(Lightening Cream Added). You will receive pain-relieving. before & after gallery diane 2020-08-11t18:17:54+00:00 BEFORE AND AFTER PHOTO GALLERY Click the buttons below to view before & after photos of Vaginal Health Center’s patients. A feeling that the rectum has not completely emptied after a bowel. They may resume their daily activities, including sexual intercourse, in about 4 weeks after the procedure. Figure 2. David Ghozland M. It happens when the tissues that support the rectum and vagina are weakened and torn. I met with my surgeon in July and decided we would do a partial hysterectomy and bladder repair. Placing a pessary in the vagina (a device that supports the vaginal walls). , Walters M. This makes a condition like rectocele complicated, because it may take multiple doctors—colorectal surgeon, gynecologist, and urologist—to figure out what's causing the problem and how to fix it. , Walters M. Outcome after transperineal mesh repair of rectocele: a case series. I've seen a urologist, a gyn and a Mayo Clinic urogynologist. If you decide to have no treatment now, it does not prevent you from having treatment at a later date if your rectocele starts to bother you more. These can be identified during digital examination and are common in women with and without constipation. Please, for the love of the beauty gods, remove your makeup and wash your face before slathering on your products. In this surgical procedure, the doctor will make an incision into the back wall of the vagina. Before and after (or now and then) pictures show a scene from the same point of view at different points of time. The cash cost of Rectocele/Enterocele Repair (Rectal Repair) is $6,000. Litrel performs a Vaginal Tightening surgery on a patient with a complaint of vaginal laxity with intercourse. His younger brother died shortly after getting his second jab. See the before/after of male enhancement surgery procedures performed by NY penis lengthening specialist, Dr. Rectocele levatorplasty is an accepted technique of rectocele repair can be perforn1ed utilizing a number of repair, it sometimes leads to vaginal narrowing and techniques, however some of these techniques severely subsequentdyspareunia. Call 434. Visionary Centre for Women. This condition is known as anterior wall prolapse, cystocele or dropped bladder. Surgery is usually used only after you have tried other treatments such as: Doing muscle-strengthening exercises, called Kegel exercises. Cystocele and rectocele should be replaced if they protrude to a greatextent in front of the head, and be held back until a force RM 2AFXG26 –. Pelvic organ prolapse quantification The images were analyzed using the MicroGOP 2000s image analysis software (Context vision AB, Linko¨ping, Sweden) All 17 patients undergoing rectocele repair using installed in a computer workstation (SUN SPARCstation 20; collagen mesh, presented posterior vaginal wall Sun Microsystems Computer Corp. It's also not recommended for those looking to address dyspareunia, or pain during intercourse due to tight vaginal muscles. Do not eat or drink anything after midnight the night before your surgery. This is how you can do it: Upload your image via browsing, drag & drop, using a link or a cloud storage. This means it uses smaller cuts (incisions) than a standard surgery. DDI domain scores were similar between patients before and after primary POP surgery and also for patients after surgery with and without stage 2 or more rectocele. Some women have little or no bleeding initially and then have a sudden gush of old blood or fluid about 10 days later. I used to weigh 155 or 160 (I'm 5' 11") in some of these "before" pictures, but now I've gained over 50. . After your surgery, you may have: Infection. Surgery is done to relieve bulging into the vagina that may be caused by a cystocele and rectocele. It’s done while you’re asleep under general anesthesia. Needle depth 1. If you have vaginal laxity and want to fix it, you need to be sure that your surgeon can fix a rectocele too. Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence. A rectocele (REK-toe-seel) is when your rectum moves forward. 15 Jul 2022. After surgery, women are usually advised to avoid heavy lifting for approximately 6-9 weeks. this shop for half an hour and we haven't seen one sales assistant! A. Block I. Watch a vaginoplasty, bladder and rectocele repair surgery before, during and after, with Michael Litrel, MD, FACOG, FPMRS. A rectocele is a bulge in the anterior (front) or posterior (rear) rectal wall. Our free service repairs both color photos and black & white ones. 6060 Labiaplasty and Vaginoplasty Before and After Photos See photos of a Labiaplasty and Vaginoplasty, performed by Michael Litrel, MD, FACOG, FPMRS. Posterior repair is a surgical procedure to repair or reinforce the weakened layers between the rectum and the vagina. Rectal prolapse occurs when the rectum protrudes or prolapses through the anus instead of the vagina. We have the #1 Anesthesiologist who is the only in Miami that is Board Certified. The technique of vaginal repair of an apical or posterior enterocele is as follows: 1. When the upper part of the vagina drops down from its usual position because of a failure of its supports, it is known as a vaginal vault prolapse. I currently have NO pain in my left foot, 3 weeks after surgery. During surgery, the lining of the bowel, or the section of bowel that has prolapsed, is removed and stitched back together. 57 rectocele stock photos, vectors, and illustrations are available royalty-free. This means it uses smaller cuts (incisions) than a standard surgery. Guffler H, DeGregorio G, Dohnicht S, et al. Wanjari mentioned, vaginal atrophy can cause pain with intercourse. Common problems of dishwashers include water leakage, failure to start and failure to clean the dishes properly. Foods That Help Heal After Surgery - healthbeautyfood. Watch a vaginoplasty, bladder and rectocele repair surgery before, during and after, with Michael Litrel, MD, FACOG, FPMRS. Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence. What can I expect during my recovery from rectocele repair surgery? A rectocele occurs when the fascia, or tissue wall, between the rectum and vagina becomes weak and bulges into the vagina. A support device is placed into the vagina at the end of end of surgery and is removed 21 to 28 days after surgery in the consulting rooms. RM 2AFY5M1 –. Robotic-assisted sacrocolpopexy is one type of surgery to repair this problem. If not, your vaginoplasty will fail. Applicable To. It depends on the type of surgery you have. Patient Information. Surgery is usually used only after you have tried other treatments such as: Doing muscle-strengthening exercises, called Kegel exercises. What are the different stages of vaginal prolapse?. Give it a try using one of the dozens of supported file formats, including DNG, JPG, TIFF, and PNG. But after my second baby was born, it. Otherwise, you may notice: A soft bulge of tissue in the vagina that might come through the opening of the vagina. Suite #111 Dallas, TX 75225. Some women have little or no bleeding initially and then have a sudden gush of old blood or fluid about 10 days later. The authors of the study (rightly) conclude that if a woman has recurrence of her bladder drop and requires another surgery, then just “fixing it” again using the same technique that failed the first time will not give good results. I use the after pseudoelement: p:after {content: url(". You know what I mean, talk about life’s little pleasures. There are many things which can lead to weakening of the pelvic floor, including advanced age. Weight Gain before and after | до и после. / residual faecal masses accumulate in the rectocele pocket and their evacuation is impaired. rectocele repair before and after pictures kk fn Whether menopause increases a woman’s chances of developing a cystoceleis unclear. This condition is known as anterior wall prolapse, cystocele or dropped bladder. This is because we use water to distend the cavity of the uterus so that we can visualise it and see clearly. The goal of rectocele repair is to strengthen the wall between the vagina and rectum. Creatives use Cleanup to create perfect visuals in seconds. You do not want to strain during bowel movements at all, or you risk tearing stitches and undoing the repair. Asimismo, se puede presentar estreñimiento y hemorroides debido a un rectocele. Fitness Home. 1986, 29:707-711. Do this up to 10 times. Litrel helps women that travel from all over the country seeking his expert skills. You very often will be asked not to drink or eat anything for 6 – 12 hours before the surgery. This means it uses smaller cuts (incisions) than a standard surgery. Rectal prolapse surgery is performed in people troubled by the pain and discomfort caused by rectal prolapse as well as the chronic symptoms that can accompany it, such as leakage of stool, inability to control bowel movements (fecal incontinence) or obstructed bowel movements. Rectocele Surgery is a medical procedure / surgery that requires coordination between specialist surgeons, anesthetists and various other specialist medical professionals. Simply upload your picture, select the objects you want to remove, and Fotor will handle the rest. To repair a dishwasher, you must first determine the specific problem. A rectocele or bulge of the back wall of the vagina is most . running, gym training, weightlifting, horseback riding, etc. The challenge lies in the uninformed person who used to use symptoms to guide movement. Pelvic cavity before Rectocele. During a bowel movement when a rectocele is present, stool typically remains trapped in the bulge. Dean Davis, MD. Magnetic resonance imaging of pelvic floor relaxation: Dynamic analysis and evaluation of patients before and after surgical repair. Urology 216. After having 6 kids, I was ready for some. Here’s what to do to take care of yourself: • Use pads to absorb discharge. This makes your intestine push on the back wall of your vagina, making it bulge (see Figure 1). Litrel performs a Vaginal Tightening surgery on a patient with a complaint of vaginal laxity with intercourse. Goodrich MA, Webb MJ, King BF, et al. Charles, IL 60174. com Email: info@olmeccosmeticsurgery. Bleeding after a hysteroscopy can be. Cystocele, urethrocele, enterocele, and rectocele are particularly likely to occur together. Clearwater, FL 33762. Your vagina may be drier for a while. The purpose of this study was to analyze change in bowel function and its relationship to vaginal anatomy 1 year after rectocele repair and pelvic reconstruction in a randomized trial of 3 techniques of rectocele repair. Mesh or a graft may be used if your tissues are not strong enough to hold the repair. This information will help you recover after a pelvic-floor repair operation. Sometimes it is called a “dropped bladder,” “dropped uterus,” “dropped vagina,” or “dropped rectum. Hold the squeeze for 3 seconds, then relax for 3 seconds. The incisions will be closed. After & Before Original Mix — Solar Cycle. Connective tissues will be tightened. I tried to pull examples. Robotic-assisted sacrocolpopexy is one type of surgery to repair this problem. Transrectal repair of rectocele using obliterative suture. It’s done while you’re asleep under general anesthesia. rectocele repair before and after pictures Simply upload your picture, select the objects you want to remove, and Fotor will handle the rest. What you upload and who you share with, should be It is highly recommended to check out if your type of images works well or not before making a purchase. A prolapse is not life threatening, but it can cause pain and discomfort. In women with symptoms of anal incontinence, an evaluation and attempt at medical management should be performed before rectocele repair. Rectocele, or herniation of the anterior rectal wall into the vagina, is a common condition that frequently occurs without symptoms and is reported as an incidental finding in up to 80% of patients who undergo defecography []. In severe cases, the vagina can protrude outside of. Dr. Maximal strength and healing around the repair occurs at 3 months and care with heavy lifting (>10kg/25lbs) needs to be taken until this time. Created for people with ongoing healthcare needs but benefits everyone. Advantages of vaginal reconstructive procedures include: Small vaginal incision, no abdominal incision. Rectocele Repair is done in the surgery center or operating room under general, regional, or local anesthesia. Apr 22, 2022 · Colon and rectum. This makes a condition like rectocele complicated, because it may take multiple doctors—colorectal surgeon, gynecologist, and urologist—to figure out what's causing the problem and how to fix it. While these problems can occasionally exist one at a time, they often occur together to varying degrees. I found that each day was better than the day before and if I kept busy--that helped. The cash cost of Rectocele /Enterocele Repair (Rectal Repair) is $6,000. This usually stops quickly. Cystocele and Rectocele Repair. A small rectocele may not have symptoms, but a. This means it uses smaller cuts (incisions) than a standard surgery. Female anatomy without a rectocele (left), with a rectocele (right) Back to top Causes of Enteroceles and Rectoceles. It is a minimally invasive method. Depends: The surgery might not be too painful depending on the amount of dissection and the location of dissection for the repair. Page 1 of 1. patients operated with native tissue repair solely for rectocele;. If not, your vaginoplasty will fail. Some women have little or no bleeding initially and then have a sudden gush of old blood or fluid about 10 days later. Some women receive approval to return to general exercise 6-8 weeks after prolapse surgery. Cystocele/Rectocele repair if needed can be done vaginally before or after. Hysterectomy, if the uterus is prolapsing and causing discomfort. no straining on the toilet or getting constipated. If not, your vaginoplasty will fail. Stage 2 non-small cell lung cancer (NSCLC) is a type of cancer that develops in one lung or the lymph nodes on the same side of the chest as the original tumor. A rectocele is a bulge, or herniation, of the front wall of the rectum into the back of the vagina. gone to B. vaginal hysterectomy, cystocele & rectocele. All had POP symptoms for the last twelve months and stage II-IV >cystocele</b> <b>and</b>/or <b>rectocele</b>. Figure 1. In the case. The aim of this study is to examine the relationship between rectal–vaginal pressure and symptomatic rectocele in patients with pelvic organ prolapse (POP). This is useful when we want to execute some common code before running a test. Cover image - June 2022; Quick Response - Contact Us; CALL FOR PAPERS. Female – Age: 68 ProcedureDetails: 3 treatments 6 weeks apart. Award-winning and recognized for his expertise, Dr. mouse over images to enlarge Rectocele and Enterocele Before Surgery. DDI domain scores were similar between patients before and after primary POP surgery and also for patients after surgery with and without stage 2 or more rectocele. The bulgy muscle underneath is then repaired with stitches. A perineorrhaphy is the term used for the operation that repairs the perineal body. Afterward, choose the compression rate. Apr 22, 2022 · Colon and rectum. After extensive research and 3 doctor's opinions, I chose to not use mesh at all. The small intestine bulges against the back wall of the vagina. The pessary is most commonly used in the management of pelvic support defects such as cystocele and rectocele. You may even be given your first ice pack before leaving the clinic. The vaginal skin is then closed. They were all grade 3 and would not improve on their own. by his brother. 21 Mar 2022. At first, the discharge tends to be bright red or pink. Placing a pessary in the vagina (a device that supports the vaginal walls). An enterocele (en-TUH-roh-seel) is when your small intestine moves downward. uq; xq. . Your perineoplasty cost will depend on the experience level of your surgeon, their practice location, whether you have local or general anesthesia (which is more expensive), and who administers it. In severe cases, the vagina can protrude outside of. If a perineorrhaphy is required, a diamond-shaped incision of the perineal skin and excision of the diamond-shaped tissue are performed. Surgery can fix the symptom but doesn’t address what contributed to the problem developing in. Before, Everything and After Demo Version — Technicolor. A hysterectomy is not needed for uterine prolapse, cystocele, or rectocele. It’s done while you’re asleep under general anesthesia. Rectocele: the rectum (final section of the large intestine, before reaching the. The only medication I had after surgery was two tylenol. no straining on the toilet or getting constipated. Permanent mesh reinforces the repair and is anchored bilaterally to the pelvic side wall and exits through a small incision approximately 3cm lateral and down from your anus. Whether menopause increases a woman’s chances of developing a cystocele is unclear. Phone: +91-11-4702 5015 , 4702 5016 Website: www. A rectocele is a bulge, or herniation, of the front wall of the rectum into the back of the vagina. Stage 2 non-small cell lung cancer (NSCLC) is a type of cancer that develops in one lung or the lymph nodes on the same side of the chest as the original tumor. It is a minimally invasive method. You can then learn to insert and remove it yourself. Jun 13, 2022 - Explore Lacey Lou's board "Rectocele Repair" on Pinterest. The technique of vaginal repair of an apical or posterior enterocele is as follows: 1. Bring clarity and natural color to your old photos while repairing them. Main Phone: (727) 540-0414. pictures, you can clean photographs, removing any unwanted thing. (See the pictures at right. Health Fitness. Many patients say recovery from this type of surgery is very painful. Basics - before() and beforeEach(). Fax: (727) 540-0672. D, 11645 Wilshire Blvd. Schedule Online. If not, your vaginoplasty will fail. vagina in order to prevent the walls from pushing against each other. Watch a vaginoplasty, bladder and rectocele repair surgery before, during and after, with Michael Litrel, MD, FACOG, FPMRS. STARR procedure: Posterior wall repair was the same as that for the KWPRWR procedure. This consists of the plication of the levator muscles or the plication of the rec-tovaginal fascia. This shows also tlie area of Denudation. 16 Jun 2022. Patient Information. Ask how much liquid to drink every day. After you have these steps down, start your regular sexual routine. We continue to provide OBGYN healthcare services specifically to women in Phoenix and the surrounding areas from their. It is a minimally invasive method. Background Aim of this study is to examine pelvic floor symptoms, anatomical results and patients’ satisfaction after sacrospinous vaginal fixation for stage 4 pelvic organ prolapse. Robotic-assisted sacrocolpopexy is one type of surgery to repair this problem. During the surgery, your doctor. Robotic-assisted sacrocolpopexy is one type of surgery to repair this problem. Restore, sharpen, and repair pictures with AI. , Piedmonte M. A consistent comment from the jurors was that the defense experts, although highly qualified, did not relate well with the jury. This condition is known as posterior wall prolapse, rectocele or . This type of Colorectal Medicine procedure / treatment can be considered reasonably expensive, especially given the skill set, experience, training and equipment used by the. A defecography shows the changes in your rectum when you poop. Hi there! In general, the risk of pain with sexual intercourse after a rectocele repair depends on:. 25 Mar 2016. Rectocele repair, for prolapse affecting the posterior vaginal wall. Your view moments before you taste me. mouse over images to enlarge Rectocele and Enterocele Before Surgery. All had POP symptoms for the last twelve months and stage II-IV >cystocele</b> <b>and</b>/or <b>rectocele</b>. atv for sale san antonio
Paul got a. . Rectocele repair before and after pictures
At Home Workouts. A rectocele is a condition where the tissue between your rectum and vagina weakens, causing your rectum to bulge onto your vagina's back wall. 0006, paired t-test). Michael Litrel, MD, FACOG, FPMRS. Visionary Centre for Women. Adhesions may appear as thin sheets of. The pessary is most commonly used in the management of pelvic support defects such as cystocele and rectocele. Cystocele Stock Photos and Images. This can cause serious constipation and discomfort, as the rectum balloons out and creates a kink in your stool's. I had rectocele surgery two years ago with absolutely no complications or pain from the surgery itself. Learn how we can help. The lower intestines complete the digestive process before food passes out of the body as waste. Choose a language:. Pessaries can also be used in the treatment of stress urinary. This means it uses smaller cuts (incisions) than a standard surgery. A rectocele is a type of prolapse where the supportive wall of tissue between a woman’s rectum and vaginal wall weakens. Pronounced: SIS-toh-SEEL or RECK-toh-SEEL. A Posterior Repair (Rectocele) is a bulging of the rectum into the vagina. Your small intestine and rectum are not part of your surgery. Rectocele is a frequent finding in constipated patients. I had rectocele surgery on January 21, 2009 and was scared to death after reading all of the info on line. Rectocele levatorplasty is an accepted technique of rectocele repair can be perforn1ed utilizing a number of repair, it sometimes leads to vaginal narrowing and techniques, however some of these techniques severely subsequentdyspareunia. Imaging: Imaging isn't often used for rectocele diagnosis. D) The vaginal wall incision is the closed with stitches. Rectoceles may cause constipation and incomplete defecation; patients may have to manually Enteroceles and rectoceles are detected by retracting the anterior vaginal wall while patients are in Vaginal apex suspension or repair. It’s subtle, but if you look carefully, you can see that the rectum has sunk down in the second picture, and there is less room between the vagina and rectum. Their content is set to '', because we don't actually want any content, we just. I also have some spotting still and an. Please speak with your doctor for more information on recovery expectations. uq; xq. Before, Everything and After Demo Version — Technicolor. Imaging: Imaging isn't often used for rectocele diagnosis. 05 vs preoperative measurement. Anterior prolapse (cystocele) Products and services. hair transplant before and after results. Rectocele is a variety of pelvic organ prolapse (POP) that involves the herniation of the rectum through the rectovaginal septum into the posterior vaginal lumen. Fitness Before After. 20 Mei 2021. Twenty percent or more of people may have a rash after surgery. Main Phone: (727) 540-0414. In 1000 females, one born with no hymen. A rectocele occurs when your pelvic floor weakens. To cut to your question, yes you can have sex (and very good sex too!) with rectocele. Bleeding after a hysteroscopy. In this anterior colporrhaphy, a speculum is used to hold open the vagina, and the cystocele is visualized (A). I met with my surgeon in July and decided we would do a partial hysterectomy and bladder repair. Weight Gain before and after | до и после. TVH with cystocele and rectocele repair : Subscribe To Hysterectomy Thread Tools: Search this Thread: 07-02-2010, 09:47 AM. Weinstein Female Pelvic Reconstructive Surgery and Urogynecology, Massachusetts. (Lightening Cream Added). This means it uses smaller cuts (incisions) than a standard surgery. Weber A. What you upload and who you share with, should be It is highly recommended to check out if your type of images works well or not before making a purchase. Those with obstructed defecation without rectocele should be investigated to exclude rectal prolapse (rectum extruding from the anus). closing the vagina. An enterocele is also called a small bowel prolapse. This procedure can help ease chronic discomfort and difficulty having . Suite 905. Marco Pelosi explains and demonstrates rectoceles and their repairs. Litrel is a double board-certified Urogynecologist and OB/GYN and specializes in advanced vaginal rejuvenation and pelvic reconstruction surgery. With Cleanup. A posterior repair, also known as a posterior colporrhaphy, is a surgical procedure to repair or reinforce the fascial support layer between the rectum and the vagina. The incisions will be closed. Am J Obstet Gynecol. I had a positive outlook before surgery, and I expect this played a part in my having such an easy recovery. Weber A. , Piedmonte M. It is produced naturally by the liver and involved in many processes in the body, including tissue building and repair, making chemicals and proteins needed in the body, and for the immune system. Avoid straining at stools (bearing down worsens the rectocele) Avoid heavy lifting. -Before and After Photos. You will be given some anti-embolism stockings ‘TED stockings’ to wear before, during and after the operation, this is to help prevent blood clots forming in your legs. This makes your intestine push on the back wall of your vagina, making it bulge (see Figure 1). Cover image - June 2022; Quick Response - Contact Us; CALL FOR PAPERS. Bleeding after a hysteroscopy. Log In My Account ib. Rectocele occurs as a result of thinning and weakening of the band of tissue that separates the vagina from the rectum. Before and after results of countless, satisfied patients allow you to see for yourself the outstanding quality at Elithair. Pressure in rectum. Although clinical results after transvagi-nal rectocele repair have been widely reported, the physiologic influences after transvaginal rectocele repair. There is no advantage in having treatment for a rectocele that does not cause any bother. ALTAS was administered to 23 patients and 18 patients were treated using TAR. Cystocele and Rectocele Repair. Your belly and thighs should not move. after surgery. Gradually increase until you can hold for up to 10 seconds and repeat 10 times. . A Posterior Repair (Rectocele) is a bulging of the rectum into the vagina. Patient H. Aug 22, 2019 · Recovery time can vary between women depending on the severity of the repair and surgical technique used. High-fiber foods include fresh fruits, vegetables, and whole grains. A posterior vaginal wall prolapse (also called a rectocele or a rectoenterocele) is a prolapse of. Creatives use Cleanup to create perfect visuals in seconds. Podophyllum: When Rectum Prolapse Occurs while Passing Stool. If you have vaginal laxity and want to fix it, you need to be sure that your surgeon can fix a rectocele too. I had the surgery done on a Wednesday and came home the following day. BeforePaul McGinleyAfter. Before and after photos are included. Curvage Casey's Before/After Transformations Updated July 20. Rectocele Repair - A rectocele repairs the fallen. To say all we want to do is poop normally is an understatement. How much does perineoplasty cost? Average Cost: $4,725 Range:. Hold the squeeze for 3 seconds, then relax for 3 seconds. Rectocele repair (posterior colporrhaphy) removes your bowel hernia from the vagina. It is a minimally invasive method. Your belly and thighs should not move. Half of the women received a urethral sling at the time of their prolapse repair surgery to reduce the chance of incontinence after the pelvic organs are returned to a more normal position. RM ADW8H6 – Prolapse of Bladder and Rectum Repaired with Colporrhaphy Procedure. The pelvic organs are held in place by muscles and tissues that can sometimes weaken and stretch. A magnifying glass. After numbing has taken place, the surgeon will then remove the entire vaginal lining (vaginal epithelium) leaving approximately 1 to 1 ½ inches. Change them every time you go to the bathroom. Log In My Account ib. In severe cases, the vagina can protrude outside of. You will receive pain-relieving. You know what I mean, talk about life’s little pleasures. Be conscious of the enjoyment level of your partner, and make sure they are satisfied as well. It explains some rectal symptoms I've been having for about a year, but I would classify my symptoms as mild and wonder whether the risks of the surgery would be worth it at this time. Every time women with rectal POP issues have a bowel movement, lock the door to make sure no one can disturb you to make it easier to relax, and "V-brace" the labia and push up on the labia gently with fingers, creating some structural support for the pelvic floor. Basics - before() and beforeEach(). ; Uterine prolapse is mild when the cervix drops into the lower part of the vagina. It’s done while you’re asleep under general anesthesia. Before and after pictures. Repeat the process 4 to 5 times before allowing yourself to orgasm. 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