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International Journal of Impotence... May 2023Cosmetic 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... (Review)
Review
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.
Topics: Adolescent; Child; Humans; Female; Adult; Minors; Vulva; Gynecologic Surgical Procedures; Body Image; Self Concept
PubMed: 34663925
DOI: 10.1038/s41443-021-00480-1 -
Shujutsu. Operation Aug 1971
Topics: Anal Canal; Female; Humans; Methods; Muscles; Rectum; Suture Techniques; Vagina; Vulva
PubMed: 4937881
DOI: No ID Found -
International Urogynecology Journal Oct 2017We provide a review of the literature about the onset and development of hypertrophy of the labia minora, together with some expert opinions on the appropriateness of... (Review)
Review
INTRODUCTION AND HYPOTHESIS
We provide a review of the literature about the onset and development of hypertrophy of the labia minora, together with some expert opinions on the appropriateness of labiaplasty.
METHODS
We searched PubMed and used popular search engines, with a greater emphasis on the physiology and hormone-mediated metabolism of these structures, and less emphasis on their surgical treatment.
RESULTS
We describe major embryological, cytological, and biochemical features of this anatomical part and summarize the clinical aspects of its hypertrophy, evaluating types of discomfort reported by women and the medical treatments available. Also, based on what is known about the artificial elongation and spontaneous hypertrophy of the inner labia, we illustrate and discuss the main biological factors that may trigger this medical condition. There are not enough data identifying a clear inheritance of inner labia hypertrophy in the absence of other pathological conditions; instead, we found indirect evidence for an association with transient episodes of local inflammation either before birth or during puberty. We also analyze the role played by estrogen receptors and other factors with regard to the onset of this condition and highlight the importance of their timing in determining the size of women's labia minora. Remarkably, most cases of enlarged labia minora should be considered as outliers that are within the physiological range of size variation described for these structures.
CONCLUSIONS
We generally advise against surgical treatment of labia minora, especially in young, pre-pubertal girls, unless specific medical conditions are also present and/or the psychological impact on the patient is deemed particularly negative.
Topics: Female; Gynecologic Surgical Procedures; Humans; Hypertrophy; Plastic Surgery Procedures; Vulva; Vulvar Diseases
PubMed: 28101640
DOI: 10.1007/s00192-016-3253-8 -
Gynecologie, Obstetrique, Fertilite &... Jun 2019In France, the number of labiaplasty increased by 57% between 2008 and 2016. To date, only one prospective study with low-power evaluated postoperative satisfaction has... (Observational Study)
Observational Study
OBJECTIVES
In France, the number of labiaplasty increased by 57% between 2008 and 2016. To date, only one prospective study with low-power evaluated postoperative satisfaction has been performed. This observational prospective study aims to evaluate the motives and post-surgery satisfaction of patients who had a labiaplasty.
METHODS
This observational prospective study include all patients over 18 years old operate at the hospital of Angers during an 18-month period. The exclusion criterion was a positive screening test to the Body Dysmorphic Disorder Questionnaire. Patients were interviewed by a written questionnaire on the day of the surgery and by phone 3 and 6 months after the surgery.
RESULTS
A total of thirty patients were included in the study, with an average age of 31.5 (± 10.58). Twenty-three patients answered 3 months after and 19 answered 6 months after. Eighteen patients (95%) expressed satisfaction at 6 months and 16 (84%) "extremely" satisfied. Functional discomfort improved in 18 patients (94%) at 6 months. Eighty-four percent have felt an improvement regarding esthetical discomfort. All patients would recommend the surgery. The main motive was the discomfort when getting dressed for 27 patients (90%).
CONCLUSION
The patients expressed a real functional discomfort and are mostly very satisfied with their surgery at 3 and 6 months after.
Topics: Adult; Esthetics; Female; France; Gynecologic Surgical Procedures; Humans; Hypertrophy; Patient Satisfaction; Prospective Studies; Plastic Surgery Procedures; Surveys and Questionnaires; Vulva
PubMed: 31003016
DOI: 10.1016/j.gofs.2019.04.005 -
Current Opinion in Obstetrics &... Dec 1994For many reasons including the recent increase in the reporting of sexual abuse, more physicians are being asked to perform genital examinations on prepubertal girls.... (Review)
Review
For many reasons including the recent increase in the reporting of sexual abuse, more physicians are being asked to perform genital examinations on prepubertal girls. Recent studies have clarified the appearance of structures in this area in nonabused children and demonstrated both acute and chronic changes that may result from trauma.
Topics: Anal Canal; Child; Child Abuse, Sexual; Female; Genitalia, Female; Humans; Hymen; Vulva
PubMed: 7893957
DOI: No ID Found -
Clinical Anatomy (New York, N.Y.) Apr 2015Patient perceptions of genital esthetics are motivating requests for plastic surgeries that could change sexual sensitivity. There is little information about the... (Review)
Review
Patient perceptions of genital esthetics are motivating requests for plastic surgeries that could change sexual sensitivity. There is little information about the sensitivities of labial and introital sites. The aim of this study is to assess the relationship between sexual sensitivity and self-reported sizes of labial and introital sites. Sixty-two healthy, sexually active, adult women (mean age 37.9, range 21-60) with no history of genital or vaginal surgery gave written consent to participate in this study. A modified version of Self-Assessment of Genital Anatomy and Sexual Function (L-SAGASF-F) was used to assess labial and introital size. Site-specific sensation was rated on Likert scales of 1-5. Anatomical locations were compared for ratings. Of 62 responders, 84% (52) described their labia as "average-sized," 11% (7) described their labia minora and 13% (8) their labia majora as "large", and 3% (2) and 5% (3) as "small". Sexual pleasure ratings were "moderate" (median value: 3.0 for external genitalia and vaginal lumen) or "strong" (median value: 4.0 for the interior vagina). Significantly higher rankings related to the vaginal opening (P=0.007). Orgasm intensity for stimulation of the external genitalia progressively increased toward the vaginal opening, from 1.0 to 3.0 (P=0.001); vaginal ratings showed a similar progression, from 2.0 at the external luminal margin to 3.0 in the deep interior (P<0.0001). Orgasm effort scores were intermediate (median: 3.0), uniform throughout the external and internal areas (P=0.626). Ratings for labial and introital sensitivity, regardless of self-reported size, were very similar to those at other genital sites for sexual pleasure. Surgical excision of labial and introital structures could modify sexual sensation.
Topics: Adult; Female; Humans; Middle Aged; Orgasm; Plastic Surgery Procedures; Risk Factors; Self Concept; Self Report; Self-Assessment; Sensation; Sexual Behavior; Vagina; Vulva
PubMed: 25683213
DOI: 10.1002/ca.22503 -
Current Biology : CB Nov 2007A surprising amount of developmental variation has been observed for otherwise highly conserved features, a phenomenon known as developmental system drift. Either... (Comparative Study)
Comparative Study
BACKGROUND
A surprising amount of developmental variation has been observed for otherwise highly conserved features, a phenomenon known as developmental system drift. Either stochastic processes (e.g., drift and absence of selection-independent constraints) or deterministic processes (e.g., selection or constraints) could be the predominate mechanism for the evolution of such variation. We tested whether evolutionary patterns of change were unbiased or biased, as predicted by the stochastic or deterministic hypotheses, respectively. As a model, we used the nematode vulva, a highly conserved, essential organ, the development of which has been intensively studied in the model systems Caenorhabditis elegans and Pristionchus pacificus.
RESULTS
For 51 rhabditid species, we analyzed more than 40 characteristics of vulva development, including cell fates, fate induction, cell competence, division patterns, morphogenesis, and related aspects of gonad development. We then defined individual characters and plotted their evolution on a phylogeny inferred for 65 species from three nuclear gene sequences. This taxon-dense phylogeny provides for the first time a highly resolved picture of rhabditid evolution and allows the reconstruction of the number and directionality of changes in the vulva development characters. We found an astonishing amount of variation and an even larger number of evolutionary changes, suggesting a high degree of homoplasy (convergences and reversals). Surprisingly, only two characters showed unbiased evolution. Evolution of all other characters was biased.
CONCLUSIONS
We propose that developmental evolution is primarily governed by selection and/or selection-independent constraints, not stochastic processes such as drift in unconstrained phenotypic space.
Topics: Animals; Biological Evolution; Caenorhabditis elegans; Female; Genetic Drift; Phylogeny; Vulva
PubMed: 18024125
DOI: 10.1016/j.cub.2007.10.061 -
Plastic and Reconstructive Surgery Apr 1985
Topics: Female; Humans; Paraplegia; Vulva
PubMed: 3983268
DOI: No ID Found -
International Journal of Dermatology Jan 2012
Topics: Adult; Female; Humans; Pregnancy; Remission, Spontaneous; Varicose Veins; Vulva; Vulvar Diseases
PubMed: 22182393
DOI: 10.1111/j.1365-4632.2010.04498.x -
Aesthetic Surgery Journal Feb 2018Nonsurgical vulvovaginal rejuvenation (NVR) is growing in popularity as a treatment for restoration of youthful female genitalia. Numerous radiofrequency (RF) and laser... (Review)
Review
Nonsurgical vulvovaginal rejuvenation (NVR) is growing in popularity as a treatment for restoration of youthful female genitalia. Numerous radiofrequency (RF) and laser devices have entered the market claiming improvement in vaginal laxity and genitourinary syndrome of menopause. There is a paucity of evidence existing concerning the effectiveness of these devices for both pre- and postmenopausal women with laxity and/or atrophy at the histologic and clinical level. Therefore, the goal of this review is to scrutinize the peer-reviewed data on NVR with RF and laser devices, identify gaps in existing literature, and propose opportunities for further investigation.
Topics: Female; Humans; Laser Therapy; Patient Reported Outcome Measures; Radiofrequency Therapy; Rejuvenation; Treatment Outcome; Vagina; Vulva
PubMed: 29040373
DOI: 10.1093/asj/sjx138