RESTORATIVE PELVIC MEDICINE

RESTORING INTIMACY:

“I knew there had to be someone who could help me.”

Custom quilt designer Patsy Costlow found help at the Center for Restorative Pelvic Medicine after years of pain and discomfort.

Center for Restorative Pelvic Medicine restores continence and sexual health

By Maureen Kovacik

Aromantic evening between husband and wife usually involves a nice candlelight dinner, wine and soft music. Patsy Costlow didn’t have the time for such niceties when it came to being intimate with her husband. They were luxuries she had to live without.

“When you have to use lidocaine and tell your husband to ‘hurry up and get ready; we only have a couple of minutes for sex before the pain kicks in,’ it’s not exactly romantic or satisfying,” the 57-year-old mother of two and grandmother of fi ve said.

Costlow met her husband Phil more than 40 years ago. She says she fell in love with him the moment she fi rst saw him, but he left for the Navy soon after they met. While he was off serving his country, she married and divorced. When he returned nearly four years later, the couple reconnected.

“I knew we would be together forever when we found each other again,” Costlow said. “You don’t fi nd this kind of relationship very often.”

The two married in 1970 and like many newlyweds, they sought a reliable birth control method. Costlow chose an intrauterine device, one of the most popular forms of birth control at the time. It was effective, but the device attached itself to her uterine wall causing damage. Doctors then removed it, causing even more damage and forcing her to have a hysterectomy.

The couple enjoyed a normal sex life over the years, but one day nearly 10 years ago, Costlow began to experience vaginal pain. Doctors discovered her bladder was falling and she needed surgery to reposition it. The procedure, called bladder suspension, involves inserting a band of tissue to form a type of sling to reposition and support the bladder. However, after two of these procedures, the pain only worsened.

“I had to numb myself because when we had intercourse, it felt like someone was stabbing me with a knife,” Costlow said. “Sex was an important part of our relationship, but every time we did it, the pain just got worse.”

Never Give Up

As the pain continued to worsen, she was referred to a urologist who diagnosed her with a chronic bladder infection, believed to stem from her two bladder suspension surgeries. Her body was rejecting the band of skin that was implanted to support the bladder.

A year later, Costlow underwent a third surgery to remove the old tissue around her bladder and replace it with a new, wider band of skin. The surgery was successful except for one thing: It left her with only 21⁄2 inches of vagina. As a result, sex with her husband became so painful the couple refrained.

“I felt so bad. I know my husband never would have left me, but I felt like that part of our life was dying,” Costlow said. “I wasn’t ready for that. He was faithful to me, and I felt I owed it to him to get this fi xed.”

Costlow went to a new gynecologist who found lesions in her vaginal area and used dry ice to burn them off. After doing all he could, he referred her to Dr. Tue Dinh, a plastic surgeon at The Methodist Hospital and the Methodist Center for Restorative Pelvic Medicine.

After examining her, Dinh conferred with Dr. Keith Reeves, a Methodist obstetrician/gynecologist. Together they developed a plan to help Costlow.

“We have performed similar surgeries in the past, but the causes were usually congenital or cancer-related,” Reeves said. “This one was unusual because it was the result of scarring caused by previous surgeries that didn’t heal properly.” During a three-hour procedure, the surgeons cut out a fl ap from what was left of Costlow’s vagina and pulled that fl ap forward and up. They went through the space they created to access the bladder area where they removed scar tissue. Dinh then took a skin graft from her groin area and sewed it into the space in such a way as to create a vaginal canal of normal length.

Drs. Keith Reeves and Tue Dinh

“It (plastic can also b in a differ improvin quality of

After a three-night hospital stay and about seven weeks of recovery, Costlow was cleared by her doctors to resume sexual relations with her husband.

“I was nervous at fi rst, and there was a little bit of pain that fi rst try,” Costlow recalls. “But now sex is great. I knew there had to be someone who could help me.”

The Center

Reeves, who is the founder of the center, says the goal is to restore continence and sexual health to both women and men. Specialists at the center — gynecologists, urologists, colorectal surgeons and plastic surgeons — work collaboratively to restore pelvic function. “We develop a customized treatment plan for patients coping with urinary and rectal incontinence, vaginal reconstruction, sexual dysfunction and rehabilitation following surgery or radiation,” he says.

Dinh says plastic surgery doesn’t just create a beautiful appearance. “It can also bring beauty in a different way by improving a patient’s quality of life,” he said.

If you don’t believe him, just ask Patsy and Phil Costlow. !

stic surgery) so bring beauty ifferent way by ving a patient’s y of life.”

The Center for Restorative Pelvic Medicine at The Methodist Hospital offers a

unique multidisciplinary approach to pelvic restoration and reconstruction. The center is the fi rst of its kind in Houston to combine an expert team of leading gynecologists, urologists, colorectal and plastic surgeons dedicated to restoring normal pelvic function and pelvic reconstruction for men and women.

Diseases and conditions treated

Fecal incontinence Pelvic pain Pregnancy and pelvic support Problems secondary to radical surgery of extensive radiation for gynecologic cancer Rectal prolapse Recto-vaginal fi stula Sexual dysfunction Urinary incontinence

RANKED SPECIALTY

Procedures and treatment options

Biofeedback Colorectal testing Coverage of complex wounds Electrical stimulation Estrogen replacement therapy Green laser therapy Irradiation wounds Pelvic fl oor prolapse Penile reconstruction Pessary Post-operative muscle rehab Post radiation injury Sexual therapy Vaginal absence deformities Vaginal reconstruction Vulvar reconstruction

To make an appointment at the center, call 713-441-5800. !