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Cosmetic gynecology—a systematic review and call for standardized outcome measures

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Abstract

Objective

Cosmetic gynecology, a field which has garnered substantial attention over recent years, lacks a universally accepted nomenclature. The aim of this systematic review is to evaluate techniques, outcome measures reported, and adverse events in patients undergoing cosmetic gynecology procedures and offer recommendations to improve reporting metrics.

Methods

A systematic literature search was performed using electronic databases from inception to April 2019. The search was based on 51 unique cosmetic gynecology keywords such as: “labiaplasty,” “vaginal rejuvenation,” and “liposuction mons pubis.” All English full-text prospective and retrospective observational and interventional studies with at least five subjects that describe a cosmetic gynecology procedure were included. Only full-text articles were included. This protocol has been registered with PROSPERO (CRD 42019131860).

Results

A total of 1837 articles were identified from the search strategy with 42 included in the quantitative synthesis. Procedures described included: labia minora reduction with or without clitoral hood reduction, labia majora augmentation, surgical vaginal caliber reduction, mons pubis reduction/suspension, and energy-based therapy for vaginal laxity or vulvar laxity. Efficacy and satisfaction metrics were highly variable ranging from validated questionnaires to no outcome subjectively or objectively quantified. Complication rates varied by procedure but were generally low and ranged between Clavien-Dindo grades I–III.

Conclusions

Although there is a breadth of literature on cosmetic gynecology surgical techniques and short-term complication rates, the terminology and outcome measures utilized are heterogeneous. To address this, standardized terminology along with uniform cosmetic and functional endpoints must be developed.

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Acknowledgements

The authors thank Charlotte Holden for her illustrations.

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Authors and Affiliations

  1. Department of Obstetrics & Gynecology, Division of Female Pelvic Medicine & Reconstructive Surgery, Louisiana State University Health Sciences Center, 5th Floor Department of OB/GYN, 1542 Tulane Ave, New Orleans, LA, 70124, USA

    Bobby Garcia, Barry Hallner, Nia Thompson & Lisa Peacock

  2. Department of Obstetrics & Gynecology, Louisiana State University Health Sciences Center, New Orleans, LA, USA

    Stacey Scheib

  3. Department of Libraries, New Orleans School of Dentistry, Louisiana State University Health Sciences Center, New Orleans, LA, USA

    Julie Schiavo

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  1. Bobby Garcia
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Contributions

B Garcia: Protocol/project development, data collection and analysis, manuscript writing.

S Scheib: Protocol/project development, data analysis, manuscript editing.

B Hallner: Protocol/project development, data analysis, manuscript editing.

Nia Thompson: Protocol/project development, manuscript editing.

Julie Schiavo: Protocol/project development, data Collection, manuscript editing.

L Peacock: Protocol/project development, manuscript editing.

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Correspondence to Bobby Garcia.

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Appendices

Appendix 1

Table 6 Clavien-Dindo classification of surgical complications16
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Appendix 2

Table 7 GRADE of evidence17
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Garcia, B., Scheib, S., Hallner, B. et al. Cosmetic gynecology—a systematic review and call for standardized outcome measures. Int Urogynecol J 31, 1979–1995 (2020). https://doi.org/10.1007/s00192-020-04294-5

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