1
|
Azmoude E, Zagami SE, Hooshmand E, Taheri E, Shoorab NJ. Exploring the decision-making process of female genital cosmetic procedures in Iranian women and constructing and validating a results-based logic model for a healthy public policy: a study protocol. Reprod Health 2024; 21:46. [PMID: 38589866 PMCID: PMC11000343 DOI: 10.1186/s12978-024-01788-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Female genital cosmetic procedures have grown rapidly in most parts of the world. Professional organizations have issued warnings about the complications and long-term consequences of these practices. To be able to adopt the right health policies, it is necessary to know why women decide to perform these procedures. Therefore, the present study will be aim to discover the decision-making process involved in performing female genital cosmetic procedures for Iranian women and construct and validate a results-based logic model for healthy public policy. METHODS The present study was conducted in three phases. In the initial phase, a qualitative study will be conducted with the Corbin and Strauss ground theory approach. The participants in the study will be healthy women who desire or have undergone female genital cosmetic procedures without medical indications. In this phase, purposive and theoretical sampling will guide recruitment and data collection. The data will be collected via semi-structured interviews, field notes and observations of individual interactions. The data will be analysed using the approach of Corbin and Strauss (2015). MAXQDA 2007 software was used for managing the process of data analysis. In the second phase, the development of a results-based logic model for a healthy public policy is performed based on the findings of the first phase of the study, interviews with key informants and a review of the results of the literature in this field. Finally, validation of the designed program will be performed by the nominal group technique with the presence of a group of experts in the third phase. DISCUSSION The findings of this study, by identifying women's main concerns related to the studied phenomenon, the existing context, participants' reactions and the consequences of the adopted reactions, can be very important in designing a program that fits Iran's cultural characteristics. In this research, a program using a logical model will be presented that is suitable for policymakers, planners and healthcare service providers to be implemented in the social-cultural context of the study.
Collapse
Affiliation(s)
- Elham Azmoude
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samira Ebrahimzadeh Zagami
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elahe Hooshmand
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Taheri
- Department of Clinical Psychology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nahid Jahani Shoorab
- Nursing and Midwifery Care Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
| |
Collapse
|
2
|
Graziottin A. Maintaining vulvar, vaginal and perineal health: Clinical considerations. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057231223716. [PMID: 38396383 PMCID: PMC10894559 DOI: 10.1177/17455057231223716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 10/31/2023] [Accepted: 12/13/2023] [Indexed: 02/25/2024]
Abstract
Knowledge of female genital anatomy and physiology is often inadequate or incorrect among women. Precise patient-physician conversations can be inhibited by a reluctance or inability to speak accurately about the vulva and vagina, with the terms often being used interchangeably. There is a paucity of scientific evidence and clinical guidelines to support women and physicians in ensuring best practices in feminine hygiene. In this review, the unmet needs in the field are highlighted. Evidence is provided for the complex array of physiological and pathological systems, mechanisms and behaviours that either protect or, if inappropriate, predispose the vulva and vagina to infections, irritation or other conditions. The need for attention to perineal health is recommended, given the interdependence of perineal and vulvar microbiota and the risk of colonic pathogens reaching the vulva and the vagina. Differences in feminine hygiene practices can vary widely across the world and among varying age groups, and suboptimal habits (such as vaginal douching or the use of certain cleansers) can be associated with increased risks of vulvar and vaginal conditions. Critical areas for discussion when advising women on their intimate health include: advice surrounding aesthetic vulvar cosmetic trends (such as depilation and genital cosmetic surgery), bowel health and habits, and protection against sexually transmitted infections. Routine, once-daily (maximum twice-daily) washing of the vulva with a pH-balanced, mild cleanser is optimal, ideally soon after bowel voiding, when feasible. Due to the finely balanced ecosystems of the vulva, the vagina and the perineal area, a scientific and clinical perspective is essential when determining the most appropriate vulvar cleansers based on their components. Correct intimate care may contribute to improved genital and sexual health and overall well-being. An increased awareness of correct practices will empower women to be the advocates of their own intimate health.
Collapse
Affiliation(s)
- Alessandra Graziottin
- Centre of Gynaecology and Medical Sexology, San Raffaele Resnati Hospital, Milan, Italy
- Specialty School, Department of Obstetrics and Gynecology, University of Verona, Verona, Italy
- Specialty School of Endocrinology and Metabolic Disease, Federico II University, Naples, Italy
- Alessandra Graziottin Foundation for the Cure and Care of Pain in Women, NPO, Milan, Italy
| |
Collapse
|
3
|
Ghorbani Z, Moghadam ZB, Mirghafourvand M, Vahidnia F, Ebrahimi E. A comprehensive interventional program based on the needs and concerns related to female genital cosmetic surgeries: protocol for a multistage mixed methods study. Reprod Health 2023; 20:177. [PMID: 38049840 PMCID: PMC10696663 DOI: 10.1186/s12978-023-01717-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 11/10/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Dissatisfaction with one's body and the subsequent rise in the cosmetic surgery trend pose significant public health concerns today. One unusual cosmetic surgical procedure involves enhancing the genital area. Numerous healthy women and girls have recently sought Genital Cosmetic Surgery (GCS) for beauty or improved sexual performance. There is a concern that this phenomenon may be linked to developing a new standard for vulvovaginal appearance. This stringent standard could potentially adversely affect women's mental health in the future, growing feelings of insecurity and possibly leading teenagers to consider plastic surgery. Implementing empowering and awareness-raising programs for women and girls is crucial, especially in light of the constantly evolving gender norms and the medicalization of sexuality and beauty as social constructs. It is essential that such training is integrated into comprehensive sexual education programs for adolescents. These efforts align perfectly with the SDG, recognizing that education in sexual and reproductive health, ensuring access to health, and empowering women are fundamental rights for women and girls. To accomplish these objectives, we will conduct this study to elucidate the needs and concerns related to the increasing trend of GCS. By doing so, we can concentrate on the factors motivating women to undergo GCS. This approach will enable us to develop effective interventions to empower women and girls considering GCS, thus enhancing their sexual and reproductive health. METHODS AND OBJECTIVES The objectives of this multistage exploratory sequential mixed-method study will be structured into three phases: First phase: qualitative study. 1. In-depth interviews will be conducted to elucidate the needs and concerns associated with GCS with women with a history of GCS, spouses of willing participants, and women actively seeking these procedures. 2. A literature review in parallel with the qualitative phase will be conducted to gain insights into the needs and concerns of women worldwide considering GCS. Second phase: program design. 1. To formulate an intervention grounded in the primary priorities identified during the qualitative stage and informed by the literature review. 2. To prioritize the needs and concerns of women seeking GCS and to validate and endorse the intervention through input from an expert panel. Third phase: quantitative study. To assess and determine the effectiveness of the intervention designed to address the needs and concerns of women applying for GCS procedures. DISCUSSION This study marks the first attempt to design and assess an intervention addressing the needs and concerns of cosmetic surgeries performed on the female genital and reproductive system. The hope is that this study's compilation and implementation will yield substantial evidence and documentation regarding the impact of educational interventions on women's and girls' sexual and reproductive empowerment. Given the rising prevalence of GCS among unmarried teenagers, this approach is of utmost significance. It underscores the necessity for gynecological and midwifery service providers to have comprehensive guidance on GCS. Such guidance can be an essential resource for healthcare providers in this field.
Collapse
Affiliation(s)
- Zahra Ghorbani
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Department of Midwifery, Bonab Branch, Islamic Azad University, Bonab, Iran
| | - Zahra Behboodi Moghadam
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Faezeh Vahidnia
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ebrahimi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
4
|
Aulia I, Valeria M. Current Perspectives in Vaginal Laxity Measurement: A Scoping Review. Arch Plast Surg 2023; 50:452-462. [PMID: 37808327 PMCID: PMC10556325 DOI: 10.1055/a-2113-3202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 06/15/2023] [Indexed: 10/10/2023] Open
Abstract
This scoping review aimed to identify and categorize the available measurement options for vaginal laxity (VL), their indications of use, and whether these measurements can sufficiently provide objective clinical judgment for cases indicated for vaginal rejuvenation with many treatment options nowadays. Systematic searches were conducted on five electronic databases, manually searching articles' bibliographies and predetermined key journals with no date or study design limitations. We included all studies involving VL in their inclusion criteria, treatment indications, and outcome parameters. We used the Arksey and O'Malley frameworks as the guideline in writing this scoping review. Of the 9,464 articles identified, 66 articles and 11,258 subjects were included in the final analysis. The majority of studies were conducted in obstetrics and gynecology (73%), followed by plastic surgery (10%), medical rehabilitation (4.5%), dermatology (4.5%), and others (8%). Most studies originated from the North American region (30%). The following measurement tools were used: (1) interviews, (2) questionnaires, (3) physical/digital examinations, (4) perineometers, and (5) others. Our results suggested that subjective perception of laxity confirmed by directed interview or questionnaire is sufficient to confirm VL. Additional evaluation of pelvic floor muscle through digital examination or perineometer or other preferred tools and evaluation of sexual function through validated questionnaire (Female Sexual Function Index, Female Sexual Distress Scale-Revised, etc.) should follow to ensure holistic care to patients. Future research on the psychometric properties (reliability and validity) of commonly used measurements and the correlation in between subjective and objective measurements should be initiated before their clinical applications.
Collapse
Affiliation(s)
- Indri Aulia
- External Genitalia Section, Division of Plastic Reconstructive and Aesthetic Surgery, Department of Surgery, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Michelle Valeria
- External Genitalia Section, Division of Plastic Reconstructive and Aesthetic Surgery, Department of Surgery, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| |
Collapse
|
5
|
Mohammad S, Joshi KS, Mohammad S, Acharya N. Aesthetic Gynaecology: What Women Want? Cureus 2023; 15:e44251. [PMID: 37772220 PMCID: PMC10523831 DOI: 10.7759/cureus.44251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 08/27/2023] [Indexed: 09/30/2023] Open
Abstract
The demand for aesthetic gynecology is growing among patients and medical professionals. It is becoming a field of increasing interest. In obstetrics and gynecology, there are currently few superspecialization or fellowship training programs that teach this subject; nevertheless, improvements have been made in aesthetic and plastic surgery training that foresee the need to add specialized training in this sector. In the US and the UK, numerous reputable certification and preceptorship programs are now where many surgeons start their careers. To give physicians interested in surgical and non-surgical therapies certification training, new programs were introduced globally in 2016-2017. We provide an overview of both surgical and non-surgical "aesthetic gynecology" treatments, as well as the opinions of the top gynecologic associations on this new field of study.
Collapse
Affiliation(s)
- Shazia Mohammad
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Ketav S Joshi
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Shirin Mohammad
- Otolaryngology - Head and Neck Surgery, NKP Salve Institute of Medical Sciences, Nagpur, IND
| | - Neema Acharya
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| |
Collapse
|
6
|
Che K, Wang K, Yuan Y, Li F, Li Q. The 50 most cited articles and science mapping analysis of vaginal tightening. Int Urogynecol J 2023; 34:1607-1617. [PMID: 36645444 DOI: 10.1007/s00192-022-05436-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/29/2022] [Indexed: 01/17/2023]
Abstract
INTRODUCTION AND HYPOTHESIS The study was aimed at exploring the 50 most cited articles related to vaginal tightening. METHODS The papers were searched through the Thomson Reuters Web of Science on 30 July 2022, and were ranked by the total number of citations. The included articles were analyzed for author, journal, country, number of citations, keywords, subject matter, and level of evidence. The search output was also imported into VOSviewer. RESULTS The 50 most cited articles were cited a combined total of 2,558 times. The papers were published between 1990 and 2020, of which 86% were published between 2010 and 2020. They included 38 original articles, 8 reviews, 3 editorial articles, and 1 letter. Most articles were published in gynecology-related journals (n=30, 60%). The articles covered a wide range of topics, the most common being laser/radiofrequency treatment, vaginal tightening procedures, and urinary incontinence. The majority presented findings supported by level IV or V evidence. Through co-occurrence analysis, high-frequency words and countries were displayed well. CONCLUSIONS The study shed light on frequently read articles and influential topics about vaginal tightening. The highly cited literature mainly focused on laser or radiofrequency treatments and gynecologists currently dominate the highly cited literature on vaginal tightening. The articles related to surgical treatments are low in number and evidence level so far. The co-occurrence analysis reveals the hot research content and active countries in the field. In general, the study provides useful evidence for future research and educational materials.
Collapse
Affiliation(s)
- Kexin Che
- Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Keke Wang
- Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ye Yuan
- Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengyong Li
- Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiang Li
- Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| |
Collapse
|
7
|
Earp BD, Abdulcadir J, Liao LM. Child genital cutting and surgery across cultures, sex, and gender. Part 2: assessing consent and medical necessity in "endosex" modifications. Int J Impot Res 2023; 35:1-6. [PMID: 37085735 DOI: 10.1038/s41443-023-00698-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Affiliation(s)
- Brian D Earp
- Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK.
| | - Jasmine Abdulcadir
- Department of Obstetrics and Gynecology, University Hospitals of Geneva (UHG), Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | |
Collapse
|
8
|
Colonnello E, Limoncin E, Ciocca G, Sansone A, Mollaioli D, Balercia G, Porst H, Zhang H, Yu X, Zhang Y, Jannini EA. The Lost Penis Syndrome: A New Clinical Entity in Sexual Medicine. Sex Med Rev 2021; 10:113-129. [PMID: 34620562 DOI: 10.1016/j.sxmr.2021.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/22/2021] [Accepted: 08/28/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The "lost penis syndrome" (LPS) is a term often used in non-clinical settings to describe the subjective perception of the loss of cutaneous and proprioceptive feelings of the male organ during vaginal penetration. Although deserving clinical attention, this syndrome did not receive any consideration in the medical literature. Notwithstanding, it represents a relatively unexceptional condition among patients in sexual medicine clinics, and it is often reported together with other sexual dysfunctions, especially delayed ejaculation, anejaculation, male anorgasmia and inability to maintain a full erection. OBJECTIVES To draft a new conceptual characterization of the LPS, defined as a lack of penile somesthetic sensations during sexual penetration due to various causes and leading to several sexual consequences in both partners. METHODS Based on an extensive literature review and physiological assumptions, the mechanisms contributing to friction during penovaginal intercourse, and their correlation to LPS, have been explored, as well as other nonanatomical factors possibly contributing to the loss of penile sensations. RESULTS Efficient penile erection and sensitivity, optimal vaginal lubrication and trophism contribute to penovaginal friction. Whenever one of these processes does not occur, loss of penile sensation defined as LPS can occur. Sociocultural, psychopathological and age-related (ie, couplepause) factors are also implicated in the etiology. Four types of LPS emerged from the literature review: anatomical and/or functional, behavioral, psychopathological and iatrogenic. According to the subtype, a wide variety of treatments can be employed, including PDE5i, testosterone replacement therapy and vaginal cosmetic surgery, as well as targeted therapy for concomitant sexual comorbidity. CONCLUSION We held up the mirror on LPS as a clinically existing multifactorial entity and provided medical features and hypotheses contributing to or causing the occurrence of LPS. In the light of a sociocultural and scientific perspective, we proposed a description and categorization of this syndrome hypothesizing its usefulness in daily clinical practice. Colonnello E, Limoncin E, Ciocca G, et al. The Lost Penis Syndrome: A New Clinical Entity in Sexual Medicine. Sex Med Rev 2021;XX:XXX-XXX.
Collapse
Affiliation(s)
- Elena Colonnello
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Erika Limoncin
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy; Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Giacomo Ciocca
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Andrea Sansone
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Daniele Mollaioli
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giancarlo Balercia
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Hartmut Porst
- European Institute for Sexual Health (EISH), Hamburg, Germany
| | - Hui Zhang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, PRC
| | - Xi Yu
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, PRC
| | - Yan Zhang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, PRC
| | - Emmanuele A Jannini
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
| |
Collapse
|
9
|
The Safe Practice of Female Genital Plastic Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3660. [PMID: 34249585 PMCID: PMC8263325 DOI: 10.1097/gox.0000000000003660] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/15/2021] [Indexed: 01/11/2023]
Abstract
The purpose of this article is to guide surgeons in the safe practice of female genital plastic surgery when the number of such cases is steadily increasing. A careful review of salient things to look for in the patient’s motivation, medical history, and physical examination can help the surgeon wisely choose best candidates. The anatomy is described, with particular attention given to the variations not generally described in textbooks or articles. Descriptions are included for labiaplasty, including clitoral hood reduction, majoraplasty, monsplasty, and perineoplasty with vaginoplasty. Reduction of anesthetic risks, deep venous thromboses, and pulmonary emboli are discussed, with special consideration for avoidance of nerve injury and compartment syndrome. Postoperative care of a variety of vulvovaginal procedures is discussed. Videos showing anatomic variations and surgical techniques of common female genital procedures with recommendations to reduce the complication rate are included in the article.
Collapse
|
10
|
Johnsdotter S, Essén B. Deinfibulation Contextualized: Delicacies of Shared Decision-Making in the Clinic. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1943-1948. [PMID: 32170548 PMCID: PMC8275533 DOI: 10.1007/s10508-020-01676-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 02/29/2020] [Accepted: 03/03/2020] [Indexed: 05/13/2023]
Affiliation(s)
- Sara Johnsdotter
- Centre for Sexology and Sexuality Studies, Faculty of Health and Society, Malmö University, 205 06, Malmö, Sweden.
| | - Birgitta Essén
- Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
| |
Collapse
|
11
|
Johnson-Agbakwu CE, Manin E. Sculptors of African Women's Bodies: Forces Reshaping the Embodiment of Female Genital Cutting in the West. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1949-1957. [PMID: 32328914 PMCID: PMC8275492 DOI: 10.1007/s10508-020-01710-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 05/05/2023]
Affiliation(s)
- Crista E Johnson-Agbakwu
- Southwest Interdisciplinary Research Center, Watts College of Public Service and Community Solutions, Arizona State University, MC 5120, 201 North Central Avenue, 33rd Floor, Phoenix, AZ, 85004, USA.
- Refugee Women's Health Clinic, Obstetrics and Gynecology, Valleywise Health, Phoenix, AZ, USA.
| | - Emily Manin
- Southwest Interdisciplinary Research Center, Watts College of Public Service and Community Solutions, Arizona State University, MC 5120, 201 North Central Avenue, 33rd Floor, Phoenix, AZ, 85004, USA
| |
Collapse
|
12
|
Carbon Dioxide Laser Vulvovaginal Rejuvenation: A Systematic Review. COSMETICS 2021. [DOI: 10.3390/cosmetics8030056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Genitourinary syndrome of menopause (GSM) causes significant symptomatic aggravation that affects the quality of life (QoL). Vulvovaginal atrophy (VVA), the hallmark of GSM, is managed with topical non-hormonal therapy, including moisturizers and lubricants, and topical estrogen application. Patients not responding/being unsatisfied with previous local estrogen therapies are candidates for a noninvasive modality. Carbon dioxide (CO2) laser therapy, especially the fractionated type (FrCO2), has drawn considerable attention over the past two decades as a non-invasive treatment for GSM. This systematic review describes the accumulated evidence from 40 FrCO2 laser studies (3466 participants) in GSM/VVA. MEDLINE, Scopus and Cochrane databases were searched through April 2021. We analyze the effects of FrCO2 laser therapy on symptoms, sexual function, and QoL of patients with GSM/VVA. As shown in this review, FrCO2 laser therapy for GSM shows good efficacy and safety. This modality has the potential to advance female sexual wellness. Patient satisfaction was high in the studies included in this systematic review. However, there is a lack of level I evidence, and more randomized sham-controlled trials are required. Furthermore, several clinical questions, such as the number of sessions required that determine cost-effectiveness, should be addressed. Also, whether FrCO2 laser therapy may exert a synergistic effect with systemic and/or local hormonal/non-hormonal treatments, energy-based devices, and other modalities to treat GMS requires further investigation. Lastly, studies are required to compare FrCO2 laser therapy with other energy-based devices such as erbium:YAG laser and radiofrequency.
Collapse
|
13
|
Zheng Z, Yin J, Cheng B, Huang W. Materials Selection for the Injection into Vaginal Wall for Treatment of Vaginal Atrophy. Aesthetic Plast Surg 2021; 45:1231-1241. [PMID: 33649927 DOI: 10.1007/s00266-020-02054-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/12/2020] [Indexed: 11/28/2022]
Abstract
Vaginal atrophy caused by the aging process and perineal trauma has a negative impact on women. A new vaginal atrophy treatment is injection of materials into the vaginal wall, including platelet-rich plasma (PRP), autogenous fat graft (AFG), hyaluronic acid (HA), botulinum toxin (BTX), and collagen, but to date their efficacy has not been reviewed. Vaginal wall injection is available only for mild cases of vaginal atrophy or as an adjunct to vaginal surgery. PRP is used mainly to restore vaginal function, and multiple injections are needed to achieve good results in vaginal atrophy. HA, AFG, and collagen are used mainly to augment the vaginal wall. BTX injection can inhibit vaginal muscle spasm and reduce pain during sexual intercourse in patients with vaginismus. Injection of most of these materials into vaginal wall is effective and relatively safe. Vascular embolisms are the most serious complication of vaginal injection and should be prevented. In addition, there has been no randomized double-blind placebo-controlled trial or discussion of methods to avoid serious complications resulting from vaginal injection. Therefore, further studies of the injection of materials into the vaginal wall to treat vaginal atrophy are required, and the procedures should be standardized to benefit more patients.Level of Evidence IV 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 .
Collapse
Affiliation(s)
- Zhifang Zheng
- Department of Anatomy, School of Basic Medicine Sciences, Southern Medical University, No. 1023 Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Junfeiyang Yin
- Department of Anatomy, School of Basic Medicine Sciences, Southern Medical University, No. 1023 Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Biao Cheng
- Department of Plastic Surgery, General Hospital of Southern Theater Command, PLA, Guangzhou, 510010, China
| | - Wenhua Huang
- Department of Anatomy, School of Basic Medicine Sciences, Southern Medical University, No. 1023 Shatai South Road, Baiyun District, Guangzhou, 510515, China.
| |
Collapse
|
14
|
Energy-Based Devices for Functional Vaginal Problems: Issues and Answers. CURRENT SEXUAL HEALTH REPORTS 2021. [DOI: 10.1007/s11930-021-00302-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Abstract
Vaginal rejuvenation is a marketing term that encompasses surgical and medical treatments for functional vaginal/vulvar problems including but not limited to genitourinary syndrome of menopause (GSM), sexual dysfunction, vaginal laxity, and stress urinary incontinence (SUI) and for esthetic concerns including dissatisfaction with vulvovaginal appearance. Multiple treatment options have become available for indications of functional vaginal problems. Noninvasive management options including the use of more novel treatments such as energy-based devices have gained interest. Previously, studies regarding the efficacy and safety of the energy-based devices for functional vaginal problems were mostly limited to cohort studies without sham treatment, control groups, randomization, or double blinding. As a result of this insufficient data in 2018, the FDA released a statement of warning against the use of energy-based devices in the treatment of functional vaginal problems or vaginal cosmetic procedures (Https://Www.Fda.Gov/Medical-Devices/Safety-Communications/Fda-Warns-Against-Use-Energy-Based-Devices-Perform-Vaginal-Rejuvenation-or-Vaginal-Cosmetic. 1–4, 2018).
Purpose of Review
This article reviews the most current treatment modalities in the realm of vaginal rejuvenation therapy with an emphasis on the efficacy and safety of the energy-based devices.
Recent Findings
In the most recent literature, there have been studies with improvements in study design that support the efficacy and the short-term safety of the energy-based devices.
Summary
More recent studies with improved study design evidence that the use of energy-based devices results in improvements in functional vaginal problems and that serious adverse events appear to be rare. The availability of these devices as treatment options for functional vaginal problems has the potential to impact patient by improving their symptoms and quality of life. Caution still remains however regarding their safety following a longer period of time after their use.
Collapse
|
15
|
Al-Jumah MM, Al-Wailiy SK, Al-Badr A. Satisfaction Survey of Women After Cosmetic Genital Procedures: A Cross-Sectional Study From Saudi Arabia. Aesthet Surg J Open Forum 2020; 3:ojaa048. [PMID: 33791669 PMCID: PMC7750879 DOI: 10.1093/asjof/ojaa048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2020] [Indexed: 11/13/2022] Open
Abstract
Background Female cosmetic genital surgery (FCGS) aims for better aesthetic genital appearance and improved functional aspects to enhance women's self-esteem and satisfaction. Objectives This study aims to assess the satisfaction of women who have undergone FCGS and its impact on their sexual, psychological, and aesthetic aspects. Methods An observational cross-sectional study was conducted in private clinics in Riyadh, Kingdom of Saudi Arabia, between March and June 2019, in women who underwent FCGS. Phone interviews were conducted in the Arabic language. The survey comprised 4 sections: demographics, motives for FCGS, quality-of-life questionnaires about genital appearance satisfaction, and sexual function. Results Out of the 196 women undergoing FCGS during the study period, 11.7% refused to participate, and 37.2% did not answer phone calls; 51% of the women participated in the study. The women's age ranged between 23 and 55 years; 64% underwent vaginoplasty, and 73% underwent other cosmetic procedures. Ninety-two percent of the women did not have any complications after these procedures. Conclusions In this group of women, FCGS was safe and effective, and the majority of participants reported overall satisfaction and improvement of sexual function, genital appearance, and self-esteem. Level of Evidence 4
Collapse
Affiliation(s)
| | | | - Ahmed Al-Badr
- Department of Urogynecology & Pelvic Reconstruction Surgery, Women's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| |
Collapse
|
16
|
Abstract
LEARNING OBJECTIVES After studying this article, participants should be able to: (1) Identify the most appropriate type of anesthesia for the female genital plastic surgical patient and minimize risks of nerve injury and thromboembolic event through proper preoperative evaluation and knowledge of positioning. (2) Define the vulvovaginal anatomy, including common variants, and assess vulvovaginal tissues after childbirth and menopause. (3) Apply surgical techniques to minimize complications in female genital plastic surgery. (4) Classify the types of female genital mutilation/cutting and design methods of reconstruction after female genital mutilation/cutting. SUMMARY Female genital plastic surgery is growing in popularity and in numbers performed. This CME article covers several aspects of safety in the performance of these procedures. In choosing the best candidates, the impact of patient motivation, body mass index, parity, menopause and estrogen therapy is discussed. Under anesthesia, consideration for the risks associated with the dorsal lithotomy position and avoidance of compartment syndrome, nerve injury, deep venous thromboses, and pulmonary embolus are covered. Anatomical variations are discussed, as is the impact of childbirth on tissues and muscles. Surgical safety, avoidance of complications, and postoperative care of a variety of vulvovaginal procedures are discussed. Videos showing anatomical variations and surgical techniques of the most common female genital procedures with recommendations to reduce the complication rate are included in the article. Finally, female genital mutilation/cutting is defined, and treatment, avoidance of complications, and postoperative care are discussed.
Collapse
|
17
|
Abstract
BACKGROUND Labiaplasty has grown in popularity, but it remains controversial. Few studies have quantified the change in specific symptomatology from before to after labiaplasty to establish its effectiveness in improving quality of life. METHODS In a prospective study, 62 patients undergoing labiaplasty completed written surveys privately in an examination room preoperatively and postoperatively about the presence of 11 physical and appearance-related symptoms. RESULTS Mean patient age was 33.5 years (range, 17 to 61 years). Two patients were of minority age. All patients presented with at least one symptom, averaging 6.5 (range, one to 11). Most (82.2 percent) had a trim labiaplasty, and the rest (17.7 percent) had a wedge. After labiaplasty, 93.5 percent of patients were symptom-free, with the average dropping to 0.23 of 11 symptoms. Symptom-prevalence changes from preoperatively to postoperatively included self-consciousness, dropping from 93 percent to 6.5 percent; tugging (from 66.1 percent to 0 percent); feeling less attractive (from 66.1 percent to 0 percent); negative impact on self-esteem (from 64.5 percent to 1.6 percent); negative impact on intimacy (from 62.5 percent to 0 percent); twisting (from 58.1 percent to 3.2 percent); being uncomfortable (from 56.5 percent to 4.8 percent); clothing restriction (from 54.8 percent to 3.2 percent); visible outline (from 46.8 percent to 1.6 percent); pain (from 43.5 percent to 1.6 percent); and exposure in swimsuits (from 38.7 percent to 1.6 percent). No major complications occurred. Two patients felt their labia were still too long and revision was offered. Average follow-up was 13.3 months (range, 6 to 24 months). CONCLUSIONS Patients with elongated labia have a high incidence of functional and appearance-related symptoms. Labiaplasty is a safe procedure that yields significant improvement in quality of life. CLINICAL QUESTIONS/LEVEL OF EVIDENCE Therapeutic, IV.
Collapse
|
18
|
Turin SY, Kearney A, Placik OJ. Anterior and Posterior Commissuroplasty: Taking Labiaplasty to the Next Level. Aesthet Surg J 2020; 40:1111-1121. [PMID: 32926100 DOI: 10.1093/asj/sjz287] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
As the popularity of female cosmetic genital surgery has grown, so has the number of publications detailing surgical techniques, particularly regarding labiaplasty. As a nascent surgical field, much room remains for finesse and exploration of new techniques to optimize outcomes and patient satisfaction. We present the techniques for anterior and posterior commissuroplasty the senior author (O.J.P.) has developed. Anterior commissuroplasty is efficacious in addressing a number of anatomic variations to achieve the appearance of a single midline cleft, which is commonly requested by patients. Posterior commissuroplasty was developed to address skin excess at the posterior fourchette that may develop as a result of labiaplasty. Either technique may be used in combination with labiaplasty or as a stand-alone procedure. These tools may be a useful addition to the repertoire of a surgeon practicing female genital surgery. LEVEL OF EVIDENCE: 4
Collapse
Affiliation(s)
- Sergey Y Turin
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Aaron Kearney
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Otto J Placik
- Northwestern University Feinberg School of Medicine, Chicago, IL
| |
Collapse
|
19
|
Sorice-Virk S, Li AY, Canales FL, Furnas HJ. The Role of Pornography, Physical Symptoms, and Appearance in Labiaplasty Interest. Aesthet Surg J 2020; 40:876-883. [PMID: 31556940 DOI: 10.1093/asj/sjz254] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND With the American College of Obstetricians and Gynecologists reaffirming its 2007 opposition to labiaplasty in 2019, the procedure continues to be controversial. Particular emphasis on pornography as a major influencer on women seeking labiaplasty contributes to its controversy and distracts from other motivations. Few articles have established pornography's influence relative to functional and appearance-related symptoms. OBJECTIVES The objective of this study was to investigate the relative influence of pornography on women's decision to seek labiaplasty relative to other factors compared with a control cohort. METHODS In this prospective study, 124 consecutive patients consulting about labiaplasty and a control cohort of 50 women were questioned about 11 labia-related symptoms and the possible influence of pornography. RESULTS The mean age was 34.2 and 38.9 years in the labiaplasty and control cohorts, respectively. Women in the labiaplasty cohort had on average 2.8 of the 6 queried physical symptoms and 3.2 of the 5 queried appearance-related symptoms compared with control patients who reported an average of 0.3 of the 6 queried physical symptoms and 0.2 of the 5 queried appearance-related symptoms (P < 0.001). Less than one-half (47% of the labiaplasty and 42% of the control cohort) never viewed pornography. Pornography was not an influential factor to seek labiaplasty in 42% of the labiaplasty cohort and 54% of the control cohort. A minority (11% in the labiaplasty cohort and 4% in the control cohort) said that pornography influenced them to seek labiaplasty. There were no statistically significant differences between these 2 groups. CONCLUSION Pornography influences some women to seek labiaplasty, but relative to other motivating factors its role is minor.
Collapse
Affiliation(s)
- Sarah Sorice-Virk
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, CA
| | - Alexander Y Li
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, CA
| | | | - Heather J Furnas
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, CA
| |
Collapse
|
20
|
Srinivasan V, Sundaram H. Commentary on: Death Caused by Vaginal Injection of Hyaluronic Acid and Collagen: A Case Report. Aesthet Surg J 2020; 40:NP269-NP272. [PMID: 32101276 DOI: 10.1093/asj/sjaa003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
21
|
Sharp G, Maynard P, Hamori CA, Oates J, Sarwer DB, Kulkarni J. Measuring Quality of Life in Female Genital Cosmetic Procedure Patients: A Systematic Review of Patient-Reported Outcome Measures. Aesthet Surg J 2020; 40:311-318. [PMID: 31720690 DOI: 10.1093/asj/sjz325] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND In the subspecialty of female genital cosmetic procedures, patient satisfaction and quality of life are key outcome measures. As such, valid and reliable patient-reported outcome measures (PROMs) examining these outcomes are essential. OBJECTIVES The authors sought to identify and scrutinize all PROMs developed for female patients undergoing genital cosmetic procedures. METHODS The authors performed a systematic literature review utilizing MEDLINE, PreMEDLINE, Ebase, Embase, OVID, CINAHL, Cochrane Library, PsycINFO, PubMed, and Google Scholar to identify PROMs developed and validated for utilization in female genital cosmetic procedure patients. Instruments identified were assessed according to international guidelines for health outcome measures development and validation. RESULTS The authors identified 50 outcome questionnaires employed in the female genital cosmetic procedure literature. Of these, 26 were ad hoc instruments (ie, had not been formally developed and tested) and 22 were generic instruments (ie, intended for use in broad groups of people, not only specific patient groups). Only 2 instruments have been validated in a female genital cosmetic procedure patient population. These were the Genital Appearance Satisfaction scale and the Cosmetic Procedure Screening Scale-Labiaplasty. Although both these scales had undergone fairly rigorous psychometric development and validation, both had content limitations. CONCLUSIONS There is a lack of specific, valid, and reliable satisfaction and quality-of-life PROMs in the field of female genital cosmetic procedures. Future research should involve the development of such measures to more accurately assess the outcomes and benefits of these procedures.
Collapse
Affiliation(s)
| | | | | | | | - David B Sarwer
- College of Public Health, Temple University, Philadelphia, PA
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
22
|
Sofra X. Dynamics of Female Sexuality; Hidden Emotional Issues. Health (London) 2020. [DOI: 10.4236/health.2020.126051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
23
|
Kalaaji A, Dreyer S, Maric I, Schnegg J, Jönsson V. Female Cosmetic Genital Surgery: Patient Characteristics, Motivation, and Satisfaction. Aesthet Surg J 2019; 39:1455-1466. [PMID: 30423019 DOI: 10.1093/asj/sjy309] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Female cosmetic genital surgery is rapidly growing. However, controversy reports raised around these procedures question their indications, motives, and safety. Warning against performing this surgery might unjustly restrict surgical alleviation of symptoms. OBJECTIVES Through anonymous research, the authors explored patient characteristics and motivation, when women started to think about surgery, and effects of surgery on psychosocial and cosmetic aspects. METHODS Of 125 patients who underwent female cosmetic genital surgery at Oslo Plastic Surgery Clinic between 2010 and 2016, 69 patients were reachable by email. A questionnaire with 40 questions was completed anonymously. Answers were processed by a third, independent party via QuestBack return mail system. RESULTS The response rate was 77%. Mean follow-up time was 31.4 months. Mean patient age was 30.8 years. Motivations for surgery were cosmetic (69.8%), physical/practical (62.3%), emotional (54.7%), and intimate (49.1%). When emotional reasons were involved, media (39.7%), pornography (31.5%), and negative comments (28.8%) influenced the decision to undergo surgery. Genital concerns had negative effects on self-esteem (63.2%) and sexual attractiveness (57.9%) among others; 90.5% thought about surgery for more than 1 year. The overall cosmetic result was satisfactory for 69.8%, and the operation as a whole was satisfactory for 75.5%. CONCLUSIONS Age, level of education, and gross income of patients who underwent this surgery seem high compared with those of breast implant patients. Genital dissatisfaction arose early in life and affected various psychosexual aspects. Most patients are satisfied with the outcome of surgery and would recommend this surgery to others. Additional anonymous multicenter studies are recommended. LEVEL OF EVIDENCE: 4
Collapse
|
24
|
Austin RE, Lista F, Vastis PG, Ahmad J. Posterior Vaginoplasty With Perineoplasty: A Canadian Experience With Vaginal Tightening Surgery. Aesthet Surg J Open Forum 2019; 1:ojz030. [PMID: 33791620 PMCID: PMC7780460 DOI: 10.1093/asjof/ojz030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Following vaginal trauma, most commonly vaginal delivery, women may experience vaginal laxity as a result of local tissue stretching and separation of the pelvic floor musculature. In addition to this generalized sensation of laxity, women may complain of decreased sexual satisfaction, gaping of the perineum, and excessive vaginal secretions. Since 2014, the authors have used a posterior vaginoplasty with perineoplasty technique for the surgical management of vaginal laxity. To date, the authors have performed surgical vaginal tightening in 30 consecutive patients and found that the posterior vaginoplasty with perineoplasty technique has allowed us to achieve reproducible outcomes with no postoperative complications. This article will review the authors’ approach to patients presenting for surgical vaginal tightening and the authors’ experience to date, including our preoperative screening, perioperative management, and detailed steps of the procedure.
Collapse
Affiliation(s)
| | - Frank Lista
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto,, Toronto, Ontario, Canada
| | | | - Jamil Ahmad
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto,, Toronto, Ontario, Canada
- Corresponding Author: Dr Jamil Ahmad, The Plastic Surgery Clinic, 1421 Hurontario Street, Mississauga, ON, Canada, L5G 3H5 E-mail: ; Twitter: @DrJAhmad
| |
Collapse
|
25
|
|
26
|
Al-Badr A, Alkhamis WH. Laser Vaginal Tightening Complications: Report of Three Cases. Lasers Surg Med 2019; 51:757-759. [PMID: 31215051 PMCID: PMC7028074 DOI: 10.1002/lsm.23110] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2019] [Indexed: 11/30/2022]
Abstract
Background and Objectives Laser vaginal tightening (LVT) outpatient procedures have become increasingly popular for cosmetic reasons, for enhancement of sexual functioning and to treat vaginal laxity, mild pelvic organ prolapsed (POP), and urinary incontinence, although scientific short‐ and long‐term evidence is lacking. Study Design/Materials and Methods Report of three patients with vaginal laxity who previously underwent LVT procedures. Results Three premenopausal women who previously underwent LVT for vaginal laxity but had no improvement. On subsequent posterior vaginal repair procedures, their vaginal mucosa was found to be scarred or friable, making surgery and dissection more difficult. Conclusions LVT procedures lack scientific evidence of safety and efficacy regarding management of mild POP and vaginal laxity, and healthcare providers should counsel and educate their patients of the potential risks, some of which is still unreported. Lasers Surg. Med. © 2019 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Ahmed Al-Badr
- Urogynecology and Pelvic Reconstructive Surgery Division, Department of Obstetrics and Gynecology, Women's Specialised Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Waleed H Alkhamis
- Department of Obstetrics and Gynecology, King Saud University Medical City, Riyadh, Saudi Arabia
| |
Collapse
|
27
|
Desai SA, Kroumpouzos G, Sadick N. Vaginal rejuvenation: From scalpel to wands. Int J Womens Dermatol 2019; 5:79-84. [PMID: 30997377 PMCID: PMC6451893 DOI: 10.1016/j.ijwd.2019.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/15/2019] [Accepted: 02/17/2019] [Indexed: 11/26/2022] Open
Abstract
Vaginal rejuvenation procedures are increasing in popularity in terms of types of treatment offered, number of patients undergoing them, clinical studies, and in the controversy surrounding them. Both non-invasive and invasive solutions are being developed by pharmaceutical and technological companies. Radiofrequency devices and lasers are spearheading the energy-based device space, and fillers and platelet-rich plasma are used to address several concerns surrounding vaginal health. In this review, an overview of the growing field of vaginal rejuvenation is presented, as well as the authors’ personal view and analysis of this clinical space.
Collapse
Affiliation(s)
- Sejal A Desai
- BCJ Hospital and Asha Parekh Research Centre, Mumbai, India.,NMC Hospitals, Dubai, United Arab Emirates
| | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School of Brown University, Providence, Rhode Island.,Department of Dermatology, Medical School of Jundiaí, Sao Paulo, Brazil.,GK Dermatology, South Weymouth, Massachusetts
| | - Neil Sadick
- Department of Dermatology at Weill Cornell Medical College, New York, New York.,Sadick Dermatology, New York, New York
| |
Collapse
|
28
|
Genito Pelvic Vaginal Laxity: Classification, Etiology, Symptomatology, and Treatment Considerations. CURRENT SEXUAL HEALTH REPORTS 2018. [DOI: 10.1007/s11930-018-0168-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
29
|
|