National Guideline Clearinghouse | Female genital cosmetic surgery.
Society of Obstetricians and Gynaecologists of Canada
Female genital cosmetic surgery.
|Shaw D, Lefebvre G, Bouchard C, Shapiro J, Blake J, Allen L, Cassell K, Clinical Practice Gynaecology Committee, Leyland N, Wolfman W, Allaire C, Awadalla A, Best C, Dunn S, Heywood M, Lemyre M, Marcoux V, Menard C, Potestio F, Rittenberg D, Singh S, Ethics Committee, Shapiro J, Akhtar S, Camire B, Christilaw J, Corey J, Nelson E, Pierce M, Robertson D, Simmonds A. Female genital cosmetic surgery. J Obstet Gynaecol Can. 2013 Dec;35(12):1108-12. [19 references] PubMed|
This is the current release of the guideline.
J Obstet Gynaecol Can. 2013 Dec;35(12):1108-14.
Female genital cosmetic surgery.
Shaw D1, Lefebvre G2, Bouchard C3, Shapiro J2, Blake J2, Allen L2, Cassell K4; Clinical Practice Gynaecology Committee, Leyland N5, Wolfman W2, Allaire C1,Awadalla A6, Best C2, Dunn S2, Heywood M1, Lemyre M3, Marcoux V7, Menard C8, Potestio F9, Rittenberg D10, Singh S8; Ethics Committee, Shapiro J2, Akhtar S11, Camire B3, Christilaw J1, Corey J12, Nelson E13, Pierce M10, Robertson D2, Simmonds A14; Society of Obstetricians and Gynaecologists of Canada.
To provide Canadian gynaecologists with evidence-based direction for female genital cosmetic surgery in response to increasing requests for, and availability of, vaginal and vulvar surgeries that fall well outside the traditional realm of medically-indicated reconstructions.
Published literature was retrieved through searches of PubMed or MEDLINE, CINAHL, and The Cochrane Library in 2011 and 2012 using appropriate controlled vocabulary and key words (female genital cosmetic surgery). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to May 2012. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies.
The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table). Recommendations 1. The obstetrician and gynaecologist should play an important role in helping women to understand their anatomy and to respect individual variations. (III-A) 2. For women who present with requests for vaginal cosmetic procedures, a complete medical, sexual, and gynaecologic history should be obtained and the absence of any major sexual or psychological dysfunction should be ascertained. Any possibility of coercion or exploitation should be ruled out. (III-B) 3. Counselling should be a priority for women requesting female genital cosmetic surgery. Topics should include normal variation and physiological changes over the lifespan, as well as the possibility of unintended consequences of cosmetic surgery to the genital area. The lack of evidence regarding outcomes and the lack of data on the impact of subsequent changes during pregnancy or menopause should also be discussed and considered part of the informed consent process. (III-L) 4. There is little evidence to support any of the female genital cosmetic surgeries in terms of improvement to sexual satisfaction or self-image. Physicians choosing to proceed with these cosmetic procedures should not promote these surgeries for the enhancement of sexual function and advertising of female genital cosmetic surgical procedures should be avoided (III-L) 5. Physicians who see adolescents requesting female genital cosmetic surgery require additional expertise in counselling adolescents. Such procedures should not be offered until complete maturity including genital maturity, and parental consent is not required at that time. (III-L) 6. Non-medical terms, including but not restricted to vaginal rejuvenation, clitoral resurfacing, and G-spot enhancement, should be recognized as marketing terms only, with no medical origin; therefore they cannot be scientifically evaluated. (III-L).
G-spot augmentation; clitoral hood size reduction; female genital cosmetic surgery; hymenoplasty; labioplasty; perineoplasty; vaginoplasty; vulvo-vaginal
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