Know the conditions for which it could help, but is less likely to be helpful.

There are two common problems for which the procedure is less likely to be helpful (though it does seem to help around 30%):

1. 1. Never had an orgasm, ever. This is more likely to respond to testosterone replacement and sex education/counseling.
   2. Wants to have an orgasm with penis-in-vagina sex with no other stimulation (as with a vibrator or hands). This is more likely to respond to hormones or a new lover or by sex education/counseling.

Know (and teach your staff) the indications for the procedure.

All people have a higher success rate after the second procedure, but over 60% see improvement after just 1 procedure. 

Here are the indications with the most likely benefit:

• • • orgasm is decrease but present
    • dyspareunia of uncertain cause
    • chronic interstitial cystitis
    • mesh pain (the procedure usually attenuates but does not completely relieve this pain).
    • pelvic floor, trigger point pain
    • stress urinary incontinence when the pelvic floor is still mostly intact
    • urge incontinence
    • lichen sclerosus