ABSTRACT
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.
Subject(s)
Patient Satisfaction , Vulva/surgery , Adult , Case-Control Studies , Female , Gynecologic Surgical Procedures/methods , Gynecologic Surgical Procedures/psychology , Humans , Prospective Studies , Treatment OutcomeABSTRACT
Little is known about the factors associated with the desire for labiaplasty. We compared 55 women seeking labiaplasty with 70 women in a comparison group who were not seeking labiaplasty. Measures administered included the Perception of Appearance and Competency Related Teasing Scale, Childhood Trauma Questionnaire, Disgust Scale Revised, and the Genital Appearance Satisfaction scale with open-ended questions about their genitalia. Approximately a third of the labiaplasty group recalled specific negative comments in the past towards their labia, a proportion significantly greater than the three per cent in the comparison group. Participants reporting genital teasing also showed higher Genital Appearance Satisfaction scores than those who were not teased. However, women seeking labiaplasty were, compared to the comparison group, no more likely to have a history of neglect or abuse during childhood. There was no difference between the groups on disgust sensitivity or the perception of being teased in the past about their competence or appearance in general.
Subject(s)
Body Image/psychology , Surgery, Plastic/psychology , Vulva/surgery , Women/psychology , Adolescent , Adult , Female , Humans , London , Middle Aged , Motivation/physiology , Personal Satisfaction , Risk Factors , Self Concept , Surgery, Plastic/methods , Surveys and Questionnaires , Young AdultABSTRACT
BACKGROUND: Existing outcome studies on women seeking labiaplasty have not used a validated scale that is specific for satisfaction with genital appearance. They have also not screened for the presence of body dysmorphic disorder (BDD). There are therefore two primary aims of this study (1) to validate the Genital Appearance Satisfaction (GAS) scale in women seeking labiaplasty and (2) to modify and validate a version of the Cosmetic Procedures Screening questionnaire (COPS-L), which has previously been used to screen for BDD. METHOD: Two groups of women were recruited: a group desiring labiaplasty and a control group. All participants completed the GAS, the COPS-L and other general measures of mood, disgust sensitivity, sexual satisfaction and body image quality of life. RESULTS: Both the GAS and COPS-L demonstrated good internal consistency, concurrent and convergent validity with measures of related constructs, and discriminated between women seeking labiaplasty and controls. Three factors were identified in the GAS but were not robust enough to recommend their use clinically as subscales. The COPS-L discriminated between women seeking labiaplasty with and without BDD. DISCUSSION: We recommend that both the GAS and the COPS-L be routinely used for audit and outcome monitoring of interventions for women distressed by the appearance or function of their genitalia. The GAS has an advantage in assessing additional functional symptoms in such women. The COPS-L may be helpful in identifying women with BDD.
