Dr. Bela Kudish | Vaginal Rejuvenation Surgery | Orlando Health ...

Cosmetic vulvovaginal surgery creates considerable controversy. As gynecologists, we are commonly asked questions about sex, including lack of interest, pain with intercourse or difficulty with arousal or orgasm. More recently, dissatisfaction with the appearance of external genitalia, labia, or complaints of a ?loose vagina? after vaginal childbirth have spawned interest in newer sexual enhancement procedures. With approximately 43% of US women experiencing some form of sexual dysfunction ? the importance of addressing sexual health has been brought to the forefront of health issues by organizations such as the WHO and has become part of the United States medical school curriculum.

Cosmetic procedures are often lumped in with bona fide reconstructive pelvic surgery operations, such as anti-incontinence and prolapse repairs, muddling the discussion of ?normal? pelvic floor anatomy and dysfunction for many women. To add to the complexity of this issue, cosmetic vulvovaginal surgery is now heavily advertised by private offices and media as a way to improve vaginal appearance or enhance sexual satisfaction. These cosmetic procedures include so-called ?laser vaginal rejuvenation,? ?designer vaginoplasty,? ?revirgination,? ?aesthetic vulvar liposculpturing,? and ?G-spot amplification.? Some of these surgeries are modifications of traditional urogynecologic procedures. Some are done to change the size or shape of labia majora or minora or to restore the hymenal ring.

Vaginal rejuvenation surgery is considered the third fastest-growing procedure in aesthetic plastic surgery. The costs of these procedures range from $3,800 for laser hymenoplasty, $6,800 for laser reduction labioplasty to $8,400 for laser anterior colporrhaphy, posterior colporrhaphy, and perineoplasty. Advocates of vaginal rejuvenation procedures state that they are providing a service for women who have legitimate concerns about the appearance and/or function of their bodies and have the right to seek physical enhancement as with any other body part even in the absence of dysfunction or disfigurement. Opponents of vulvovaginal rejuvenation question the safety, efficacy, the added benefits from a laser, and psychosocial benefit of these procedures in the absence of legitimate outcome data. Many also believe that external vulvar procedures may affect outward appearance of the genitalia but may not serve a functional role.

When a woman presents to the OB-GYN?s office with a request to undergo cosmetic vulvovaginal surgery, a gynecologist should first explore the rationale behind the woman?s desire for this procedure before agreeing to perform surgery. The range of normal appearance of labia minora and majora is quite wide. A gynecologist should educate women about the diverse appearance of external genitalia. Because many women view these surgeries as relatively risk-free and do not expect significant discomfort or problems with the postoperative recovery, it is important for the surgeon to inform the patient fully regarding treatment alternatives and the potential risks of pain, infection, scarring, negative effects on sexuality as well as the purported benefits of the proposed surgical options. Furthermore, patients should be informed that there are no established stringent guidelines in training, surgical techniques, or postoperative monitoring of care after these surgeries.

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Source: http://blog.winniepalmerhospital.com/vaginal-cosmetic-surgery-dr-kudish-explains-the-third-fastest-growing-cosmetic-surgery-and-an-ob-gyns-role-in-the-decision/

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