Outcomes of labiaplasty in women with labial hypertrophy
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ORIGINAL ARTICLE
Outcomes of labiaplasty in women with labial hypertrophy Katie Propst 1
&
Cecile A. Ferrando 1
Received: 8 October 2020 / Accepted: 16 November 2020 # The International Urogynecological Association 2020
Abstract Introduction and hypothesis High-quality data are lacking to understand outcomes in women who undergo labiaplasty for labial hypertrophy and whether there is an association with body dismorphic disorder (BDD). Methods This was a cross-sectional study of a retrospective cohort of women who underwent labiaplasty for labial hypertrophy at a tertiary care referral center. Women were identified by CPT codes and were included if the procedure was performed by a urogynecologist. The health record was queried for demographic, pre-, intra-, and postoperative data. For the cross-sectional component of the study, participants were contacted to complete a survey. Results Thirty-six women met study inclusion criteria; 21 participated in the survey, and retrospective data were available for 20. At the time of labiaplasty, the women had a mean age of 30 ± 12 years and mean BMI of 23.9 ± 4.4 kg/m2. The most common preoperative motivation for undergoing labiaplasty, based on the medical record, was pain (85.0% 17/20). Complications were uncommon and minor. No women met criteria for BDD. Participant survey-reported primary motivation for undergoing partial simple vulvectomy was “pinching” in 10 (47.6%), “pain” in 4 (19.0%), and “appearance” in 7 (33.3%). The majority of women reported that labiaplasty achieved their preoperative goal (20/21, 95.2%). Conclusions Women who underwent labiaplasty were primarily motivated by functional concerns, and outcomes indicate a high satisfaction with genital appearance postoperatively as well as a positive effect on body image and quality of life. We recommend that surgeons work to understand what motivates women to pursue surgical intervention by asking about cosmetic concerns. Keywords Female genitalia . Vulvectomy . Gynecologic surgery . Body dysmorphic disorder
Introduction Labiaplasty refers to surgical reduction in size of the labia minora due to hypertrophy. Elective female genital surgery is a controversial topic [1]. The American College of Obstetricians and Gynecologists discourages female genital cosmetic surgery in women with “no apparent structural or functional abnormality” [2]. However, performance of elective female genital surgery is on the rise, with labiaplasty rates increasing more than 50% in the US between 2014 and 2018 [2]. The literature indicates that women seek labial reduction for a variety of reasons, and the majority of studies have shown that a concern about cosmesis is the most commonly reported
* Katie Propst [email protected] 1
Urogynecology & Reconstructive Pelvic Surgery, Obstetrics/ Gynecology and Women’s Health Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk A-81, Cleveland, OH 44195, USA
indication for surgery [3–6]. Fewer studies describe functional concerns as the primary reason for labial reduction [7]. The literature
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