Exploring the motivations for pursuing operative labiaplasty in Chinese patients.

This study aimed to investigate the motivations for Chinese patients seeking operative labiaplasty. Data was collected from January 2018 to December 2019 using a standardized questionnaire, which examined factors influencing patients' motivations, including aesthetic and functional reasons, as well as psychological factors. Of the 216 patients who responded to the questionnaire within 24 months, 22.2% cited cosmetic reasons, while 38.4% reported functional discomfort. Both functional and aesthetic reasons were cited by 35.2% of patients, while 4.2% reported psychological troubles. It is noteworthy that patients who sought surgical intervention for physical complaints did so as a personal decision, and only 6.3% of patients seeking labiaplasty for cosmetic reasons were influenced by their sexual partner. Additionally, 7.9% and 66.7% of patients with other motivations were influenced by their male spouse, while 2.6% and 33.3% were influenced by the media. In conclusion, this study suggests that most Chinese patients seek labiaplasty for functional reasons, with few being influenced by sexual partners or media.Impact statementWhat is already known on this subject? The growing demand and interest in labiaplasty surgery has been widely acknowledged. Existing reports from western countries have highlighted that aesthetic concerns are the primary motivations behind patients' requests for this surgical intervention. However, there is limited information available regarding the factors influencing Chinese patients' decisions to undergo labiaplasty, as China has a large population. Therefore, the specific reasons behind Chinese patients' requests for labiaplasty are not well understood.What do the results of this study add? This clinical study focuses on the perspectives of eastern women regarding labia reduction surgery, contributing to the existing literature on this topic. Notably, this study is one of the few that examines the request for surgical reduction of hypertrophy of the labia minora and highlights that not all patients undergo surgical intervention purely for personal reasons.What are the implications of these findings for clinical practice and/or further research? The implications of these findings for clinical practice and further research are significant. Given the increasing demand for labiaplasty, gynecologists in Australia, Western Europe, the United States, and New Zealand are likely to encounter a rising number of women seeking labial reduction surgery. Similarly, labiaplasty has become an increasingly popular cosmetic surgery procedure in China. This study's results differ from previous research, which suggested that functional concerns were the primary motivation for women seeking to undergo labiaplasty. The request for pursuing labiaplasty is influenced not only by personal preferences but also by external factors. Therefore, a comprehensive evaluation before considering the procedure is crucial, and if practitioners are unsure, multidisciplinary specialized evaluation should be considered.

Long-Term Follow-up in Labiaplasty in 414 Women: A Single-Center Experience in China.

ABSTRACT: Women with labial hypertrophy may opt for labiaplasty. The aim of the study was to analyze the complications, long-term follow-up of clinical outcomes and satisfaction in this population over the past 10 years.All women who underwent labiaplasty with or without clitoral hood reduction at our center between January 2008 and August 2020 were retrospectively identified. Retrospective study was conducted, recording follow-up outcomes, motivations, techniques, postoperative complications, reasons requiring reoperation, and surgical satisfaction concerned different clinical characteristics. A concrete analysis of each specific outcome and a detailed knowledge of these procedures were performed.A total of 52.41% reported functional impairment, 20.25% cited aesthetics complains, and 27.34% were motivated by both the previously mentioned reasons. Women undergoing surgical correction sometimes mixed with various psychological aspects. A total of 91.06% reported that they were moderately (6.04%) or extremely (85.02%) satisfied with the outcomes after surgery, and 37 (8.94%) reported dissatisfied. Revision surgery was needed in a small number of patients (n = 7 of 414 patients, 1.69%) because of undesirable appearance. The most common complication in our patients was asymmetry (6.28%). Women requested labiaplasty in the last 2 reasons or procedures or without psychological distress were more likely feel satisfied with the results (satisfaction rate >90%). There was a significant difference in satisfaction among the 3 concerns as well as between the 2 kinds of psychological conditions ( P < 0.05). Satisfaction of patients with aesthetic complains compared with the other 2 worries was significantly lower ( P < 0.05). There was no significant difference among the 3 procedures in this comparison group ( P > 0.05). In addition, satisfaction in labiaplasty with or without clitoral hoodoplasty, neither of which was statistically different ( P > 0.05). Patients aged 30 to 39 years reported the lowest satisfaction in comparison with the other age groups.Labiaplasty of the labia minora is the most commonly performed genital cosmetic surgery procedure. This study on 414 patients demonstrated that it is associated with a high degree of patient satisfaction and low morbidity and provided evidence of safety and effectiveness preliminary, indicating that the procedure may be regarded as safe.

Reliable data transmission in wireless sensor networks with data decomposition and ensemble recovery.

Wireless sensor networks (WSNs) are usually used to helps many basic scientific works to gather and observe environmental data, whose completeness and accuracy are the key to ensuring the success of scientific works. However, due to a lot of noise, collision and unreliable data link, data loss and damage in WSNs are rather common. Although some existing works, e.g. interpolation methods or prediction methods, can recover original data to some extent, they maybe provide an unsatisfac-tory accuracy when the missing data becomes large. To address this problem, this paper proposes a new reliable data transmission scheme in WSNs by using data decomposition and ensemble recovery mechanism. Firstly, the original data are collected by sensor nodes and then are expanded and split into multiple data shares by using multi-ary Vandermonde matrix. Subsequently, these data shares are transmitted respectively to source node via the sensor networks, which is made up of a large number of sensor nodes. Since each share contains data redundancy, the source node can reconstruct the original data even if some data shares are damaged or lost during delivery. Finally, extensive simulation experi-ments show that the proposed scheme outperforms significantly existing solutions in terms of recovery accuracy and robustness.

Data-Loss resilience video steganography using frame reference and data ensemble reconstruction.

In this paper, we propose a robust video steganographic method, which can efficiently hide confidential messages in video sequences, and ensure that these messages are perfectly reconstructed by recipient. To apply proposed scheme to video sequences, we must be faced with two nontrivial problems: (a) how to effectively minimize the total steganographic distortion for each video frame? (b) how to recover the hidden messages if some frames are lost or damaged? We tackle the first question by designing a new distortion function, which employs two continuous adjacent frames with the same scene as side-information. The second question is addressed by data sharing. In this mechanism, the original data is expanded and split into multiple shares by using multi-ary Vandermonde matrix. Since these shares contain a lot of data redundancy, the recipient can recover the hidden data even if some frames are damaged or lost during delivery. Extensive experiments show that proposed scheme outperforms the state-of-the-arts in terms of robustness and diverse attacks.

Congenital absence of the penis (aphallia): A rare case report.

RATIONALE: Absence of the penis, known as aphallia, is a very rare congenital anomaly. It is believed to be a result of either the absence of the genital tubercle or its failure to fully develop and is associated with the level of hormones and chromosomal rearrangements. The failure of the genital tubercle influences the development of the penis and partly depends upon testosterone secreted by Leydig cells of the testis. Chromosomal polymorphisms may affect the functions of protection and regulation, potentially leading to susceptibility to congenital diseases. Herein, an extremely rare case of a congenital absence of the penis is described. PATIENT CONCERNS: A 3-month-old was brought to the OPD by his parents with complaints of absence of penis since birth and urine being passed rectally. When he was born, he was registered as a boy because his chromosomes were 46XY but with 9qh+. Local examination revealed the total absence of the penis. The scrotum was well developed. The testes were palpable bilaterally. The anal opening was located normally. No urethral orifice could be identified. However, his parents had not yet decided whether to accept treatment. The child has been lost to follow up. DIAGNOSIS: Congenital absence of the penis (aphallia) (46 XY normal male karyotype). INTERVENTIONS: We explained the nature of the abnormality and management options to the parents. However, it was much regretted that the patient was too young to make a decision and that his parents had not made a decision yet. They left without any further contact. OUTCOME: Because the parents left our hospital without any contact, it has not been possible to develop a follow-up plan. LESSONS: In consideration of the rarity and devastating psychosocial consequences of this case, we accordingly call for active cooperation with doctors to minimize the negative impact of this malformation. Early assignment of gender avoids confusion and contradiction. Parental confidence solidifies the child's own confidence in his or her gender.

Autologous Buccal Micro-Mucosa Free Graft combined with Posterior Scrotal Flap Transfer for Vaginoplasty in Male-To-Female Transsexuals: A Pilot Study.

BACKGROUND: The inverted peno-scrotal flap method is considered the standard method of vaginoplasty in male-to-female genital reassignment surgery. Though with numerous advantages, the method has its limitations regarding skin texture, lack of inherent lubrication, and that the tissues for creating the labia depend on the amount of tissues remaining after vaginoplasty. Our purpose was to describe the procedure and outcome of vaginoplasty applying a new technique: autologous buccal micro-mucosa free graft combined with posterior scrotal flap transfer, which could solve some of the problems the previous methods had. METHODS: Nine male-to-female transsexual patients received our new method of vaginoplasty from July 2010-October 2015. We described the details of the surgical procedure and evaluated the long-term anatomical and functional outcomes. RESULTS: In a mean clinical follow-up period of 25.3 months and phone interview follow-up of 50.3 months, we observed that the neovaginas in the nine cases were all of sufficient volume, lined with mucosa, with natural mucosal discharge. The oral donor sites resulted in no visible scars or malfunction. Eight patients experienced uneventful postoperative periods, while one patient suffered from scrotal flap prolapse. All the patients were sexually active and reported sexual satisfaction, with no need of lubrication. CONCLUSION: The reported technique achieves the outcomes of creating a neovagina of sufficient volume, without serious stenosis in long-term follow-up. The neovagina is lined with mucosa and has appropriate lubrication as well as good sexual sensation. The reported method is easy and economical to perform and retains enough tissues for vulvoplasty to achieve a superior cosmetic appearance, with rare risk of complications and donor area malfunction. Additionally, this technique is feasible and advantageous to the patients who have insufficient peno-scrotal skin for neovaginal lining as well as those with unfavorable previous vaginoplasty. All of these indicate that this technique is a promising option for vaginoplasty in male-to-female transsexual surgery. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A new surgical technique of hymenoplasty.

OBJECTIVE: To review data from patients who have undergone hymenoplasty with a novel surgical technique, termed the STSI (suture three stratums around the introitus) method. METHODS: In a retrospective study, data were reviewed from patients who underwent hymenoplasty by STSI at a center in Beijing, China, between January 2010 and January 2014. Patients were scheduled to attend a follow-up appointment 1 month after surgery. Long-term follow-up was conducted by telephone. Follow-up data and preoperative and postoperative photos were assessed. RESULTS: Overall, 125 patients had undergone hymenoplasty using the STSI method. Only 1 (0.8%) patient had an early postoperative complication (uncontrolled bleeding). Among the 99 patients who returned for follow-up at 1 month, healing was recorded for 91 (91.9%). Long-term follow-up suggested that no patient had persistent dyspareunia, menstruation changes, or other health problems after the surgery. Among 51 patients who reported sexual intercourse since the surgery, 47 (92.2%) were satisfied with the outcome and 28 (54.9%) reported blood loss during the first intercourse. CONCLUSION: The STSI method seems to be an effective, enduring, and safe technique of hymenoplasty.

Long-term outcomes of vaginoplasty with autologous buccal micromucosa.

OBJECTIVE: To evaluate the technical feasibility and anatomical and functional outcomes of one-stage vaginoplasty with autologous buccal micromucosa. METHODS: We retrospectively reviewed our experiences with 38 patients with vaginal agenesis treated with primary surgery from June 2006 to April 2012. All patients underwent transvestibular vaginoplasty with autologous buccal micromucosa. We describe the details of this technique and evaluate the long-term anatomical, functional, and sexual outcomes. RESULTS: A total of 38 patients (33 with Mayer-Rokitansky-Kuster-Hauser syndrome and five with complete androgen insensitivity syndrome) were included in the present study. The mean operative time was 86.4 minutes (range 75-120 minutes). The mean blood loss was 68.5 mL (range 40-80 mL). At a mean follow-up of 33.5 months (range 15-76 months), the mean depth of the neovagina was 8.5±0.66 cm (range 7-10 cm), the mean circumference was 12.3±1.24 cm (range 10-15 cm), and the mean volume was 100±8 mL (range 85-120 mL). By histologic examination, we found the neovaginal mucosa was stratified nonkeratinized squamous mucosa and had secretory function. The mean female sexual function index score of the 32 sexually active patients was 28.8±2.1. No spouse reported discomfort during intercourse. The mean postoperative dependence on the vaginal stent was 15±2.1 months (range 9-20 months). CONCLUSION: Transvestibular vaginoplasty with autologous buccal micromucosa is an effective and feasible approach for patients with Mayer-Rokitansky-Kuster-Hauser syndrome and complete androgen insensitivity syndrome. The procedure has satisfactory long-term anatomical and functional results. LEVEL OF EVIDENCE: III.

[Application of tunica vaginalis flap for multi-fistulas after urethroplasty in hypospadias].

OBJECTIVE: To discussed a new technique for multi-fistulas after urethroplasty in hypospadias. METHODS: 8 cases with postoperative multi-fistulas, which were not successfully repaired by previous treatment, were reoperated with tunica vaginalis flap combined with urethral stent and elastic dressing. The multi-fistulas were located between glan and scrotum. The number of fistulas was 3-7 (median, 5). RESULTS: Primary healing was achieved in all the 8 cases. The micturition and esthetic result were satisfied. 5 cases were followed up for 8-10 months with no recurrence of fistula. There was also no dysuria and penile curvature. CONCLUSIONS: Tunica vaginalis flap combined with urethral stent and elastic dressing is an effective technique for multi-fistulas after urethroplasty. It is easily performed with reliable result.

[Application of tissue granule of oral mucous in plastic surgery].

OBJECTIVE: To study the application of tissue granule of oral mucous in plastic surgery. METHODS: Tissue granule of oral mucous was placed on glutin sponge and they were used for urethral (12 cases) and vaginal (14 cases) reconstruction in 26 cases. RESULTS: Satisfactory results were achieved in 24 cases. One case of urethral fistula and one case of urethral meatus stricture were happened. The two cases underwent secondary operation. CONCLUSIONS: Tissue granule of oral mucous membrane is good supply for repairing mucous defect. It has the advantages of high growth and survival rate, and less shrinkage. It is useful for urethral or vaginal reconstruction which are covered with mucous membrane.

[Staged treatment of the severe hypospadias in adult].

OBJECTIVE: To report the treatment of serious hypospadias in adults with free graft of tubed mouth mucosa and scrotal fascia flaps. METHODS: The tubed mouth mucosa was free grafted to fabricate the distal segment of urethra. It was anastomosed to the urethra at the second stage. The scrotal fascia flap was used to cover the penile wound. The biggest flap was 3 cm in width and 6.5 cm in length. RESULTS: From Jan. 2002 to Dec. 2007, 76 adults with severe hypospadias were treated. Infection happened in 4 cases. 2 cases had urethral fistula due to the partial flap necrosis which was healed automatically within 2-4 weeks. All the other patients healed primarily. CONCLUSIONS: It is a good method for the treatment of serious hypospadias in adults with scrotal fascia flaps and free graft of tubed mouth mucosa which is anastomosed to the urethra at the second stage.

[Clinical application of expanded submental island flap in facial soft tissue defect].

OBJECTIVE: To investigate the application of the expanded submental island flap in facial soft tissue defect. METHOD: 12 patients with facial soft tissue defects were treated with the expanded submental island flaps during September 2004 to September 2008. At the first stage, soft tissue expander was implanted in the neck. At the second stage, the submental island flap was designed to repair the facial soft tissue defect. The largest size of the flap was about 16 cm x 9 cm. RESULT: All flaps survived well except for one case of partial epidermal necrosis at the distal part of the flap. The wound healed with dressing. 4 patients were followed up for 6-24 months with satisfactory results. CONCLUSION: The submental artery was a constant branch of facial artery. Large cervical flap with high quality tissue can be provided after expansion. The expanded submental island flap is a good choice for repairing the facial soft tissue defect.