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Maggie McKay: Pelvic floor health of a woman, probably not a topic most women think of until there's a need to. So, what are some of the treatment options? Today, we'll talk with Dr. Steven Karp about some of the advancements.

This is the Top Docs podcast. I'm your host, Maggie McKay. Dr. Karp, thanks for being here. Can you please introduce yourself?

Steven Karp, MD: Yeah, sure. My name is Dr. Steven Karp. I am the practice owner of Laser Skin Med Spa in beautiful Glen Mills, Pennsylvania, which is just outside of Philadelphia and north of Wilmington, Delaware.

Maggie McKay: Beautiful. So to begin, let's get right to it. What is urinary incontinence and who does this affect?

Steven Karp, MD: Well, urinary incontinence affects men and women, especially as they get older or if there's some kind of damage to the nerve region in the pelvic area after some trauma or even certain medications may affect that region. But we focus on helping women recover from pelvic floor dysfunction. Pelvic floor dysfunction manifests in several ways. One of the ways is urinary incontinence. So, women typically in their 50s and 60s, typically after childbirth. And frequently, what happens is laughing and sneezing causes peeing, dripping or even exercise-induced. We have several women who are CrossFit and, as they're doing activities, they notice leakage and it's a major problem.

Maggie McKay: And what is the job of the pelvic floor? How would you even know if it had weakened as a woman?

Steven Karp, MD: Yeah. Well, the pelvic floor's job is to create a foundation for strength across the pelvic region and really supporting the bladder and all the connective tissue into the pelvic region. And over time, due to various reasons, the tissue becomes weak, it becomes lax and very dysfunctional and very unsupportive. And it manifests itself in pain, instability and things like urinary incontinence for sure.

Maggie McKay: Let's find out about the good news on this topic. There is some good news. What are the new advancements in women's health?

Steven Karp, MD: One of the things that I kind of came up with as I'm sharing it, because these are sensitive topics. This is like a patient comes in with this kind of concern and it's a real game-changer in their life. Sometimes they'll have to use a pad to prevent dripping into their clothes. And, especially for some people, it can be kind of a humiliating experience. So, I came up with a little phrase that says, if you sneeze and pee or don't like what you see, then we can help you with your vaginal rejuvenation needs.

So as it is for women to help with the internal issues of pelvic dysfunction and urinary incontinence and pelvic floor strengthening, aesthetically with radiofrequency skin tightening, that's what we're using here, RF, we can make a huge difference on the aesthetics also. So for women that have a lot of skin laxity or asymmetry or they don't like what they see, we make a huge difference and it happens in 20 minutes and it happens on the table. It's really amazing and immediate.

Maggie McKay: Is that without surgery?

Steven Karp, MD: It's without surgery. Yeah, it's a technique. The machine is called the TempSure Vitalia. It's made by Cynosure. It uses technology of radiofrequency to superheat the tissue using around 103 to 109 degrees, and that causes a response in the tissue to think the tissue is being damaged. So, it creates fresh collagen, fresh elastin. It takes tissue that's very lax, very droopy and it lifts it, it tightens it, and it brightens it. And it creates a beautiful response. Typically, most patients are going to need between three and five sessions. The sessions are going to be around three weeks apart. And again, you see the changes happen on the table. And I've been in aesthetics for a long time now. I've owned the practice for several years and we don't see a lot of immediate responses in most things that we do. In terms of a positive change, I mean, in 20 minutes to see tissue that's very lax and very droopy to lift, tighten and have a beautiful response that you can be really proud of and it helps a lot with self-esteem issues. So as much as that it does make changes internally, the external changes are absolutely amazing.

Maggie McKay: I've heard some women refer to it as a miracle.

Steven Karp, MD: It is, it is. And I, of course, not being as familiar with that type of tissue, not having that type of tissue myself, men, we have our own issues when it comes to the way we look in certain regions of our body. But it's more straightforward for men. For women, it's a lot more complicated because we're not just dealing with pelvic floor issues. We're also dealing with painful intercourse, like interstitial cystitis. We're dealing with issues of dryness. And at the end of the day, if intercourse is painful for you, you're probably not going to want to have a lot of intercourse, right? So, this is a game changer. You want have your love life back. You want to increase your libido. You want to have more sensation, increased blood flow. This is like a blood magnet, right? So, we're rejuvenating tissue on the outside. We're rejuvenating tissue on the inside. Everything starts to function and work. And I have a testimonial I'd love to read, if that's okay.

Maggie McKay: Sure.

Steven Karp, MD: This is from Melissa. Now, Melissa's a 52-year-old woman with one child. She's one of our CrossFitters. And when she's exerting, she's dripping, right? So, I mean, how embarrassing is that and how uncomfortable is that to be exercising and then have wetness in your shorts? So, this is from Melissa, Melissa had three sessions, right? Usually, it's somewhere between three and five. We found three is really a great start. And then, some women will want to come back every couple of years for a maintenance session. Again, these sessions are 20 minutes. And we have a beautiful facility here. Mary Beth is one of my providers that does the vaginal rejuvenation. And she's very experienced, she's very kind, she's very gentle. She's had it done herself, so she knows what it feels like. She knows what the results are like. She's done now 30 or 40 procedures and the outcomes are great. And Melissa was probably one of our best outcomes because she had two issues. Not only did she have the internal issues of dryness, painful intercourse, but she had the aesthetic issue. She had a lot of asymmetry. It looked like a zipper that was going left and right, instead of symmetrical lines. So, she didn't feel confident and she's been married for a long time. But she'd lost her confidence. So, this was a big thing for her. And she sent me this, she'd actually texted me this recently. She said, "I didn't really understand how Vitalia would improve my bladder issues and other gems of menopause. After the first treatment, I noticed I was no longer leaking from a sneeze or laughter. I was also able to hold it better and my visits to the bathroom were more productive. I'm not just getting a little bits of urine at one time." She said, "Vitalia in combination with an estrogen gel has made sex less painful. No one warns women about what happens to their sex life during menopause. Lastly, my cookies look more like a 30 something than a 50 something, and that's really the best part."

Maggie McKay: I like the gems of menopause part.

Steven Karp, MD: The gems of menopause.

Maggie McKay: So Dr. Karp, who would be a candidate for TempSure Vitalia?

Steven Karp, MD: Well, really any woman who has issues with pelvic floor dysfunction, pelvic floor weakness, urinary incontinence, issues like frequent urinary tract infections, low estrogen, postpartum vaginal laxity issues, vaginal dryness, and painful intercourse and, of course, the aesthetics, right? Anybody who just doesn't love what they see. You know, they love what they look like in their 20s and 30s and now in their 50s and 60s, it's like somebody else's vagina. Well, we can restore that and help them get their confidence back.

Maggie McKay: I like also what Melissa said, "Nobody warns you about menopause." It's right. You don't know anything until you're in it, right? No one's going tell you it's just like childbirth, but you can't avoid it. So if someone's interested in this treatment, I know you talked a little bit about what it entails, but what are the next steps? Like how many times you have to come? Is it painful?

Steven Karp, MD: We always start with a complimentary consultation, right? We always start with that conversation, let's get to know people first. So, let's find out what your goals are, what your concerns are, because really at the end of the day, Laser Skin Med Spa, we stand for rejuvenation. Whether it's skin rejuvenation or vaginal rejuvenation, that's what we do here, right? So, we're going to get to know our patients, going to find out what their needs are. And then, we're going to create a customized plan and journey that meets their needs every step along the way. And then, we're going to be there for them to make sure that they're happy, right?

So, we're this boutique. We're this little boutique practice in beautiful Glen Mills, Pennsylvania. And we're finding these mountaintops to shout from that we can help these people with all these issues, right? And so, this is the best mountaintop I can think of to create an opportunity to share with our community. We're going to put this in places and I really am grateful for the opportunity to sit down and chat with you and for you to get to know us better. But at the end of the day, we're here to help people recover from issues that revolve around their pelvic floor dysfunctions

Maggie McKay: I love that it only takes 20 minutes and that there is no surgery. That's the best part if you ask me, right?

Steven Karp, MD: There's no surgery. It takes 20 minutes and changes happen on the table.

Maggie McKay: It's amazing.

Steven Karp, MD: When you leave, you will see a major difference. Now, you need about three sessions, right? You need about three sessions to really strengthen the tissue and to make changes that are more permanent.

Now, the other thing is people ask me, "Are these changes permanent?" Well, we're still aging, right? Mother Nature is undefeated, right? So, we're going to have some more laxity issues as we get older. You know, our body's going to age, right? So, there may be some necessity for maintenance every year or two coming in for a followup session. But for what you get out of it, that is a really small consideration.

Maggie McKay: So, if someone would like to find out more or make an appointment with you, where would they go?

Steven Karp, MD: Well, we have lots of information on our website at laserskinmedspa.com. And of course, you can always call us here at the med spa at 610-886-4980.

Maggie McKay: Dr. Karp, your passion for helping people is so apparent and this has been so informative.

Steven Karp, MD: I've been practicing for 27 years.

Maggie McKay: What? That's impossible.

Steven Karp, MD: Twenty-seven years I've dealing with this. I love to help people. Listen, it's a passion.

Maggie McKay: Thank you so much for your time and sharing your expertise and your passion. It's been a pleasure talking with you.

Steven Karp, MD: I appreciate it so much. Thanks, Maggie. It's great to get to know you.

Maggie McKay: You too. Again, we've been talking with Dr. Steven Karp, owner of Laser Skin Med Spa in Pennsylvania. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for more topics of interest to you. This is the Top Docs podcast. I'm Maggie McKay. Thanks for listening.