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24
Jan
2024

The Gynaecologist's Guide to Aesthetic Gynaecology

Doctor Nadia Yousri is a Speaker, to RCOG & A winner of the Best Arab in the World" Award 2022.

The female intimate area (the genital area) has the most sophisticated anatomy and physiology. The micro details of the intricacies of anatomy and physiology are owned by Gynaecologists rather than GPs or junior doctors/medical students.

Dysfunctions of this area are such specialised syllables to Gynaecology. Adequate management of these dysfunctions is beyond the primary care realm and is the reason for referral to . Examples of these include Vaginismus treatments, urinary stress incontinence (urine leakage), dyspareunia (pain during sex), vaginal dryness and itching, reduced sensation and many more that are linked to post-delivery effects, birth trauma or due to menopause. Which again comes under sheer OB&GY scrutinised knowledge and assessment.

In the past, the available treatment options were either surgical or natural and "conservative" e.g. Kegel’s exercises for pelvic floor muscles or the use of HRT etc. These options do require thorough assessment and case selection with risk vs benefit analysis to get the utmost of the results and avoid side effects/complications.

Then the time came when Gynaecologists thought of exploring the world of Regenerative Medicine (RM). This is already an up-and-running practice for decades- in other medical specialities like sports medicine (injuries) and orthopaedic, arthritis etc attaining very successful results and backed with a gravitas of evidence-based studies. 

The principle of RM lies in applying non-surgical techniques to stimulate the regenerative cells of the body to rejuvenate a certain area by improving circulation and enhancing new tissue formation, which subsequently leads to improvement in function as well. Hence, Aesthetic Regenerative Gynaecology non-surgical procedures were developed and are increasingly growing because of the successful results. These procedures are considered a brand-new category of treatment options placed between the surgical and conservative.

In my opinion: Gynaecologists are best qualified and suited to perform Regenerative Gynaecology procedures for the following reasons:

1) Aesthetic Regenerative Gynaecology is a new MEDICAL Specialty where NON-surgical procedures are used to treat Gynaecological symptoms in Women.

Therefore, As for any other treatment option, it is imperative to apply the rules of proper assessment, case selection and counselling by the authorised and trained specialists who know how to employ these procedures in the best possible way for maximum results ^[1].

Getting the right qualified and trained specialist to do the right procedure for the right patient in the right place with the right outcome ^[2]. [Clinical Governance and Good Medical Practice rules]

2) It is essential to undertake proper Gynaecological history and examination prior to any procedure. The right standards of assessment can be performed by the Gynaecologist (including performing screening tests for infection or cervical smear etc).

3) Gynaecologists are acquainted with the complicated conditions that affect this particular area. S/he is the ultimate referral specialist to be implored to deal with these difficult conditions.

4) There are rules (and standards) set by both the and the about who is permitted to and the prerequisites before conducting the "Intimate examination" and assessment to ensure best practice. ^{[3,4 and 5]}

5) The feminine area’s dysfunctions have usually compounded factors and are notorious for their negative impact on women’s family life, self-esteem and sense of well-being. Women confide in Gynaecologists because they are best suited to appreciate the multifactorial aspects of the problem and are fully trained to manage the complex nature of feminine areas’ dysfunctions.

6) Gynaecologists have a better understanding of the pathophysiology of the various dysfunctional conditions. They are in a privileged position to select the most remedial procedure that is likely to obtain the most successful outcome.

7) Gynaecologists are capable to deliver a holistic approach including understanding, explaining and counselling the condition and various options of treatments with the likelihood of success, side effects, pros and cons of each based on their expertise.

8) The public does trust and in fact prefers to have a specialist to treat them; "The more you know what you are doing, the more you can get the best possible results risks".

9) Patients’ safety and risk management. Avoiding complications.

Gynaecologists are vigilant in detecting and monitoring any reported side effects associated with a procedure or an Energy Based Device.

They know how to piece up the collected data together according to the Gynaecological module of building evidence- on each Aesthetic Gynaecology procedure and design a structured research study to enhance evidence-based practice further.

10) Using energy-based devices is promoted by the manufacturers as safe to handle, however, long-term effects remain, in my opinion, to be monitored and confirmed ideally by the most unbiased specialists who act as the standing guards to women’s health. ^[7]

On July 30, 2018, the U.S. Food and Drug Administration (FDA) issued a  Currently, no vaginal laser device or procedure is cleared or approved by the FDA for any of these vaginal issues.

The FDA is concerned that the safety and effectiveness of these devices haven’t been proven in scientific studies and that using the devices could lead to serious side effects, including vaginal scarring and burns.

"We’ve recently become aware of a growing number of manufacturers marketing