Psychosexual outcome after labiaplasty: a prospective case-comparison study.

INTRODUCTION AND HYPOTHESIS: Our goal was to determine psychosexual outcome after labiaplasty in the long-term with specific measures of genital body image and sexual dysfunction. METHOD: We conducted a prospective study with a matched-comparison group of women not wanting labiaplasty. Forty-nine women were compared against a group of 39 women matched for age, sexual orientation, ethnicity, and marital status. The labiaplasty group was assessed before, 3 months after and between 11 and 42 months after surgery. The comparison group was assessed at two time points 3 months apart to control for the passage of time. The primary outcome measure was the Genital Appearance Satisfaction (GAS) scale. RESULTS: Of the 49 women receiving labiaplasty, 19 (38.8 %) were lost to follow-up but were reassessed clinically. Twenty-four of 25 (96 %) women in the labiaplasty group showed a reliable and clinically significant improvement on the GAS scale 3 months after the procedure; 21/23 (91.3 %) showed an improvement at the long-term follow-up. A large effect size was found for improvements on the GAS scale in the labiaplasty group. Small-effect sizes were found for improvements in sexual functioning. Nine women obtaining labiaplasty met diagnostic criteria for body dysmorphic disorder before the operation; eight lost that diagnosis at the 3-month follow-up; 26 % reported minor side effects. CONCLUSIONS: Labiaplasty is effective in improving genital appearance and sexual satisfaction, but larger studies are required to determine the prevalence of potential side effects.

Repeated botulinum toxin type A (Dysport) injections for women with intractable detrusor overactivity: a prospective outcome study.

INTRODUCTION AND HYPOTHESIS: We present the cohort of 33 women who underwent botulinum toxin type A (BTX-A) injections examining the efficacy and safety of BTX-A in idiopathic detrusor overactivity (IDO). The aim of this report is to describe the outcomes of those who underwent repeated injections of BTX-A. METHODS: All 33 women had 3 or more injections with an initial dose of 500 units of Dysport with subsequent injections between 500 and 750 U, administered by the classic trigone-sparing flexible/rigid cystoscopic technique. An informed consent was obtained in all cases. Efficacy was measured using voiding diaries and quality of life (QOL) assessed with the International Consultation on Incontinence Questionnaire-Short Form (ICIQ -SF). This project was approved by the Clinical Effectiveness Department and the Drugs and Therapeutics Committee (DTC). Therefore, ethical approval was not required. RESULTS: This study included 33 women who have been successfully treated with repeated intradetrusor injections of BTX-A (Dysport). Mean duration between the first and second injections was 15.2 ± 7.2 months, whereas between the second and third was 19.2 ± 10 months (P = 0.025). Two women developed urinary tract infection and required clean intermittent self-catheterization. Three women required dose escalation to 750 units. Longer duration of subjective QOL improvement was noted between the second and third botulinum toxin injections compared to duration between the first and second injections. CONCLUSIONS: BTX-A appears to be effective and safe after repeated administration in women with IDO. The duration of the injection tends to get prolonged after the second injection.