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Doctor Rich

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Doctor Rich He is a certified Center of Excellence surgeon and one of only 25 da Vinci Epicenter program directors in the United States.

Texas Urogynecology & Laser Surgery Center provides expert and compassionate gynecology care to women in all stages of their lives and offers comprehensive diagnostic and treatment services for pelvic floor disorders. Dr. Farnam is board certified in both Obstetrics & Gynecology and Female Pelvic Medicine & Reconstructive Surgery (Urogynecology) and is a leader in the field of Minimally Invasive Gynecology and Laser Surgery.

11/03/2026

“I’m 85, I’ve been diagnosed with bladder prolapse, and I’m in good health. What procedure would you suggest?” 💬

This viewer question is one of the best we’ve gotten, and it’s exactly why I read your comments out loud. 👏

When a woman is in her mid-80s, the conversation about prolapse surgery can change. In medicine, we talk about two broad approaches:
🔹 Reconstructive surgery: rebuilding support, often with normal s*xual function in mind
🔹 Obliterative surgery (colpocleisis): a “tightening” or closure procedure so that nothing can fall out

The literature shows that after about age 85, more patients, after appropriate counseling, lean toward colpocleisis. Every woman is different, and this is a decision to make with your own doctor.

I put the question to Dr. Erin Myers, but this clip cuts off right before she answers! 👀
▶️ Watch the FULL video on my YouTube channel (link in bio) to hear her take.

Have a prolapse question? Drop it below. If you’re thinking it, a thousand other people are too. 💬

10/31/2026

we mean this from the bottom of our hearts 🫶

10/29/2026

🏀 “I’m the LeBron James of fibroid surgery.” 🩺

I sat down with as she shared what it takes to become a master at minimally invasive fibroid surgery:

🧊 She compares it to an iceberg. The small part you see is the surgery, but the massive part underneath is 15 years of work.
📚 She went out and learned from pioneers in the gynecology world.
🌙 She stays late at night helping with surgery because she’s passionate.
🎬 She watches her own surgery videos, like an athlete watching film, asking how she could move more delicately and more smoothly.
✨ Her belief: every woman deserves the opportunity to have minimally invasive surgery.

Talent gets you started. The work is what makes you great.

If you’re researching fibroid surgery, myomectomy, or how to choose a surgeon, this conversation will help you know what to look for. 🩺

🎥 Full video on my YouTube channel. Link in bio!

What matters most to you when choosing a surgeon? Tell me below. 👇

If you’re thinking it, a thousand other people are too. 💬

10/27/2026

My son came to me with a question from a Twitch streamer: “Dad, can a tick bite really make you allergic to red meat?” Yes. It’s called alpha-gal syndrome, and he’s about to learn it’s not a Marvel superhero. 😄

Here’s what’s actually happening. When a tick bites you, it can introduce a sugar called alpha-gal into your body. Your immune system learns to attack it, and that sugar is found in beef, pork, and lamb, basically every mammal except humans.

The tricky part is the timing. A peanut allergy hits within minutes. Alpha-gal syndrome is delayed by hours. You eat a burger for dinner, and at 1:00 in the morning you’re covered in hives. Almost nobody makes the connection, so they blame the restaurant.

A few things to know:
🔹 Many people never remember getting bitten.
🔹 It’s most common on the East Coast and in the South, home of the lone star tick.
🔹 For some people it fades over time if they avoid further bites. For others it doesn’t.
🔹 Prevention is simple: bug spray, and a tick check when you come inside.
🔹 If you get hives or nausea hours after red meat, see an allergist.

I’ll be honest: I had a patient with this years ago, before all the media attention, and I had to look it up. Half the doctors in one survey did too. Now you know, I know, and so does everyone watching.

If you’re thinking it, a thousand other people are too. 👇 Ask your questions in the comments.

10/24/2026

🤦

10/22/2026

Bruh..

10/20/2026

“Hysterectomy” might be the scariest word a woman can hear. 😳

I sat down with my patient to talk about the questions nobody asks out loud:

💬 Is my va**na going to be different?
💬 Is s*x going to be different?
💬 Does this mean early menopause?
💬 What about osteoporosis risk?

Brenda told me that before her surgery she went looking for someone her age who had been through it. She asked friends. One coworker connected her with another coworker she never knew had had a hysterectomy. Thats how rarely women talk about it.

“It’s this underground thing.” And today, it’s still taboo. 🙅‍♀️

What helped Brenda the most (after going down the Dr. Google rabbit hole) was hearing from someone who LIVED it.

I’ve done 4,500 robotic surgeries, but I will never have a hysterectomy myself. That’s why Brenda’s voice matters so much. Her experiences are her own, and they might be exactly the point of view you need right now. 💛

Have you had a hysterectomy, or are you considering one? Tell me your biggest question in the comments. If you’re thinking it, a thousand other women are too.

10/17/2026

The Weekend Protocol.. 😂

10/15/2026

Can you get pregnant after a hysterectomy? 🤯

After my “where do the swimmers go” video hit 600K views, so many of you asked: what if I kept my cervix?

That’s called a supracervical hysterectomy. The uterus comes out, but the cervix stays. And yes, it changes the answer.

Here’s the real picture:
💛 About 100 cases of pregnancy after hysterectomy are reported in the world’s medical literature, the first back in 1895
💛 That’s roughly one in a million, about the odds of being struck by lightning
💛 Every one of them was an ectopic pregnancy, not a birth control failure
💛 It’s a life-threatening surgical emergency. One woman arrived in shock six years after her hysterectomy with a 13-week pregnancy on her cervical stump

If you kept your cervix, remember:
1️⃣ You STILL need cervical cancer screening. The cervix can still get HPV.
2️⃣ About 12% of women may still have light monthly bleeding.
3️⃣ Randomized trials show no difference in s*xual function whether you keep the cervix or not.

One in a million is super rare, but it’s not zero. If you’re of reproductive age, still have an o***y, and end up in an ER with pain or bleeding, a pregnancy test matters.

Share this with someone who’s had a hysterectomy. 💬 Did anyone ever tell you that you still needed Pap smears? Tell me below. If you’re thinking it, a thousand other people are too.

10/13/2026

Is s*x "tighter" after sacrocolpopexy? 😳 We got this question, so Dr. Myers and I answered it.

Here’s the short version: 👇

💗 Prolapse surgery usually improves s*x. Women with significant prolapse often have a severe drop in s*xual function. They worry about hurting themselves, find s*x uncomfortable, or feel embarrassed by the bulge. Restoring normal anatomy vastly improves it.

📏 But sacrocolpopexy doesn’t make things tighter. Dr. Myers explains that it pulls the tissue back inside, and the width of the va**na doesn’t change. Length changes by about a centimeter at most, depending on whether the cervix is removed. One of her learners called it “putting a pair of suspenders on it,” and honestly, that’s pretty accurate. 😂

🪡 Want it tighter? That’s a second procedure. Adding a posterior repair lets your surgeon place sutures va**nally to change the diameter. Decide this with your surgeon before surgery.

⚠️ If you have stage 3 or stage 4 prolapse (outside the body), the va**nal opening may have stretched. Tell your surgeon you want it addressed.

Ask your surgeon:
✅ Will my va**nal width change?
✅ Should we add a posterior repair?

💬 Has prolapse affected your s*x life? Tell me below. If you’re thinking it, a thousand other people are too.

Address

4501 N. Mesa Street
El Paso, TX
79902

Opening Hours

Monday	9am - 5pm
Tuesday	9am - 5pm
Wednesday	9am - 5pm
Thursday	9am - 5pm
Friday	9am - 5pm

Website

https://www.farnammd.com/

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