and how such analysis can be used to better understand orgasm—the Orgasm System.

    Good sexual health, like good health in general, is not an event where you do one or two things occasionally and all is good for the rest of your life.

    Wellness, sexual or otherwise, arises with the daily practice of certain behaviors combined with specific modern therapies when things are broken.

  • A Story of a Small-Town Internist

    Charles Runels MD started out as small town internist with a passion for science, a drive to excel and a knack for marketing. His career has been shaped by a series of challenges.

    Today his name is synonymous with the most popular platelet rich plasma (PRP) procedures in the specialties of cosmetic dermatology, gynecology and urology. But that’s only the tip of the iceberg.

    Relax and enjoy the fascinating story of a talented entrepreneur.
    _____________________

    Dr. Charles Runels can be reached at CellularMedicineAssociation.org

    Dr. Marco Pelosi III can be reached at DrMarcoPelosi.com

  • Lasers + O-Shot® Equals Dry in Australia

    I was looking through the most recent research about stress incontinence, and saw this really important paper that came out of Adelaide, Australia from some of our colleagues down that way. Stress incontinence is really a severe problem that people don’t think about. They think about it more of as a hygiene problem. But when you have stress incontinence, it interferes with your life. You have trouble sleeping. It can make it difficult to exercise, so you have weight gain. You’re up in the night, trying to urinate, so you’re not as rested the next day. It interferes with your focus at work. So it can be a problem that really changes your life.

    That’s the definition of stress incontinence, if it’s a hygiene problem or it interferes with your life. It’s pretty common. Close to half of the women that are 50 and up, and it’s 1 in 20 of women in their twenties, so it’s a really common problem. It’s worth looking at because all the things that have been tried are useful. Some women are able to help this with Kegels. The surgeries are still an important tool that should be used when necessary. The mid-urethral sling, 90% of people get good results with that, only 10% have problems or have it fail. But the problem is that, with the surgery, there is some risk to the nerves that are involved with sexual response. And of course diapers are a last resort.

    So there’s this new thing called the O-Shot®, where you use plasma, PRP, to inject it in the right place. These authors, they combine the use of our O-Shot® with a laser. So the lasers usually go about the thickness of a business card, not much thicker than that. So it’s not a really deep laser, but it’s enough to cause some changes and improvement in the structure and the health of the tissue, especially when you combine it with our O-Shot®.

    Physicians apply for training and licensing to provide the O-Shot® procedure (your patients will thank you)<—

    So let’s look at what happened. I think this summarizes it the best. If you look at this picture, in the beginning, at baseline, the people who participated, 62% percent of them were frequently bothered by their incontinence, and 37% were bothered daily. But by the time they finished the study, it was more that shifted quite dramatically, so that you can see that many of them were not bothered at all or occasionally, and only 10% were daily, where it was more like 100% were either daily or frequently in the beginning.

    The fun thing about this procedure is that, the procedure being both the laser and combination with the O-Shot®, is that the downside is minimal so that if it doesn’t work, you can still go to surgery. But if it does work, and we’re seeing over 90% effectiveness with either the O-Shot® alone or combined with the laser, and when it works, you see great results, with the side effect of sex getting better.

    So I think it’s worth discussing this research with your physician. If you want to find someone who’s expert at the O-Shot®, check out our list of providers on our directory, those who are actually licensed to perform the procedure under the standards that we’ve come up with. So check out the research, read it, and share it with your doctor.

    Here’s where to read the research<—

    Here’s where to find the nearest O-Shot® provider<–

  • A new way to use O-Shot® technology to improve fertility in women

    Transcript

    This is a very important, extremely important article about the very difficult and heart-wrenching problem of how to help a woman become pregnant who is struggling with a particular form of infertility where the lining of the endometrial cavity is or the endometrium is too thin. If you think about it, and this was pointed out in the article, it’s really miraculous that a woman can have bleeding and shedding of the endometrium every month throughout her reproductive years without scarring. Any other tissue in the body would have trouble with scarring. But unfortunately, there are some women who do scar, it’s talked about in this study, is Asherman’s syndrome where intrauterine adhesions happen, which the miracle is that all women don’t have that as this bleeding and shedding takes place every month. Or then some people just seem to have somewhat genetic propensity to it. And then there is this lactobacillus-dominant endometrial microbiome that’s supposed to be happening and sometimes that happens to not be the case. There’s something other than lactobacillus dominating the endometrial microbiome.

    And I know that there are those who poo-pooed the studies of putting yogurt in the vagina, but just as a sideline, it makes sense. There’s only two places I know of in nature where lactobacilli live, the woman’s vagina, the endometrial cavity and in yogurt. So unflavored yogurt, it really just does help change the flora and there are studies to support that. How many studies we need to make it a prescription accepted thing, I don’t know. But I know this, if there was a medicine that had the same sort of biological and logical reasoning for working and I had a patent behind it, you’d see ads about it on television. But anyway, that’s a sideline. The bottom line is that some people don’t have lactobacillus-dominant endometrial microbiome and some women do have scarring and some people do have thinning.

    So there were two studies that are referenced in this article about using PRP, which is known in dentistry and known in wound healing, plastic surgery, orthopedics for 20 years. This is not new science in those arenas, but as pointed out here, it’s new to the arena of gynecologists. And you see gynecologist jumping up and down saying, “There’s no research to support this.” Well, this as in using PRP or platelet rich plasma to help women with urogynecological problems, it’s because they’ve lived in a bubble where this research hasn’t existed. If you read dental research or if you talk with dentists, orthopedists, they’ve quit debating about whether platelet rich plasma does anything. It’s not the magic cure-all be-all, but their discussions are on a deeper level about what does it do and what can we do with it and what can we not do with it.

    Hence, you’re starting to see, as pointed out here, that there has been minimal investigations in date in gynecology about PRP, but minimal in relations to other domains or specialties like dentistry and orthopedics, but still a growing number. And hopefully in the next 10 years, it’s usually 20 years for a new idea to take effect, we’re 10 years in with the O-Shot®, so probably in the next 10 years it will become widely done. Just watch, it will happen.

    So what’s happened is there’ve been two people published studies showing that infusing the uterine cavity or in bathing the endometrium with PRP helps rejuvenate the tissue to make it healthier, to enhance the probabilities of becoming pregnant for a woman with the problems that happen with endometrial thinning. So hence, this study to say, “Okay, we have those clinical reports. Let’s look on a cellular basis in vitro, in a culture, outside of the body with those cell types and see what happens with platelet rich plasma.”

    So they use saline as a control. They use platelet rich plasma and platelet poor plasma, and they found that platelet rich plasma does enhance the growth of the right kind of tissue and migration of the right kind of cells to the right place for the same things you see in dentistry to prevent scarring and to grow healthier, more vascular tissue, which in theory would explain why they saw the effect in the two studies that were done to show that it may actually help women with this as a cause of their infertility. The other thing is that we have in vitro studies showing that PRP, which is what your body normally makes … It’s not some esoteric thing. When you scraped your knee as a child, PRP is what caused the scab and the healing and the regeneration of the skin. PRP’s what happens every time you have surgery or you have a wound. That’s how it heals. The platelets bring growth factors, the [inaudible 00:05:11] cascade happens and you recruit stem cells to the area and you grow new tissue.

    It’s not a new idea. It’s been around since people have been wounded. When people fought in the middle ages with swords, the PRP healed the wound. So it’s not a new idea. The newness is, how can we take what’s already happening in the body and harness that to help people with disease. The other thing is because we know that’s part of the healing process, we have multiple studies showing that PRP has anti-microbial … It acts as an antibiotic. And it could be that’s another reason that’s happening, because it may help take care of the bad microbes and therefore help the good microbes or lactobacilli flourish.

    That’s a reach for the explanation, but it’s in line. It’s not homeopathy or some weird idea from outer space. Homeopathy as not in nutrition as some people apply it, but homeopathy is one part in 10 million somehow make something happen, which doesn’t happen. So this is not homeopathy. This is a logical thing that’s backed up by every time you heal a wound and by 20 years of research in other arenas and now it’s finally becoming more commonly done. We’ve done it with the O-Shot® now for the past 10 years to help rejuvenate the tissue around the urethra. It doesn’t work in everybody, just like antibiotics don’t’ working in everybody. 5 to 10% of people in the hospital with pneumonia still die, even with antibiotics. 30% of the people in the intensive care unit with pneumonia still die even with antibiotics. But we don’t say antibiotics don’t work. They just don’t work all the time because sometimes a person, their milieu or their body’s not able to heal itself for whatever reason.

    In the same way, maybe the problem isn’t the vagina. Maybe the problem with infertility is hormonal issues or low sperm count with a man. This isn’t the end-all, be-all, cure-all, but it’s a very intelligently designed way to help a woman who has endometrial thinning or scarring of the endometrium as a cause for her infertility and it should definitely be studied. The problem is, as we found with the O-Shot® procedure, funding is difficult because there’s no patent on blood, so yay for these investigators who had to do this out of their own pocket as we have had to done with the O-Shot®. I’ve spent over $300,000 just in a couple of years with research on the O-Shot®. More coming. We’ll spend another 100,000 this year. It’s funded by the physicians in our group, who by the way, should be giving money back and almost all of us do, if a patient isn’t happy.

    You can’t be preying on people’s pocketbook if you’re not keeping their money, if they’re not happy. I started taking cash in 2003. I’ve never kept a penny of a patient who wasn’t happy. In that case, we’ve lost our money and we’ve lost our time and we’re very sorry the person isn’t well and we try to find something else to help them. Every procedure is with risk and without 100% guarantee. Every procedure has risk and every procedure is without 100% guarantee. So there’s a consent form with our procedure. If you have the O-Shot® or if you have PRP infused into your endometrium, you should read the consent form. You should understand that you don’t have to be treated at all. You certainly don’t have to be treated with PRP. You should make sure that someone in our group has agreed to use FDA devices that are designed to prepare platelet rich plasma to go back into the body.

    If things don’t work well, you should discuss it with your physician and continue to demand that someone help you. Don’t give up. Sexual function is so important. It’s more than about pleasure. It’s about relationships. It’s about the psychology of feeling whole. It’s about even spiritual enlightenment. Hence, the ideas of chastity when it comes to spiritual enlightenment in many cultures and religions. Sexuality has to do with creativity and personality. So it’s not just about pleasure, it’s about part of the foundation. Emerson said it was the scaffolding of love, hence the scaffolding of our families to build. Maybe you don’t need a scaffolding after the empire is built, but it helps build the building of your relationship with your lover. So consider this talk with your physician about it. If your physician wants training, we have training. We have teachers around the world. We have over 2000 doctors in our group. We have people in over a dozen medical schools. We have ongoing research. Read it, think about it, talk with your doctor about it, and let’s push our tools for healing women.

    It breaks my heart when, when it comes to sexual dysfunction, we keep offering women vibrators and lubes or psychological. Everything’s not in your head. If you have an endometrium that’s thin, that’s not in your head. That’s in your endometrium. If you have scarring from having a big baby that tore the vagina, that’s not in your head. Hence, the treatment is not psychological medicines that affect the brain. And there’s better treatments than just a lube and a vibrator. We have so much better science than we did. I hope that you’ll investigate. Read the science for yourself. Don’t just blindly listen to the naysayers. Usually, 20 years for a new procedure to take effect in medicine. Read the science. Talk with your doctor and take care of your body and value your sexuality. I hope this helps you or someone you love.

    Read the research–>>(click)–>In vitro evidence that platelet-rich plasma stimulates cellular processesinvolved in endometrial regeneration<–

    Yogurt for healthier vagina-research

    PRP as antibiotic–research

    More O-Shot® research<–

    Find nearest O-Shot® provider

    Physician training for O-Shot® procedure

    Cellular Medicine Association

  • Research for Incontinence and for Better Sex

    Here’s new research about how to improve urinary continence in women…

    Click here to read the research<–

    So stress incontinence is a really serious problem that can affect your life and in ways that are sometimes difficult to deal with it, both in your personal and your business life. It can make it difficult to focus at work. It makes it difficult to get through a meeting, difficult to travel without stopping, it wakes you up at night, it makes it hard to exercise because you might be leaking urine and you’re not sleeping well so it makes it hard to feel rested during the day so it’s a significant problem and a lot of research going on trying to find an in between.

    The pills that you take can sometimes cause anticholinergics can cause trouble with constipation, trouble thinking and associated with dementia and surgery is a viable option but all of us would like to avoid surgery if we can. So here’s a really interesting study where they looked at successfully using autologous drive muscle STEM cells. Autologous muscle drives cells to grow, not STEM cells, but muscle drives cells to grow the bulk of the sphincter that helps a woman control her urine and actually it’s not a circumferential sphincter like a man, it’s more like a flap which makes it more difficult to hold urine and that flap is only a few cells thick so increasing the strength, just like you strengthen your bicep might help with that and that’s exactly what they showed; significant increase in sphincter volume as in a larger bicep muscle instead of larger sphincter volume or muscle to hold the urine in when compared with the placebo group.

    So check this out. It’s not something that’s mainstream yet as far as being able to offer but you might want to talk with an alternative which does something similar which is using PRP. In the athletic committees have sometimes even banned platelet rich plasma because not only does it heal tissue, but can add sometimes strength to the muscle.

    So it’s possible that one of the reasons our O-Shot is improving incontinence is because platelet rich plasma can increase the muscle strength as well as improve the health and the blood flow around the tissue. So a side effect could be improved sexuality response with orgasm or ability to have orgasm. So you might want to talk with your physician about this if they’re not a provider, there’s training on the website and we have a list of licensed providers on the website that are already trained, agreed to follow strict criteria and with the FDA approved devices.

    It’s not for everybody but that’s who I would contact to find out more information about this or talk with your physician about becoming certified or licensed to do the procedure. Hope you find it helpful and you’ll share this idea with your physician or with someone who might be suffering with incontinence.

    Find nearest O-Shot® provider

  • Urinary Incontinence & Vaginal Laser. New Research

    Transcript

    Charles Runels, MD: So urinary incontinence can be an extremely family and social disruption for you. Surprisingly common, it’s around half of the people by the time they reach 50. Half of women have incontinence and incontinence defining as interfering with your social life or your hygiene. You know a few drops doesn’t matter, but if you’re having to stop doing the things that you do or wear a pad that’s incontinence. And then occurs in one in 20 women in their twenties about 5% of women in their twenties. So young women may have to stop their cheerleading or their gymnastics because of incontinence. It’s not just from childbirth or from aging.

    So it’s really important that we find better answers. We have surgical solutions, but before we go to surgery it’s nice if we can find something more quickly or acting with less trouble and less downtime.

    So people are starting to look at using lasers. This is a really nice study that was published this month. Obstetrics and Gynecology Reproductive Biology, respected journal where they talk about using a laser. Now, the interesting about these lasers is that the depth of them is about the depth of two or three pieces of paper. It’s actually more shallow than a business card. So it’s really, a tiny pinpoint laser made holes that are in a grid, but it’s no deeper than several pieces of paper. So it’s reasonably safe and in the right hands it can really change lives.

    So these people did this study showing that not only did it help many women with their incontinence, but it also as a side effect helped their sexuality. So worth looking at if you have this problem and asking your doctor about.

    Now most of the leaders, and the thought leaders using lasers to help with urinary incontinence are also combining it with platelet rich plasma and a procedure called the O-Shot. And it seems to enhance the effects of it.

    Lasers have been known to improve the results and the speed of healing for facial lasers for 15 years. So we’re seeing the same thing when you combine the laser with PRP. So ask your doctor about it. If you want to know more about it, there’s some links below this video to check out. Hope you find this helpful.

     Find nearest O-Shot® provider<–

    Here’s where to read the research<–

  • Treating dyspareunia (painful sex) after breast cancer

    research from Menopause<–

    Research about building healthier vaginal tissue<–

    Transcript

    Charles Runels. Somewhere around one in eight women in the United States will eventually suffer with the effects of breast cancer. Thankfully most women who have breast cancer will survive it, but unfortunately they survive with some problems that might plague their love life. One of those is dyspareunia, or painful sexual intercourse, due to the fact that vagina may be dry with hormonal changes that are secondary to the treating of breast cancer. So it might be helpful to look at a couple of papers involving that.

    This paper was published in SKINmed here on PubMed. You can see the whole paper if you click up here and find it. But these guys talked about using platelet rich plasma and how it uses the same technology, or the same bowel Segler strategies, that are used in the face and in growing hair, to help the tissue of the vagina become healthier, even when there’s no estrogen. Which it’s better to have estrogen on board, but if you can’t have it because of breast cancer, as much as you would like, this is a great way to help the tissue become healthier and more moist. And so this is one paper that talked about it.

    Another one of my favorite research papers appeared in Menopause, a highly respected journal, where they use platelet rich plasma and documented that the pain from the sex went down because they were lubricating better after having an O sharp procedure done. So I highly recommend you forward this to anyone you know who may be struggling with this. There’s … breast cancer is … it’s not just about the cancer. It’s how it affects families and love relationships. So it’s a serious problem. And there are other ways to do it. You could use a lubrication, you could use lidocaine cream, but it seems to me nothing would be better than actually making the tissue healthier. So I’ll put links to this research below the video, and I hope you’ll share it with anyone who might be helped.

    Find nearest O-Shot® provider<–

     

     

     

  • Reviving Ovaries to Improve Life

    

    Find provider<–

    Read the research mentioned in the video<–

    You might’ve seen this episode of the Housewives of Orange County that came out this month. A lot of press has been out and discussing what happened with Shannon Storms, and why she got the shot and what might be possible with it. I think might be helpful to actually go to the medical research and look at this paper that came out this year about actually seeing what happens with the behavior, and the sex drive and, the whole life of people who have platelet rich plasma injected into actually the ovaries.

    So what this study did was they injected ovaries with PRP, which is just a … It’s the concentrate of the growth factors in the platelets of someone’s blood. And then they documented that the ovary started to create new hormones and creating a younger mindset within the woman’s body. Obviously your ovaries do more than make eggs.

    They have to do with metabolism and how you think, and how things work. So they documented an improvement you see and clarity of thinking. Lots of things happened by waking up the ovaries. There’s also been recent studies showing that you can use platelet rich plasma to help a post-menopausal woman sometimes produce fertile eggs again.

    But now what we do with our O-Shot®, what Shannon had, was instead of using it in the ovary, or instead of using in the face like with our vampire facelift, we’re using it in the genital tissue to restore blood flow and nerve function, and improve the sexuality and the urinary continence of women who might have problems with those things.

    If you think this might be of help to you, I will put a link to the research below the video and also there’s a link to find one of our providers who would be happy to talk with you about it. I hope you found this helpful and you’ll send it to someone whom you think might be helped by it.

  • O-Shot® Procedure Helps Woman Conceive?

    Hey, so I thought you might be interested in this article where this woman got an O-shot and not only did it make her sex better but somehow helped her to conceive. So, you can believe it or not believe it, but I think it’s a pretty simple concept to think that maybe if someone wants to have sex more they might be more likely to get pregnant. But more interesting, and it doesn’t cover that in this article, but some of the people in our O-shot group have demonstrated that you can actually inject the ovaries and a postmenopausal woman be able to become fertile again.

    Some Italian doctors published that study about a year ago, but people in our group have been doing it now for several years. So really interesting, but it might be fun to actually go look at some of the research about it. If you go over to PubMed and you look at this article, it’s written by a Brazilian doctor Dr. [Nato 00:01:01] down in Brazil who sees so many patients as a gynecologist down there and documented the improvement in incontinence and in sexual function, which makes sense, PRP’s been around so long.

    So if you go Google, if you just look at platelet-rich plasma in PubMed, there’s so much about it. I’ll just show you right now. If you just Google platelet-rich plasma on PubMed where all the good research lives, you’ll see there’s 11,000 papers. It’s been researched for the past 20 years, and if you think about what we’re doing, if you just look at the anatomy of the vagina, I’ll just pull it up here for you, and look at images here, what we’re doing is we’re coming in and rebuilding the tissue that’s right here between the vagina and the urethra, and this tissue correlates on ultrasound studies with the ability to have an orgasm. It correlates with continence. It becomes thin with menopause. We’ve known for 20 years, the orthopedic surgeons, the wound care doctors, that PRP helps rebuild healthy tissue with fibroblast and new blood vessels and new nerve.

    But we’re just now beginning to explore this with research about how rebuilding tissue here using the same protocols can help with sex and can help with continence. So if you’re interested, you should call one of our doctors listed on the directory and have somebody check it out for you.

    Research about the O-Shot for urological conditions<–

    Woman pregnant after O-Shot® procedure<–

    Research demonstrating help with incontinence<–

    Find nearest O-Shot® provider<–

  • Ultimate Intimacy

    Cindy Barshop: Hey ladies, we’re here at The VSPOT, which is a women’s intimate health spa. And my name is Cindy Barshop and we’re here with renowned Dr. Carolyn Delucia, world renowned gynecologist. And we’re here to tell you the truth about women’s intimate health and vaginal rejuvenation. So first of all, vaginal rejuvenation is not saying, “I want a cute vagina.” It’s saying that we want more intimacy. We don’t want to suffer in silence with what? Let me just think of a few of the things, dryness, inability to orgasm, difficulty to orgasm, after you have a baby, some looseness, yes, that’s possible. It doesn’t pop back.

    Carolyn Delucia: And losing urine.

    Cindy Barshop: That was my big problem was the losing urine. So those are just a few of the things that we’re going to address. But why are we talking about it now? Because it’s super, super important to get the word out. We’re trying to educate people. And the most unbelievable way to educate people is the way Carolyn did it, is she put out a book, a simple, unbelievable, the greatest book about everything. Even your child should know. Well, not child, let’s say mid age, like after menstruation, to really find out. So just please Carolyn, tell us a little bit about it.

    Carolyn Delucia: Thank you, Cindy. The book I wrote is called Ultimate Intimacy: The Revolutionary Science of Female Sexual Health. It’s available on amazon.com right now on an ebook. And the reason I wrote the book, as Cindy has mentioned, is that we have all been suffering. Women suffer every day. You may be suffering from not having comfortable intercourse with your partner and stopping from even being intimate because of pain, because of lack of pleasure. Why are we going through this when women have a solution? And there-

    Cindy Barshop: Because there’s not enough information out there. That is the facts.

    Carolyn Delucia: That’s right.

    Cindy Barshop: And that’s why Carolyn came out with the book. Honestly, Carolyn, I even read through the book super quick and I was like, “Whoa, finally people have the truth. They have the options.” You know, what do I do for looseness?

    Carolyn Delucia: Yeah, exactly. So in the whole book, we’ll go through what traditionally has been done, what the problem is, what solutions we have now, and what is to come in the future. There’s so much promising information out there for women and these conditions. Never having to go through those lonely times, when you’re sitting there wondering, “Do I even like my partner anymore? Is it me? Is something different?” And you torture and torment yourself.

    Cindy Barshop: Is it in my head? I hate that. It always goes to women, it’s in your head. It’s horrible. It’s not.

    Carolyn Delucia: It’s not. And there are ways to treat this. So the book goes through all of those topics. And my goal was to really educate women that there are solutions to everything we’re experiencing, and we provide them here at The VSPOT. But there are many other physicians, as well, and I give resources to that in the book.

    Cindy Barshop: Let’s stop suffering in silence, ladies.

    Carolyn Delucia: Yes.

    Cindy Barshop: Excuse me. Let’s let our friends know that there are solutions out there and join together. It’s like the year of the woman. Yay.

    Carolyn Delucia: Yay.


    Research<–

    V-Spot™ <–

  • Sex after Breast Cancer–New Research

    Transcript

    Hello, I’m Charles Runels. I’m a physician who’s been taking care of women, thousands of women for the past 20 years, and I’d like to talk with you about a really serious problem, which is how to have comfortable, enjoyable sexual relations as a woman who has survived breast cancer.

    They say around one in eight women will struggle with breast cancer. It’s personal to me because I have women in my family who have fought breast cancer and I’ve taken care of a hundreds of women who have suffered with the problem. And imagine what happens in the heartache from having survived the cancer, and now having pain when you try to have sexual relations with your husband.

    Research from this video<–

    Research about O-Shot® for dryness after breast cancer<–

    More research–summary of other options<–

    Find nearest O-Shot® provider<–

    Well, the things that have been tried for that are legion because it’s a really disheartening thing. Unlike say, lack of desire or trouble with orgasm, pain will cause people to start to avoid each other. So, a woman can be deeply in love with her husband and start to avoid him because she loves him and doesn’t want to say no to him. Yet, if she says yes, there’s pain. And so, love becomes associated with pain.

    What a horrible thing.

    So what’s been tried are things like lubricants and numbing medicine. But imagine that, you’re going to have sex but you’re going to put on lidocaine cream so you can’t feel the sex. It’s been a really difficult problem to solve. You can put the woman back on hormones, but now she has comfortable sex, but has to worry more about recurrence of her breast cancer.

    So, I was looking at this research which pointed out some of the … this is just out recently, and it points out that there are people now who are doing laser therapies, and they mentioned this warning, some of the laser companies about using this as a way to treat the problem. Actually to expand upon that, the warning was not having to do with the possibilities of it helping so much as it had to do with the laser companies making claims to try to sell the laser that were not approved by the FDA.

    So physicians who are using these lasers are often getting great results. It’s just that the person actually selling the laser or the companies were not following proper guidelines. So, that’s a possibility that’s fairly recent that could be used in place of some of the estrogen therapies.

    Another possibility, which was published in Menopause, is the use of platelet rich plasma [as done with our O-Shot® procedure] as a way to help because it has a local effect that doesn’t increase estrogen levels. What it does is just repair the tissue by recruiting growth factors to the area. Just like the professional football players have done for many years, over 10 years, and orthopedic surgeons and dentists to recruit growth factors to the area to repair tissue.

    So, we’re having a really wonderful result with this. Over 85% of our women are getting better with this after an O-Shot® placed in the anterior vaginal wall to wake up the Skene’s glands (or the periurethral glands) and help that tissue become healthier and for more comfortable sex to happen without having to be on estrogen.

    I recommend that you contact one of our O-Shot® providers and discuss, it may not be right for you. I’m obviously not your physician, but I want you to be aware of this as a possibility, and I hope that you find it helpful for you or someone you love. You’ll find links to this research below this video.

    Apply to become an O-Shot® provider<–

  • A “Triad” for Incontinence in Women

    Transcript

    Dr. Pelosi: Our next speaker is Dr. Oscar Aguirre from Colorado. If you don’t know Oscar he is an urogynecologist who’s been performing cosmetic vaginal procedures for a very long time … surgical and non-surgical, and he’s going to speak to us about his experience with the Viveve System, the radiofrequency with the active cooling.

    Dr. Aguirre: Good morning. Thank you, Dr. Pelosi, for inviting me and wanted to talk about the Viveve System and how I incorporate that into my practice initially and some good work being done on showing its efficacy for stress incontinence. As [Marco 00:01:00] mentioned … Which is my forward? So as he mentioned I am a urogynecologist. I’m in Denver, Colorado. This is the focus of my practice, I started first off as a urogynecologist but then added cosmetogynecology in 2007 as Dr. Pelosi mentioned, and then some body contouring.

    Dr. Aguirre: So at first my practice is, I called it pelvic specialty care. I thought that was great as a urogynecologist concentrating on what you see here on the left side. As most urogynecologists, we concentrate on the pelvic floor, we’re dealing with incontinence, pelvic relaxation, pelvic surgery, of course. In 2005, when the meshes came out, then doing Sacral Neuromodulation for voiding dysfunction, fecal incontinence, and adding Botox for that as well.

    Dr. Aguirre: But during this seven-year period of my early career, patients were always asking other things, saying, “Well, while you’re doing my bladder repair, can you do something about my tummy? Is everything okay down there? I want my vagina to be tighter. I want it nicer or a smaller labia.” So all these things weren’t things that we were taught in residency, let alone, pelvic surgery fellowship. So, and then what changed things even worse, or even further was the 2011 FDA statement, with regards to mesh. So the practices are changing quite a bit.

    Dr. Aguirre: But then, in 2006 or so, the robots started coming out, and I made a point of not specializing in doing any robotic surgery but decided to do more cosmetic surgery. So I went and got trained with Dr. Matlock, I went with Dr. Alinsod to see how he does this in the office, then went with the Pelosis to learn liposculpture. So, that was the change in my practice. So from 2006, I changed the identity of my practice and it’s more pelvic surgery, intimate aesthetics. I thought that was cool.

    Dr. Aguirre: But then, so where do the lasers come in? Where do the non-surgical rejuvenation treatments come in? From 2007 to 2013, I felt my practice reached a ceiling. I was focused on surgical rejuvenation, where patients weren’t always looking for surgery. There was a small percentage of women who had really a normal exam, who wanted better sex, and their only option at the time was a vaginoplasty. I kind of felt bad. They were really at the stage one relaxation, and I’m doing surgery on them. And a lot of those women didn’t want surgery, so vaginoplasty is a great option for the right patient but most women just want sex to be better. They may be already having good sex.

    Dr. Aguirre: So, I tell patients, it’s hard to make, I can’t make good sex better surgically. I don’t want to stand a risk of their being a problem. If they’re having terrible sex, great. Hands down, vaginoplasty is probably the best option. And the majority of women with incontinence, they don’t want surgery, and they certainly don’t want a sling anymore, the majority of them.

    Dr. Aguirre: Then in 2013, I saw Dr. Bader who gave a talk on vaginal lasers for tightening. I thought, “That doesn’t work. How can that work for looseness? It’s just a laser.” So, Alma was good enough to let me borrow the laser for a couple months, and my first patient was a surgical tech who volunteered. She didn’t have an issue or a medical problem, she didn’t have prolapse. She was willing to do it because, in her life, sex was good. I thought, at first, “No, this isn’t real. I’m looking for someone with a problem.” And then she kind of slaps me on the hand, says, “Sex can always be better, stupid.”

    Dr. Aguirre: That was a paradigm shift in my thinking and how I approach patients because the majority of our patients that we treat are doing well. They just want to be better in a non-surgical way, certainly. So then, came the fractional CO2 to my practice. Then I trained with Dr. Runels, I did the O-Shot®, and that combination is beautiful. So we heard a nice talk this morning about combination therapy, so combining laser with PRP. So why would I need to add Viveve, which is a very quick frequency, because a lot of my patients were still wanting that introital tightened. They had better sensation inside. The laser worked well for many features. The O-Shot® was great but they still wanted more, so it’s like, “Oh, maybe she needs surgery.”

    Dr. Aguirre: So, that’s where, when we think about by in 2017 also, when I purchased the Viveve System, there were many other, there’s a lot of, as Dr. Pelosi said there’s an overcrowded market, but actually the non-surgical applications of what we’re doing is a bigger [inaudible 00:06:08]. It’s a larger piece of the pie of patients that want non-surgical treatments.

    Chapter 14 Covers the O-Shot® Procedure

    Dr. Aguirre: So, now it’s how, combining all these modalities into our patients, all for, think of vaginal rejuvenation. The patients look at it as vaginal rejuvenation by leading to individually thinking what aspect of their symptoms are we trying to improve by introducing collagen deposition, improving tissue remodeling, etc. All those treatments, the goal is to improve lubrication, sensation, and bladder control. And to them, it’s vaginal rejuvenation. To me it’s incontinence, atrophy, it’s more medical.

    Dr. Aguirre: So, the reason for the Viveve is when I first heard of the randomized sham study, well controlled study demonstrating efficacy at one year for improving sexual sensation, I thought, well that’s what I needed to add to my complimentary services. And it’s great because I don’t have to do the treatment. I have three nonmedical doctors in my office doing treatments. We have two systems, so it’s a way of moving along with our patients. So I thought of combining them with the other treatments.

    Dr. Aguirre: So how does it work? Really quickly so, Dr. Pelosi mentioned the tip of the system cools the surface of the skin while the RF goes deeper into the tissues. It treats down into the lamina propria. So now, it’s effect on incontinence. So was it beneficial? Also, these patients are choosing mainly the Viveve for improving introital laxity. Many of these patients have incontinence, of course, and those symptoms are improving. Now I’m going to show some information, some data here on some early work on the feasibility study that now led the way towards the two studies, one an international study that just finished enrollment, and then a US study that will start enrollment, and I would happy to be a part of it later this year.

    Dr. Aguirre: But to be brief, so, this is showing, it’s kind of a busy slide, but there’s five parameters that we’re looking at. So a one-hour pad weight test is the most impressive. So if you look at one year out, or at the baseline scores was 7.3 grams of one hour, reduced down to … threw me off there … so reduced down to 3.2 at 12 months. So what this essentially shows that in one year 72% of patients showed a marked reduction in their pad weight test. So that’s a one-time treatment demonstrating results at six months and even up to a year.

    Dr. Aguirre: So then, looking at it in one year also, 52% of patients or subjects at one year showed a greater than 50% reduction in their padway test. And also, if you look at the more moderate stress incontinent patients, they also showed improvement. They actually showed, 67% of them showed a greater than 50% reduction in their incontinence in their pad weight test. So this is taking even more, pretty incontinent patients, making them relatively dry. And actually, 50% of them showed to demonstrate a cure rate defined as less than one gram of leakage in a one-hour pad weight test compared to seven and a half grams.

    Dr. Aguirre: Again this shows that at four months, six months, and 12 months, it shows a persistent efficacy of the one-time treatment. And also looking at questionnaires UDI-6, IIQ-7. So, and then some additional clinical updates. So that was just the [Pita 00:10:08] study. The international LIBERATE study, which is what it’s called, just finished enrollment earlier this year. We should have that data in about six months. That’s the study done in Canada, with over 100 patients. And that LIBERATE U.S. study will be started later this year, hopefully. Our goal is to enroll more than 50 patients.

    Dr. Aguirre: Then the Viveve II. I purchased it based on the Viveve I data, which I mentioned earlier, the pre-poll. So that study showed that in one year, women had three times more improvement in their vaginal sensation aside from placebo. So now this Viveve II study has been going on. It should finish enrollment later this year. That’s in the U.S.

    Dr. Aguirre: So then, what’s my approach? If you think of, as a urogynecologist, so I see women with vaginal relaxation, and I’m always asking questions about their sexual function, their urinary function, valve function. So think of the female sexual dysfunction. It could be orgasm issues, could be incontinence with sex, could be dyspareunia, it could be looseness, it could be vaginal dryness, stress incontinence. You look at that whole picture, ask all those questions, and then what are our current traditional treatments? Well, we always say do Kegels, doing biofeedback, vaginal [inaudible 00:11:36]. Do they need a psychiatric evaluation? Would they benefit from testosterone? Maybe it’s a sling, or reconstructive and cosmetic vaginal surgery, so from non-surgical to surgical.

    Dr. Aguirre: And of those new treatments, I will add, depending, and offer depending on what their complaints are. So the Viveve if they, if on exam day on introital laxity and they complain of it, and they wanted their to improve sensation and orgasm, and now they have incontinence. So a woman with those three symptoms, that’s a great option for them. Now if she’s 65 and post-menopausal entropic, then I’m gonna add fractional CO2 to it, to improve vaginal health, improve vaginal dryness and atrophy, and also probably prove helpful in incontinence.

    Dr. Aguirre: If they wanna improve orgasm, then we’ll add O-Shot®. So probably our most popular, common treatment in our office is doing this triad of treatments. So what works best is doing an O-Shot®, Viveve, and fractional CO2 at the first setting, and then having them come back two more times to finish their laser series.

    Dr. Aguirre: But it all depends on what symptoms they’re wanting to improve, and we as specialists in women’s health think it’s important for us to provide women with all their options for feminine rejuvenation and go beyond what’s traditionally taught. We should listen to our patients, and it was mentioned earlier, hand a patient a mirror and have a discussion. Have them look at themselves and explain to them. It’s a great time to educate them on, why are they feeling loose? Why are they incontinent? And then provide them with all the options, and then some realistic expectations, of course.

    Dr. Aguirre: Thank you very much.

    Research<–

    Dr. Oscar Aguirre <–

    ISCG (International Society of Cosmetogynecologists) <–

    Find O-Shot® provider<–

    Apply for training as an O-Shot® provider<–

  • Dr. Oscar Aguirre discusses urinary incontinence

    Transcript

    Dr. Pelosi: Our next speaker is Dr. Oscar Aguirre from Colorado. If you don’t know Oscar he is an urogynecologist who’s been performing cosmetic vaginal procedures for a very long time … surgical and non-surgical, and he’s going to speak to us about his experience with the Viveve System, the radiofrequency with the active cooling.

    Dr. Aguirre: Good morning. Thank you, Dr. Pelosi, for inviting me and wanted to talk about the Viveve System and how I incorporate that into my practice initially and some good work being done on showing its efficacy for stress incontinence. As [Marco 00:01:00] mentioned … Which is my forward? So as he mentioned I am a urogynecologist. I’m in Denver, Colorado. This is the focus of my practice, I started first off as a urogynecologist but then added cosmetogynecology in 2007 as Dr. Pelosi mentioned, and then some body contouring.

    Dr. Aguirre: So at first my practice is, I called it pelvic specialty care. I thought that was great as a urogynecologist concentrating on what you see here on the left side. As most urogynecologists, we concentrate on the pelvic floor, we’re dealing with incontinence, pelvic relaxation, pelvic surgery, of course. In 2005, when the meshes came out, then doing Sacral Neuromodulation for voiding dysfunction, fecal incontinence, and adding Botox for that as well.

    Dr. Aguirre: But during this seven-year period of my early career, patients were always asking other things, saying, “Well, while you’re doing my bladder repair, can you do something about my tummy? Is everything okay down there? I want my vagina to be tighter. I want it nicer or a smaller labia.” So all these things weren’t things that we were taught in residency, let alone, pelvic surgery fellowship. So, and then what changed things even worse, or even further was the 2011 FDA statement, with regards to mesh. So the practices are changing quite a bit.

    Dr. Aguirre: But then, in 2006 or so, the robots started coming out, and I made a point of not specializing in doing any robotic surgery but decided to do more cosmetic surgery. So I went and got trained with Dr. Matlock, I went with Dr. Alinsod to see how he does this in the office, then went with the Pelosis to learn liposculpture. So, that was the change in my practice. So from 2006, I changed the identity of my practice and it’s more pelvic surgery, intimate aesthetics. I thought that was cool.

    Dr. Aguirre: But then, so where do the lasers come in? Where do the non-surgical rejuvenation treatments come in? From 2007 to 2013, I felt my practice reached a ceiling. I was focused on surgical rejuvenation, where patients weren’t always looking for surgery. There was a small percentage of women who had really a normal exam, who wanted better sex, and their only option at the time was a vaginoplasty. I kind of felt bad. They were really at the stage one relaxation, and I’m doing surgery on them. And a lot of those women didn’t want surgery, so vaginoplasty is a great option for the right patient but most women just want sex to be better. They may be already having good sex.

    Dr. Aguirre: So, I tell patients, it’s hard to make, I can’t make good sex better surgically. I don’t want to stand a risk of their being a problem. If they’re having terrible sex, great. Hands down, vaginoplasty is probably the best option. And the majority of women with incontinence, they don’t want surgery, and they certainly don’t want a sling anymore, the majority of them.

    Dr. Aguirre: Then in 2013, I saw Dr. Bader who gave a talk on vaginal lasers for tightening. I thought, “That doesn’t work. How can that work for looseness? It’s just a laser.” So, Alma was good enough to let me borrow the laser for a couple months, and my first patient was a surgical tech who volunteered. She didn’t have an issue or a medical problem, she didn’t have prolapse. She was willing to do it because, in her life, sex was good. I thought, at first, “No, this isn’t real. I’m looking for someone with a problem.” And then she kind of slaps me on the hand, says, “Sex can always be better, stupid.”

    Dr. Aguirre: That was a paradigm shift in my thinking and how I approach patients because the majority of our patients that we treat are doing well. They just want to be better in a non-surgical way, certainly. So then, came the fractional CO2 to my practice. Then I trained with Dr. Runels, I did the O-Shot®, and that combination is beautiful. So we heard a nice talk this morning about combination therapy, so combining laser with PRP. So why would I need to add Viveve, which is a very quick frequency, because a lot of my patients were still wanting that introital tightened. They had better sensation inside. The laser worked well for many features. The O-Shot® was great but they still wanted more, so it’s like, “Oh, maybe she needs surgery.”

    Dr. Aguirre: So, that’s where, when we think about by in 2017 also, when I purchased the Viveve System, there were many other, there’s a lot of, as Dr. Pelosi said there’s an overcrowded market, but actually the non-surgical applications of what we’re doing is a bigger [inaudible 00:06:08]. It’s a larger piece of the pie of patients that want non-surgical treatments.

    Chapter 14 Covers the O-Shot® Procedure

    Dr. Aguirre: So, now it’s how, combining all these modalities into our patients, all for, think of vaginal rejuvenation. The patients look at it as vaginal rejuvenation by leading to individually thinking what aspect of their symptoms are we trying to improve by introducing collagen deposition, improving tissue remodeling, etc. All those treatments, the goal is to improve lubrication, sensation, and bladder control. And to them, it’s vaginal rejuvenation. To me it’s incontinence, atrophy, it’s more medical.

    Dr. Aguirre: So, the reason for the Viveve is when I first heard of the randomized sham study, well controlled study demonstrating efficacy at one year for improving sexual sensation, I thought, well that’s what I needed to add to my complimentary services. And it’s great because I don’t have to do the treatment. I have three nonmedical doctors in my office doing treatments. We have two systems, so it’s a way of moving along with our patients. So I thought of combining them with the other treatments.

    Dr. Aguirre: So how does it work? Really quickly so, Dr. Pelosi mentioned the tip of the system cools the surface of the skin while the RF goes deeper into the tissues. It treats down into the lamina propria. So now, it’s effect on incontinence. So was it beneficial? Also, these patients are choosing mainly the Viveve for improving introital laxity. Many of these patients have incontinence, of course, and those symptoms are improving. Now I’m going to show some information, some data here on some early work on the feasibility study that now led the way towards the two studies, one an international study that just finished enrollment, and then a US study that will start enrollment, and I would happy to be a part of it later this year.

    Dr. Aguirre: But to be brief, so, this is showing, it’s kind of a busy slide, but there’s five parameters that we’re looking at. So a one-hour pad weight test is the most impressive. So if you look at one year out, or at the baseline scores was 7.3 grams of one hour, reduced down to … threw me off there … so reduced down to 3.2 at 12 months. So what this essentially shows that in one year 72% of patients showed a marked reduction in their pad weight test. So that’s a one-time treatment demonstrating results at six months and even up to a year.

    Dr. Aguirre: So then, looking at it in one year also, 52% of patients or subjects at one year showed a greater than 50% reduction in their padway test. And also, if you look at the more moderate stress incontinent patients, they also showed improvement. They actually showed, 67% of them showed a greater than 50% reduction in their incontinence in their pad weight test. So this is taking even more, pretty incontinent patients, making them relatively dry. And actually, 50% of them showed to demonstrate a cure rate defined as less than one gram of leakage in a one-hour pad weight test compared to seven and a half grams.

    Dr. Aguirre: Again this shows that at four months, six months, and 12 months, it shows a persistent efficacy of the one-time treatment. And also looking at questionnaires UDI-6, IIQ-7. So, and then some additional clinical updates. So that was just the [Pita 00:10:08] study. The international LIBERATE study, which is what it’s called, just finished enrollment earlier this year. We should have that data in about six months. That’s the study done in Canada, with over 100 patients. And that LIBERATE U.S. study will be started later this year, hopefully. Our goal is to enroll more than 50 patients.

    Dr. Aguirre: Then the Viveve II. I purchased it based on the Viveve I data, which I mentioned earlier, the pre-poll. So that study showed that in one year, women had three times more improvement in their vaginal sensation aside from placebo. So now this Viveve II study has been going on. It should finish enrollment later this year. That’s in the U.S.

    Dr. Aguirre: So then, what’s my approach? If you think of, as a urogynecologist, so I see women with vaginal relaxation, and I’m always asking questions about their sexual function, their urinary function, valve function. So think of the female sexual dysfunction. It could be orgasm issues, could be incontinence with sex, could be dyspareunia, it could be looseness, it could be vaginal dryness, stress incontinence. You look at that whole picture, ask all those questions, and then what are our current traditional treatments? Well, we always say do Kegels, doing biofeedback, vaginal [inaudible 00:11:36]. Do they need a psychiatric evaluation? Would they benefit from testosterone? Maybe it’s a sling, or reconstructive and cosmetic vaginal surgery, so from non-surgical to surgical.

    Dr. Aguirre: And of those new treatments, I will add, depending, and offer depending on what their complaints are. So the Viveve if they, if on exam day on introital laxity and they complain of it, and they wanted their  to improve sensation and orgasm, and now they have incontinence. So a woman with those three symptoms, that’s a great option for them. Now if she’s 65 and post-menopausal entropic, then I’m gonna add fractional CO2 to it, to improve vaginal health, improve vaginal dryness and atrophy, and also probably prove helpful in incontinence.

    Dr. Aguirre: If they wanna improve orgasm, then we’ll add O-Shot®. So probably our most popular, common treatment in our office is doing this triad of treatments. So what works best is doing an O-Shot®, Viveve, and fractional CO2 at the first setting, and then having them come back two more times to finish their laser series.

    Dr. Aguirre: But it all depends on what symptoms they’re wanting to improve, and we as specialists in women’s health think it’s important for us to provide women with all their options for feminine rejuvenation and go beyond what’s traditionally taught. We should listen to our patients, and it was mentioned earlier, hand a patient a mirror and have a discussion. Have them look at themselves and explain to them. It’s a great time to educate them on, why are they feeling loose? Why are they incontinent? And then provide them with all the options, and then some realistic expectations, of course.

    Dr. Aguirre: Thank you very much.

    Research<–

    Dr. Oscar Aguirre <–

    ISCG (International Society of Cosmetogynecologists) <–

    Find O-Shot® provider<–

    Apply for training as an O-Shot® provider<–

  • A Way to Calm the Pain of Vestibulodynia

    Find nearest O-Shot® provider<–

    Read the research<–

    Charles Runels: So I thought you might want to share this research that came out this month. It’s talking about using Botox to help with provoked vestibulodynia. In other words, it hurts when you touch the opening to the vagina, so the vestibule or the opening of the vagina, dynia or pain provoked by touch. This is a very severe problem, and although you may not suffer with it, I can tell you this right here really breaks up relationships, and if you know someone who’s suffering with this, I’d really like you to forward this to them, because it just came out this February of this year.

    What they did was they took women and they divided them into three groups, and one group got saline, and then one group got 50 units of Botox, and another group got 100 units of Botox. They found by injecting the Botox, the group that got the Botox at three months and again at six months, they had significant decreases in their pain. I also think it might be helpful because of the anti-inflammatory effects of it, of injecting PRP in this region. We’re seeing that helps also with dyspareunia, especially with lichen sclerosis and with scarring. We’re not sure exactly what caused provoked vestibulodynia in many patients, so that could be a combination therapy.

    RESULTS WILL VARY

    There is not a lot more I can say about this except that the downside of it should be not bad […for most people, please see consent form, results will vary and no medical procedure is perfectly effective or perfectly predictable in either results or side effects]. The worst that’s going to happen is if it doesn’t work, and hopefully the good side is that if your body or your lover’s body responds as they did in this trial, it could really be life changing.

    Consent Form<–

    I hope you’ll give us a call if you think this might be something you want to try, so thank you very much.

    FIND NEAREST O-SHOT® PROVIDER<–

  • Brave Reporter Undergoes the O-Shot® Procedure–Tells All in Cosmo

    Sophie Blackman does very brave reporting about her quest to find better sexual relations. Thousands of women will benefit.

    Sophie Blackman reports the details of her experience with the O-Shot® procedure in this eye-opening report. Not only will the last 3 paragraphs make you laugh–if you have a heart–you’ll understand why sexual dysfunction can cause deep emotional hurt and why finding better ways to help women is so very very important.
    Here’s where to read the article (click)<–

    Read the research<–

    Find nearest provider<–

    Physicians and physician extenders apply for training to be come an O-Shot® provider<–

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