The Vagina Monologues

Knee replacements, back problems, the flu: People love to talk about their health issues. But for women, there’s at least one exception: the vagina. And in the absence of medical help, they can suffer pain, discomfort, and dysfunction that seriously impairs their lifestyle.

But new technology can solve those problems, which can be caused by a number of factors. We went to an expert, Dr. Karen Boyle at Chesapeake Urology Associates (CUA), to learn more about a patented solution called diVa Laser Vaginal Therapy, which is a quick, safe, and effective laser-resurfacing procedure.

Can you tell us what sorts of problems women experience that would call for vaginal treatments or reconstruction?

Pregnancy, vaginal childbirth, aging, and menopause can have negative effects to the internal and external vaginal tissue. The loss of estrogen can also change the health of the vagina. In addition, women can experience lack of lubrication from vaginal atrophy which causes dryness, itching, burning, recurrent urinary-tract infections, diminished sexual response or laxity, pain with intercourse, undesired genital appearance, and stress incontinence.

How does diVa Vaginal Laser Therapy work?

DiVa uses Sciton’s revolutionary hybrid fractional laser technology to treat the both the superficial and deep layers of the vagina to improve and heal the mucosa for improved vaginal lubrication and elasticity, as well as stimulate collagen in the deeper tissue. Most other therapies available only treat the top layer, but diVa is customizable, allowing patients to have an individualized treatment plan based on their clinical needs, age, symptoms, vaginal depth, and degree of vaginal atrophy, disease, or scarring. The laser uses a disposable sterile sheath that is placed gently into the vagina, ensuring comfort and safety. DiVa is performed as a series of three intravaginal laser treatments, timed about four to six weeks apart. Similarly, with diVa Tyte to address vulvar skin, we typically perform 3–5 treatments spaced at time intervals. There is also a yearly maintenance treatment to maintain results and vaginal health.

Is this under anesthesia, and what side effects or downtime is there?

Both procedures are performed in the office under local anesthesia. The treatments are extremely well tolerated and take minutes to complete. There is virtually no real downtime—patients will often return to work that same day and may only experience a bit of spotting or mild swelling, for which we recommend some cool compresses and topical ointment like Aquaphor.

What are the first steps for patients, and what about cost and insurance?

The first step is to make an appointment for consultation to discuss one’s concerns and symptoms and take a reproductive history, followed by a physical examination. These procedures, like most elective laser procedures, are currently not covered by insurance. The cost is comparable to the fees associated with laser dermatologic procedures and are reasonably priced.

You’re well-known in this field. Tell us about your background.

I am a board-certified urological surgeon. I was educated at Harvard College, Albany Medical College, and completed my surgical training at The Johns Hopkins Hospital and my fellowship in reconstruction and microsurgery at Baylor College of Medicine. I practiced as faculty at Johns Hopkins for a number of years before joining Chesapeake Urology Associates. Under the mentorship of Drs. Siegel and Lerner, we formed Chesapeake Aesthetic Surgery and created a division within CUA to focus not only on women’s health, but also aesthetics. I work with a wonderful group of physicians and nurses: They include Sondra Barker, who is a women’s health nurse practitioner with a career dedicated to the treatment of women’s urologic care and incontinence, and Dr. Kelly Johnson, a board-certified urologist with fellowship training in female urology, neurourology, and reconstructive surgery, as well as Dr. Victoria Staiman, who is also a board-certified urologist with specialization in voiding dysfunction, incontinence, and pelvic prolapse. These providers, combined with our dedicated medical and administrative coordinators, Lisa Tibo and Erin Albright, round out a compassionate team to help patients with all of their vaginal health and urological health issues.

Tell us about the history of CUA.

Chesapeake Urology is the largest urology practice in the Mid-Atlantic region, providing an array of urological services. We have divisions in female personal health and continence, over-active bladder, prostate cancer, microsurgery, vasectomy reversal, male fertility, sexual health, urologic cancers, erectile dysfunction, kidney stones, cancer infusion treatments, genital aesthetics and reconstruction, enlarged prostate, and cutting-edge urological research. Chesapeake formed when the most prominent Baltimore urology practices joined under the leadership and direction of Dr. Sanford Siegel. Now led by Dr. Brad Lerner, we operate 25 medical offices and 16 accredited ambulatory-surgery centers with a staff of more than 850, including 87 physicians.