G-spot: Fact or Fiction?: A Systematic Review

Sexual dysfunction in patients after cystocele surgery. Is the g-spot a myth or reality?

The anterior wall of the vagina is very rich in nerves, blood vessels, and exocrine glands. This anatomical region is related to female sexual desire. During the anterior colporrhaphy operation, dissection of the anterior vaginal wall causes damage to this area, which may lead to decreased sexual satisfaction. In the present study, we aimed to investigate sexual function after anterior vaginal wall surgery.

METHODS

Totally 89 patients who had undergone the anterior colporrhaphy operation between May 2021 and December 2021 were included in the study. The patients' sexual function was investigated before surgery and six months after surgery. The effects on sexual function were determined according to the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire.

RESULTS

According to our study results, orgasm and orgasm intensities decreased after anterior colporrhaphy surgery (p = 0.000; p = 0.000), while sexual desire or arousal did not change (p = 0.405; p = 0.052). In addition, an increase in pain was observed during sexual intercourse after surgery (p = 0.000). No statistically significant difference was observed in the PISQ-12 score before or after anterior colporrhaphy surgery (p = 0.675).

CONCLUSION

Based on the results of our study, we found a remarkable decrease in orgasm in these patients. Furthermore, we think that it is appropriate to recommend conservative or alternative treatments for the early stages of cystocele. Nevertheless, larger-scale studies may be designed to reveal the importance of this region in sexual function.

Cosmetic gynecology-An emerging field for the dermatologist

INTRODUCTION

Cosmetic gynecology is an expanding field with a steep rise in awareness and demand for procedures to enhance the aesthetic appearance of female genitalia.

AIM

This article aims to provide an overview of aesthetic gynecology for a practicing dermatologist.

METHODS

A study conducted in India showed a rising trend in the demand of aesthetic vaginal procedures from 3.9% in 2012 to 28.97% in 2015.

CONCLUSION

Several aesthetic modalities such as peels, platelet rich plasma, and energy-based devices and surgical modalities have been in use, though serious evidence for efficacy of many of these procedures is lacking.

A Novel Technique Combining Human Acellular Dermal Matrix (HADM) and Enriched Platelet Therapy (EPT) for the Treatment of Vaginal Laxity: A Single-Arm, Observational Study

BACKGROUND

There is a paucity of knowledge about cosmetic vaginal tightening procedures; therefore, the present study aimed to describe the clinical effects of a novel combination technique of human acellular dermal matrix (HADM) and enriched platelet therapy (EPT) for the treatment of vaginal laxity.

METHODS

This single-arm, observational study was conducted on 52 patients with grade II to III vaginal relaxation. HADM biological band (U-shaped) was implanted in these patients by submucosal puncture in vagina under anesthesia. This was followed by thrice administration of EPT injection, once at the time surgery followed by each dose at a time interval of one month. Patients were followed up for a period of 6 months based on Female Sexual Function Index (FSFI) and Vaginal Health Index (VHI) scores. Patient satisfaction was measured using Visual Analogue Score (VAS).

RESULTS

About 52 women with median age of 39 years were included in the study. The average time reported to complete HADM surgery was reported as 27 minutes. Following implantation, it was found that labia minora was significantly closed and perineal length was increased from 1.5 to 2.2 cm. Moreover, there was improvement in elasticity, contractility and lubricity of vaginal mucosa. The sexual function scores from pre- to post-surgery were significantly increased (7.95 vs. 30.09; p value: <0.001). The mean VHI score also increased significantly after 6 months of treatment (mean ± S.D. before vs after treatment: 11.2 ± 3.3 vs. 19.6 ± 4.1, P < 0.0001). The mean VAS after surgery was 1.61 ± 0.31. About 96% of the patients did not feel any pain after treatment at 6-month follow-up. No adverse effects were reported in this study.

CONCLUSIONS

These findings supported that combination treatment with HADM and EPT was safe and associated with both improved vaginal laxity and sexual function. These results may provide a novel surgical technique for this prevalent and undertreated condition.

LEVEL OF EVIDENCE IV

Therapeutic Study This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cosmetic labiaplasty on minors: a review of current trends and evidence

Cosmetic labiaplasty is a form of Female Genital Cosmetic Surgery (FGCS) that is performed with the deliberate intent to alter the appearance and morphology of the external genitalia in the absence of medical concerns. Over the last decade, there is an increasing demand for FGCS and the industry behind it is constantly growing. Adolescents comprise an extremely vulnerable population, with labiaplasties in this particular age group having also increased. However, labiaplasty has been widely contested due to the irrevocable alteration of a psychosexually significant body part on minors too young to consent. Besides, the changes that occur during pubertal development in the genital area can significantly alter pediatric surgical results. Genital anatomy is more diverse than we previously thought and there is evidence to suggest that the labia minora with their rich innervation play an important role in sexual arousal and pleasure. Education regarding the wide range of normal genital appearance suffices in most cases to dissolve concerns regarding body self-image. Mental health issues should always be explored and, if identified, the girl should be referred to an experienced professional for their resolution. Postponing labiaplasty until adulthood is strongly recommended to help adolescents achieve a well-informed decision regarding an irreversible procedure with possible adverse esthetic and functional outcomes.