Obstetrics and Gynecology

“Myoma” or “fibroid” refers to benign (non-cancerous) tumors that develop in the inner wall, outer wall, or muscle layer of the uterus (womb).
They can grow in different parts of the uterus and vary in size. Fibroids are also commonly known as uterine fibroids.

The symptoms of fibroids depend on their size, location, and number.
Some women may not even realize they have fibroids, while others may experience symptoms such as pain, heavy menstrual bleeding, pelvic pressure, frequent urination, constipation, or abdominal bloating.

The treatment of fibroids varies depending on the severity of symptoms, the woman’s age, general health, and future reproductive plans.
Treatment options may include the following:

Observation (Watchful Waiting)

If symptoms are mild and the fibroids are not showing signs of growth, the doctor may prefer to monitor the condition regularly.

Medication

Drugs may be used to regulate menstrual bleeding or relieve fibroid-related symptoms.
These may include hormonal medications or pain relievers designed to reduce discomfort and bleeding.

Minimally Invasive Procedures

• Laparoscopic Myomectomy: Removal of fibroids using a minimally invasive surgical method called laparoscopy.

• Hysteroscopic Myomectomy: Removal of fibroids from the uterine cavity using a device inserted through the cervix.

• Radiofrequency Ablation or High-Intensity Focused Ultrasound (HIFU): Techniques that destroy fibroid tissue by heating it with energy waves.

• Myolysis: Destroying or coagulating fibroid tissue using energy sources such as needles or lasers.

Hysterectomy (Removal of the Uterus)

If the fibroids are large, symptoms are severe, or other treatments have failed, complete removal of the uterus may be necessary.
However, this option is considered a last resort, as it permanently ends fertility.

It is important to consult your doctor to determine the most appropriate treatment option.
Your treatment plan should be tailored to your individual condition and specific needs.

What Is Labia Majoraplasty?

Labia majoraplasty is a surgical procedure performed to aesthetically reshape and rejuvenate the outer labia (labia majora) of the genital area.
The genital lips are divided into outer (labia majora) and inner lips (labia minora).
The term labiaplasty generally refers to surgery involving either or both of these structures.

Goals of the Procedure

• To provide a more aesthetic and harmonious appearance to the labia.

• To restore comfort that may have been lost due to anatomical changes.

• To correct sagging and deformation caused by aging, weight fluctuations, or hormonal factors.

About the Outer Labia (Labia Majora)

• They are externally located and contain hair follicles.

• Compared to the inner labia, the outer labia are thicker, containing sebaceous glands, sweat glands, and fat tissue.

• The labia majora may undergo aging-related or hormonal changes over time.

Ideal Labial Structure

• Ideally, the outer labia appear full, firm, and pinkish-beige in color.

• When standing or sitting, the inner labia should not protrude beyond the outer ones.

Aesthetic Procedures for the Outer Labia

Aesthetic interventions may be performed to correct sagging, volume loss, or tissue irregularities in the outer labia.
Common methods include:

• Fat grafting (lipofilling)

• Hyaluronic acid fillers

• Plasma or thread suspension techniques
  If excess fat tissue is present, it can be reshaped or removed to relieve discomfort and improve appearance.

How Is Labia Majoraplasty Performed?

• The procedure is performed under local or general anesthesia.

• Incisions are made carefully, considering the anatomy of the genital area.

• Excess skin, subcutaneous tissue, and if necessary, fat tissue are excised.

• The area is then sutured with self-dissolving aesthetic stitches.

• Sutures may be visible initially but will gradually dissolve and disappear over time.

• Recovery is generally quick, typically completed within two months.

Recovery Process

• Patients can return home the same day after surgery.

• The first week focuses on hygiene and local care.

• Stitches usually dissolve within a month, and full recovery may take up to two months.

• The appropriate time to resume sexual activity will be determined by your doctor.

Risks and Considerations

• The surgery should be performed by a qualified and experienced surgeon.

• There is a risk of bleeding; careful postoperative care is essential.

• Achieving perfect symmetry can sometimes be challenging.

• The healing process varies between individuals.

After Childbirth and Sexual Activity

• After labia majoraplasty, patients can give birth normally or by cesarean section in the future.

• Sexual intercourse should only be resumed after medical clearance from your doctor.

Conclusion

Labia majoraplasty is a surgical procedure aimed at the aesthetic correction of the outer labia.
It should be performed by a specialist surgeon, and careful attention should be paid to the recovery period for optimal results.

Labiaplasty is a surgical procedure that involves the aesthetic correction of the inner labia (labia minora).
It is one of the most commonly performed genital aesthetic surgeries among women.

Darkening or pigmentation of the inner labia can only be corrected through surgery — treatments such as laser or mesotherapy are not effective for this condition.

In cases where the inner labia are elongated, sagging, asymmetrical, or excessively enlarged, labiaplasty can help restore the desired aesthetic appearance and comfort.

One variation of the so-called “Barbie” genital aesthetic procedures involves reducing the inner labia to the point where they are completely covered by the outer labia (labia majora), creating a smooth and youthful appearance.

As women, we place great importance on our physical appearance.
The mons pubis is the first visible part of the genital area — the section just below the bikini line that marks the beginning of the external genital region.
Mons aesthetic surgery (monsplasty) is not only about improving appearance but also about enhancing daily comfort and confidence.

Skin Tone and Appearance

Darkening of the skin in the mons area can be corrected with laser treatment, often in a single session.
Additionally, mesotherapy and plasma treatments can help both lighten skin tone and reduce the appearance of scars.
These methods contribute to achieving a younger, smoother, and healthier-looking mons pubis.

Excess Fat and Contouring

In some cases, the mons area contains excess fatty tissue, which may negatively affect daily comfort and body aesthetics.
For example, when wearing tight clothing, the area may appear bulky or protruding, similar to a small belly, causing discomfort or self-consciousness.

To achieve a more balanced contour, excess fat can be removed either through surgical excision or liposuction, resulting in a flatter and more proportional appearance.

Menopause is the stage in a woman’s life when her reproductive ability ends and menstrual cycles permanently stop.
It typically occurs between the ages of 45 and 55, though this may vary from person to person.
Menopause is caused by hormonal and physiological changes in the body, which can lead to a range of symptoms — one of the most common being hot flashes.

What Are Hot Flashes?

Hot flashes are characterized by a sudden and intense feeling of warmth, often accompanied by sweating, facial flushing, and a rapid heartbeat.
Women commonly experience these sensations in the face, neck, and upper body.
This symptom is primarily linked to hormonal fluctuations, especially the decrease in estrogen levels that occurs when the ovaries stop producing eggs.

The drop in estrogen affects the hypothalamus — the part of the brain that regulates body temperature — disrupting the body’s heat balance and triggering hot flashes.

How Severe Can They Be?

The intensity of hot flashes can vary greatly from woman to woman.
For some, they may cause only mild discomfort, while for others, they can significantly impact daily life and sleep quality.

Treatment and Management Options

1. Hormone Therapy

Hormone Replacement Therapy (HRT) can help replace the hormones — particularly estrogen — that decline during menopause.
However, it is essential to discuss the potential risks and benefits of HRT with your healthcare provider before starting treatment.

2. Lifestyle Changes

Simple adjustments in daily life can help reduce hot flashes:

• Maintaining a balanced diet

• Exercising regularly

• Managing stress effectively

• Ensuring adequate sleep

3. Herbal Supplements

Certain herbal or plant-based supplements, such as soy products rich in isoflavones, may help alleviate the intensity of hot flashes for some women.

4. Alternative Therapies

Practices such as yoga, acupuncture, and meditation have been shown to improve general well-being and help manage menopausal symptoms.

5. Medications

In some cases, doctors may recommend non-hormonal medications to help reduce the frequency or severity of hot flashes.

Conclusion

Both hot flashes and other menopausal symptoms vary from person to person.
For this reason, it is important to consult a healthcare professional to determine the most suitable and effective treatment for your individual needs.
With the right approach, menopause can be managed comfortably while maintaining quality of life and emotional balance.

Urinary incontinence in women is a medical condition that refers to the involuntary leakage of urine from the urinary tract.
This issue can occur for various reasons and is classified into several types based on the underlying cause and symptoms.

Types of Urinary Incontinence

1. Stress Incontinence

Urine leakage occurs when intra-abdominal pressure increases, such as during coughing, sneezing, laughing, or exercising.
It is often caused by weakening of the pelvic floor muscles and tissues that support the bladder.

2. Urge Incontinence (Overactive Bladder)

This type is characterized by a sudden, intense urge to urinate followed by involuntary leakage.
It occurs due to loss of bladder control or overactivity of the bladder muscles.

3. Mixed Incontinence

A combination of stress and urge incontinence.
Women may experience leakage both during physical activities and with a sudden urge to urinate.

4. Overflow Incontinence

Occurs when the bladder becomes overly full and can no longer hold urine effectively, leading to constant dribbling or overflow leakage.
It is often associated with incomplete bladder emptying.

5. Functional Incontinence

Happens when a woman is physically or mentally unable to reach the toilet in time, despite normal bladder control.

Causes

Urinary incontinence in women is most commonly linked to:

• Aging

• Pregnancy and childbirth

• Menopause

• Obesity

• Weak pelvic floor muscles

Treatment Options

Treatment depends on the type of incontinence, severity of symptoms, and underlying causes.
Common approaches include:

Pelvic Floor Exercises

Also known as Kegel exercises, these strengthen the pelvic muscles and are especially effective for stress incontinence.

Medications

Used mainly for urge incontinence, these help control bladder contractions and reduce sudden urges to urinate.

Behavioral Therapy

Includes bladder training, timed voiding, and lifestyle adjustments aimed at reducing leakage frequency and improving bladder control.

Surgical Interventions

In more severe cases, surgery may be required to correct issues such as pelvic organ prolapse or to support the bladder neck.

Conclusion

Urinary incontinence is a treatable condition that affects many women but can be effectively managed with the right combination of therapy, medication, and lifestyle changes.
Consulting a qualified healthcare professional is essential to determine the most appropriate treatment plan and restore comfort and confidence in daily life.

Infertility is defined as the inability of a couple to achieve pregnancy after one year of regular, unprotected sexual intercourse despite actively trying to conceive.
In some cases, this period may be shortened to six months, but the general definition remains one year.
Infertility can result from female factors, male factors, or a combination of both, depending on which reproductive system is affected.

Causes of Infertility

Female Factors

Infertility in women may be caused by:

• Ovulation disorders

• Problems within the uterus (endometrial abnormalities)

• Blocked or damaged fallopian tubes

Male Factors

In men, infertility often results from:

• Abnormal sperm production or function

• Blockages that prevent the transport of sperm

Environmental Factors

Certain lifestyle and environmental influences can negatively affect fertility, including:

• Smoking

• Excessive alcohol consumption

• Obesity or being underweight

• Chronic stress

Genetic Factors

Some genetic abnormalities can increase the risk of infertility in both men and women.

Age Factor

Fertility naturally declines with age, especially in women, as both egg quality and quantity decrease over time.

Medical Conditions

Chronic illnesses such as diabetes or thyroid disorders may interfere with reproductive health.

Infections

Reproductive tract infections can cause inflammation or scarring that leads to infertility.

Medications

Certain medications may impair fertility by affecting hormone balance or reproductive organ function.

Diagnosis and Treatment

Diagnosis and treatment of infertility depend on the underlying cause and the individual circumstances of the couple.
After consultation with a fertility specialist, various treatment options may be recommended, including:

• Lifestyle modifications

• Medication therapy

• Surgical procedures

• Assisted Reproductive Technologies (ART) such as In Vitro Fertilization (IVF)

Conclusion

Infertility is a common and treatable condition that affects both men and women.
With modern diagnostic tools and personalized treatment approaches, many couples are able to achieve successful pregnancies and build healthy families.

Childbirth — one of the most sacred and transformative experiences for women — can unfortunately cause irreversible physical changes in the body.
During a vaginal delivery, an incision known as an episiotomy is often made and later sutured in the perineal area (the region between the vagina and anus).
Over time, this area may lose its original appearance or elasticity.
Perineoplasty is a surgical procedure designed to repair and restore the perineum, removing scars and returning the tissue to its pre-childbirth condition.

Scar Removal After Genital Wart Treatment

In women who have previously undergone genital wart treatment, scars in the perineal region may remain.
These scars can be successfully treated and minimized using mesotherapy or plasma therapy, helping to restore a smooth and healthy appearance to the area.

Hysterosalpingography (HSG) is a medical imaging test used to evaluate the female reproductive system, specifically the uterus (womb) and fallopian tubes.
It is most commonly performed as part of the infertility evaluation process to help identify potential structural or functional problems that may affect conception.

How the HSG Test Is Performed

During the HSG procedure, a contrast dye is gently injected into the uterus and fallopian tubes through a thin catheter placed in the cervix.
Using X-ray imaging, the movement of the contrast dye is then tracked and recorded in real time.
This allows physicians to assess:

• The shape and structure of the uterus

• Whether the fallopian tubes are open or blocked

• The presence of any abnormalities or adhesions

What to Expect During the Procedure

The HSG test is typically performed in an outpatient clinic and usually takes only a few minutes.
Some women may experience mild cramping or discomfort during the procedure.
In certain centers, local anesthesia or pain relief may be offered, but for most patients, the discomfort is tolerable without anesthesia.

Why the HSG Test Is Important

The results of an HSG provide valuable information about uterine or tubal abnormalities, such as:

• Blockages in the fallopian tubes

• Uterine fibroids or polyps

• Congenital uterine anomalies

• Scar tissue (adhesions)

This information helps doctors identify the cause of infertility and plan the most appropriate treatment approach.
In some cases, the procedure itself can even help clear minor blockages in the tubes, improving fertility.

The clitoris is surrounded by the extensions of the labia minora (inner lips).
The surgical correction of the tissue covering the clitoris from above is called hoodoplasty,
while the correction of the tissue located below the clitoris is referred to as frenuloplasty.

When there is excess tissue around the clitoris, it may become partially or completely covered, making sexual stimulation more difficult and leading to orgasm disorders.
In addition, this condition can cause discomfort during daily activities, clothing irritation, and hygiene challenges.

Both frenuloplasty and hoodoplasty are procedures designed to remove excess tissue, helping women achieve:

• Improved sexual comfort and satisfaction

• Better genital hygiene

• Enhanced aesthetic appearance

These surgeries are often part of “Barbie” genital aesthetic procedures, in which the frenulum and prepuce tissues are reduced through frenuloplasty and hoodoplasty to prevent the inner tissues from protruding between the outer labia.

Some women experience nosebleeds (epistaxis) during pregnancy.
This is generally considered a normal side effect of pregnancy and is usually not a cause for concern.
Here are the common causes of nosebleeds during pregnancy and ways to manage them effectively:

1. Hormonal Changes

During pregnancy, hormonal fluctuations — particularly increased levels of estrogen and progesterone — cause blood vessels in the nose to expand, making them more fragile and prone to bleeding.

2. Increased Sensitivity of the Nasal Mucosa

The mucous membranes inside the nose become more sensitive during pregnancy.
This sensitivity can lead to easier tearing of the small vessels, resulting in bleeding even from mild irritation.

3. Increased Blood Volume

Pregnancy causes the body to produce and circulate more blood than usual.
This increased blood pressure in nasal vessels can lead to spontaneous nosebleeds.

4. Dry Air and Dehydration

The higher blood flow during pregnancy may also lead to increased water loss from the body, making the nasal mucosa dry and prone to cracking, especially in dry or air-conditioned environments.

How to Prevent or Reduce Nosebleeds

You can minimize nosebleeds during pregnancy by following these simple steps:

• Use a humidifier to keep indoor air moist.

• Apply saline sprays or nasal moisturizers to prevent dryness.

• Avoid picking or rubbing your nose.

• When a nosebleed occurs, lean forward slightly and apply gentle pressure on the soft part of your nose for a few minutes.

• Breathe slowly through your mouth until the bleeding stops.

• Stay hydrated and avoid overly dry environments.

• Keep in regular contact with your doctor and report any persistent or severe nosebleeds.

When to Seek Medical Attention

If nosebleeds become frequent, heavy, or difficult to stop, it is important to consult a healthcare professional.
In rare cases, recurrent nosebleeds may be a sign of another underlying medical condition.
Always remember that the information provided here is general guidance, and your individual situation should be evaluated by your doctor.

Autologous fat grafting, a procedure widely used for many years in plastic surgery and dermatology, can also be safely applied to the genital area.
For women whose labial structure has lost volume or elasticity, this method provides both a rejuvenating and volumizing effect, leading to highly satisfactory results.

During the procedure, fat tissue is harvested from the patient’s own body, purified, and then injected into the labia majora to achieve a fuller, smoother, and more youthful appearance.
Because the fat comes from the patient herself, the procedure is biocompatible and natural-looking, with minimal risk of allergic reactions.

This treatment is particularly beneficial for:

• Women who experience volume loss or sagging due to aging, hormonal changes, or weight fluctuations

• Those seeking improved aesthetic balance and comfort in the genital area

Labia majora fat grafting helps restore both functionality and confidence, offering women a more rejuvenated and harmonious appearance.

Hyaluronic acid fillers, which have been widely used for years in plastic surgery and dermatology clinics, can also be safely applied to the genital area.
For women with deformed or volume-deficient labial structures, these fillers provide both a rejuvenating and volumizing effect, leading to highly satisfactory aesthetic results.

The procedure aims to restore firmness and symmetry to the labia, improving both appearance and comfort.
By using biocompatible hyaluronic acid, the results are natural-looking, safe, and immediate, without the need for surgery or long recovery periods.

This treatment is ideal for:

• Women who wish to enhance volume in the genital area

• Those who experience tissue laxity or asymmetry due to aging, hormonal changes, or weight fluctuations

• Individuals seeking non-surgical rejuvenation and aesthetic improvement

Genital hyaluronic acid fillers offer a minimally invasive solution that enhances self-confidence and comfort, providing a more youthful and harmonious appearance.

For women who experience difficulties in their sexual life despite having normal anatomical structures, a combination of plasma and mesotherapy-based treatments known as Orgasm Injections can be applied.
These injections aim to enhance sexual pleasure and sensitivity by revitalizing the genital tissues and improving blood circulation in the area.

The procedure is non-surgical — it involves injectable treatments, not an operation.
Depending on the patient’s individual needs, the formulation and injection site may vary to address specific sexual health concerns.

Orgasm injections are designed to:

• Increase genital sensitivity

• Improve sexual arousal and satisfaction

• Support overall genital rejuvenation

This innovative approach offers women a safe, effective, and minimally invasive way to restore confidence and enhance intimate well-being.

Hysteroscopy is a surgical procedure used to examine the inside of the uterus and, when necessary, to perform certain treatments.
It is performed using a thin optical instrument called a hysteroscope, which has a camera at its tip.
This device allows the physician to visually inspect the uterine cavity and to carry out diagnostic or therapeutic interventions when needed.

There are two main types of hysteroscopy:

1. Diagnostic Hysteroscopy

This type of procedure is performed to identify abnormalities inside the uterine cavity, such as polyps, fibroids, adhesions, or congenital anomalies.
It is often recommended for patients who experience irregular bleeding, pelvic pain, or infertility.

2. Operative Hysteroscopy

Once a diagnosis is made, certain treatment procedures can be performed through the hysteroscope — such as removing uterine polyps or fibroids, releasing adhesions, or correcting structural anomalies.
Procedures like endometrial ablation, where part of the uterine lining is removed, can also be done during operative hysteroscopy.

Hysteroscopy is usually performed under local anesthesia or sedation, and most patients can go home the same day.
Recovery is generally quick and well-tolerated.

However, as with any medical procedure, it is important to consult a qualified healthcare professional for accurate and personalized medical advice.

1. Minimally Invasive Technique

Laparoscopy is a surgical method performed through small incisions.
A camera and fine surgical instruments are inserted into the abdominal cavity, allowing the procedure to be carried out with minimal tissue damage and trauma, compared to laparotomy, which requires a large incision.
Laparotomy generally involves more extensive tissue cutting and therefore leads to longer recovery times.

2. Shorter Hospital Stay

Patients who undergo laparoscopy usually experience a shorter hospital stay.
This enables faster recovery and earlier return to daily activities, whereas open surgery often requires a longer hospitalization period.

3. Less Pain and Better Cosmetic Results

Since laparoscopy is performed through small incisions, patients typically experience less postoperative pain.
These small incisions also leave minimal scars, resulting in better cosmetic outcomes compared to the larger scars left by laparotomy.

4. Reduced Blood Loss

Laparoscopic procedures generally involve less blood loss, while open surgery (laparotomy) can lead to greater bleeding due to the larger incision size.

5. Faster Recovery

Because laparoscopy causes less tissue trauma, patients tend to heal faster and return to normal life more quickly than after open surgery.

6. Lower Risk of Infection

Smaller incisions and less exposure of internal tissues reduce the risk of postoperative infections.

7. Milder Immune Response

Laparoscopic surgery triggers a less intense immune and inflammatory response, which can help speed up healing and minimize complications.

8. Lower Risk of Adhesion Formation

Postoperative adhesions (where internal organs or tissues stick together) are less likely to occur after laparoscopy compared to open surgery.

Although laparoscopy offers many advantages, open surgery (laparotomy) may still be necessary in certain cases.
The decision depends on the patient’s condition, the type of operation, and the surgeon’s clinical judgment.

Laparoscopic hysterectomy is a surgical procedure in which the uterus (womb) is removed using laparoscopic (minimally invasive) surgical techniques.
This method involves making small incisions through which a laparoscope — a thin instrument with a camera and light source — and other surgical tools are inserted into the abdomen.
Compared to traditional open surgery, laparoscopic hysterectomy causes less tissue trauma and offers a faster recovery period.

How Laparoscopic Hysterectomy Is Performed

1. Anesthesia
   The patient is given general or epidural anesthesia to ensure there is no pain or discomfort during the operation.

2. Creating Entry Points
   Small incisions are made in the abdomen, typically around the navel or lower abdominal area, to insert the laparoscope and surgical instruments.

3. Visualization with the Laparoscope
   The laparoscope, which contains a camera and light source, is inserted through one of the incisions.
   This allows the surgeon to view the inside of the abdominal cavity on a monitor in high detail.

4. Removal of the Uterus
   Through other small incisions, laparoscopic surgical instruments are inserted.
   The uterus is carefully detached and removed.
   The surgeon then seals blood vessels and ensures hemostasis.

5. Closing the Incisions
   After removal, the small incisions are closed using sutures or surgical adhesive.

Advantages of Laparoscopic Hysterectomy

• Smaller incisions lead to less pain and faster recovery.

• Shorter hospital stay compared to open surgery.

• Lower risk of complications and infection.

• Minimal scarring and better cosmetic results.

Important Considerations

Although laparoscopic hysterectomy is generally safe and effective, it still carries certain risks, as with any surgical procedure.
Your surgical team should inform you thoroughly before and after the operation and address any questions you may have.
It is important to follow your doctor’s postoperative instructions carefully to ensure a smooth and successful recovery.