Doctor Rich

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Doctor Rich 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.

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.

10/10/2026

I'm not judging..

10/09/2026

Swallowed? A**l? Somewhere else entirely? 😅 Under all those comment-section jokes were real anatomy questions, so I finally answered them.

Short version: your digestive tract is a closed tube, so oral and a**l s*x can’t cause pregnancy.

Infection is the real risk, and throat STIs are easy to miss unless you ask for a swab.

Real question about your body? Drop it below. 👇

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

10/06/2026

She looked pregnant. She wasn't. 🤰

A large fibroid can create a belly so big it looks like a pregnancy. In this conversation with , I talk about a patient whose uterus went from size 16 to size 4 after we removed the fibroid bulk. ✨

I also share something I tell my residents: be grateful for the difficult cases. They're exhausting and stressful, but they make you a better surgeon. Those patients are the reason we are the surgeons we are today. 🙏

Dr. Crable put it perfectly: the easy cases only look easy because of the hard ones. 💪

Bloating, pelvic pressure, heavy periods, a growing belly, and frequent urination are all worth getting checked. You don't have to just live with it. ❤️

Have you or someone you know dealt with large fibroids? Share below. If you're thinking it, a thousand other people are too. 👇

10/03/2026

The FBI would bore themselves to sleep..

10/01/2026

Jokes aside, this matters. Millions of women are told that va**nal dryness, painful s*x, itching, burning, urinary urgency, and recurrent UTIs are "just a natural part of aging."
They're not something you have to live with. 💛

Here's what I want you to know:
✅ Effective treatments exist for s*xual pain, dryness, itching, burning, incontinence, urinary frequency, and urinary infections.
✅ Most women have only heard about messy va**nal creams. Not everyone can use estrogen, especially with a history of breast cancer or blood clots.
✅ For those women, laser rejuvenation may be an ideal option to discuss.
✅ Yes, it's usually out of pocket. But most patients tell me the convenience is worth it: after the initial series, it's one treatment a year instead of tubes and applicators several times a week, forever.
✅ Satisfaction rates are high, around 85%.

What I can promise you: after 50, if you do nothing, symptoms tend to get worse. More pain. More dryness. More discomfort.

So at your next annual visit, ask your doctor about laser va**nal rejuvenation. Bring your symptom list. No question is too embarrassing. 🤝

💬 Tell me below: what have you been afraid to ask your doctor?

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

09/29/2026

Hysterectomy recovery: how long does it really take? ⏱️

The standard leave period under FMLA is 8 weeks. In my office, for my patients in my specific setting only, we typically see people back to about 90% in around 2 weeks after minimally invasive surgery.

But here's what matters: that doesn't mean you can't take 2 or 3 months. It means you have the option. 🙌

In this conversation, Brenda shares something so many women miss: she was told to eat four times a day with at least 40g of protein per meal to support healing. She'd assumed she could jump right back into her routine.

Surgery is a trauma to the body. Your body needs fats, carbs, and protein to rebuild. Michael Phelps ate 6,000 calories the day before competition, and your recovery deserves the same respect. 🏊‍♂️

We also talked about the "Should I call? Should I bother him?" moment. You should call. Open communication with your surgeon is part of healing. 💛

Robots may make surgery more precise, but we're all human, and bodies still need time to heal.

💬 What's your biggest question about recovering from surgery? Tell me below.

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

09/26/2026

Gotta be strong Ortho..

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

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