Cosmetic gynaecology

Introduction: The study was planned to investigate the opinions of midwifery students about genital cosmetic surgery and their perceived competence in providing care to women who have undergone genital cosmetic surgery. Methods: In this descriptive study, 731 volunteer students from the midwifery departments of universities located in seven geographical regions of Turkey and selected using a random sampling method were included. Data were collected using the Research Survey Form prepared by the researchers via Google Forms. Numbers and percentages were used and the chi-square test was performed in the analysis of the data. Results: The average age of the students participating in the study was 21.60. Of them, 73.9% and 68.8% stated that topics on general aesthetic surgery and genital cosmetic surgery, respectively were not included in their courses. Of the genital cosmetic surgery procedures, the one known most is hymenoplasty. The response to the question “Why should genital cosmetic surgery be performed?” with the highest rate was “concern about aesthetic appearance” (88.4%). There was a significant relationship between genital cosmetics topics taught in courses, and the variables such as a year of at school and self reported competence to provide care to women who had genital cosmetics surgery. Conclusion: Giving education to midwifery students on the issue in line with international guidelines and current literature is important for the development of their professional competence and the health of women for whom they will provide care after graduation.

We live in a society where beauty and sensations are important. Advances in medical technologies have brought on waves of new notions of beauty where commercial interests both in the media and the health industry spurred by fashion, advertising and celebrity promotion have tended to popularise body modifications and enhancements. In recent times, through offerings on cable television channels and glossy consumer magazines, medical procedures hitherto only in the precincts of medical schools, gyneacological clinics and medical journals have now pervaded the population. More seriously, on the Internet particularly, medical experts now offer services and graphic details of labiaplasty, clitoral hood reduction or enhancement, vaginal rejuvenation, etc. Here, we examine the public communication of the phenomenon of aesthetic genital surgery and interrogate thus; is it decent, honest, balanced and ethical? Relying on textual analysis, personal observation and literature review for data gathering, we observe that besides tending to commercialise and medicalise the female genitalia, a coalescence of medical, advertising and fashion interests as played out in the media sensationalises the benign science of plastic surgery and robs it of its truthfulness, genuineness, and purposefulness. The conclusion is that in Africa, where the effect of the development crises is telling, the hype surrounding cosmetic or aesthetic genital surgery is a damaging distraction particularly when the continent is waging a battle against female genital mutilation. The recommendations are that media and medical regulatory bodies should impress it upon media and medical industry operators that glaring commercial promotions of cosmetic genital surgery in the public media be checked, and that such communication should bear equal weight of facts related to risks, short comings, complications, and threats; in physical, social, and psychological terms.

OBJECTIVE: Complications following labiaplasty procedures are understudied and underreported1 and could possibly include loss of sensation in the female pudendum.2 As the number of procedures each year increase,3 it is important to continue to explore ways to ensure positive outcomes for patients. The aim of this study was to determine variability in the course and branching of the dorsal nerve of the clitoris (DNC) and to generate a surgical safe zone. METHODS: Ninety-seven Cadavers from the University of Nebraska Medical Center, Creighton University, and Kansas City University anatomy labs were examined for this study. A shallow vertical incision was made from the pudendal cleft superiorly through the mons pubis. The glans clitoris was identified and used as a landmark while the fascia surrounding the body of the clitoris was carefully removed. The DNC was located where it pierces the perineal membrane and traced distally. The following measurements were taken: (1) from the point where the DNC pierces the perineal membrane to the urethra, (2) from the point where the DNC pierces the perineal membrane to the pubic bone, (3) from the angle of the clitoris to where the nerve branches on the dorsum of the body of the clitoris, and (4) from that branch point to the distal most portion of the glans clitoris. A subset of the population (n = 72) cadavers were examined for abnormal branching patterns, which were noted and characterized. All statistical data analyses were conducted through IBM SPSS. RESULTS: Thirty-five DNCs were characterized as anomalous in the branching pattern analysis. Type 1 was the typical DNC branching pattern (splits once into two terminal branches). Type 2 was distinguished by the presence of an early branch near where the DNC pierces the perineal membrane. Types 3–6 corresponded to the number of branches the DNC had (type 3 had 3 branches, etc). Finally, the measurements that were taken were used to generate a surgical safe zone, which can be used to avoid injury to the DNC during procedures involving the female pudendum. CONCLUSIONS: The findings of this study allowed the investigators to map out a surgical safe zone for procedures involving the female pudendum to avoid injury to the DNC and identify and classify anomalous branching patterns. This information should be useful to physicians performing procedures near the DNC to increase patient satisfaction and safety. Further research should be done into the DNC and outcomes of labiaplasties and other surgeries that could impact this nerve. REFERENCES: 1. Goodman MP. Outcomes. In: Goodman MP, ed. Female Genital Plastic and Cosmetic Surgery. First. John Wiley & Sons, Ltd.; 2016:206–211. 2. Runacres SA, Wood PL. Cosmetic labiaplasty in an adolescent population. J Pediatr Adolesc Gynecol. 2016;29:218–222. 3. Vieira-Baptista P, Almeida G, Bogliatto F, et al. International Society for the study of vulvovaginal disease recommendations regarding female cosmetic genital surgery. J Low Genit Tract Dis. 2018;22:415–434.

This chapter considers the role of choice as a normative transformer in relation to the practice of female genital cosmetic surgery. It is common, in law and practice, to distinguish between two sorts of female genital cutting. One is described as ‘female genital mutilation’ (FGM) and prohibited; the other is described as ‘female genital cosmetic surgery’ (FGCS) and permitted, even provided by the state in certain circumstances. The chapter argues that distinguishing between the two requires going beyond a simplistic contrast between choice and coercion. Both practices can be understood only within a cultural context that makes them available and marks them as appropriate. As with many other forms of cosmetic surgery, FGCS cannot be exonerated merely by an appeal to individual choice.

Female genital mutilation (FGM) or female circumcision is the term given to traditional practices involving the intentional cutting or partial or total removal of the external female genitalia (WHO, 1999). This two part study used both qualitative and quantitative methods. The first part of the study aimed to explore the views and experiences of FGM amongst women who had undergone the practice. It also explored their views about what clinical psychologists needed to know and do in order to provide appropriate services. In this part of the study six participants were interviewed using a semi-structured interview. The data was analysed using interpretative phenomenological analysis (IPA). Findings indicated that participants felt that despite there being many reasons given for FGM none of them justified the continuation of the practice. Further findings suggested that participants felt that clinical psychologists needed to; understand how FGM is accounted for (e.g. reasons and contexts); acknowledge the different views towards the practice; have knowledge of the many consequences of the procedure (e.g. on physical health, psychological health and relationships) and talk about FGM in a sensitive and non-judgemental manner during consultations. Part two of the study explored the experiences, knowledge and training needs related to FGM amongst qualified clinical psychologists. A survey was completed by 74 clinical psychologists working in a range of specialities. The findings indicated that there was minimal experience of working with FGM related difficulties amongst participants. Knowledge about FGM and the consequences of it were also limited. Furthermore, clinical psychologists had received little training about FGM and many did not feel confident in working with issues related to the practice. Implications for clinical practice and recommendations for further research are suggested including; training opportunities specifically regarding FGM and further research that explores the connections between the physical and psychological consequences of the practice.

Objective To assess the knowledge, attitudes and practices with regard to female genital mutilation (FGM) among gynaecologists in Flanders, Belgium.Methods A questionnaire-based survey was sent to 724 Flemish gynaecologists and trainees.Results Three-hundred-and-thirty-four questionnaires were returned. The survey revealed gaps in the knowledge of FGM and the provision of care by Flemish gynaecologists to women who had been mutilated. It also appeared that FGM was not properly addressed in the basic and specialized medical training in Flanders, that little was known about codes of conduct issued by the hospitals when these were not lacking altogether, and that knowledge about legislation concerning FGM was deficient. There was much confusion whether re-infibulation is authorized, and what its legal status is. Some respondents considered cosmetic vaginal surgery as a form of FGM and many were in favour of the medicalization of FGM. Gynaecologists were most commonly confronted with complaints related to sexual problems caused by FGM. Finally, the study also showed that only about a third of the gynaecologists were discouraging women from having their daughters excised.Conclusion There is a need for a thorough discussion among all those concerned of the ethical and legal aspects of re-infibulation, medicalization of FGM and cosmetic vaginal surgery.

While the practice of female genital mutilation (FGM) has been abandoned in western countries, it remains common in many African countries from Senegal to Somalia, in the Middle East, in some parts of South-East Asia and even among immigrant communities in Europe, North America and Australia. Previous studies in Burkina Faso reported a high prevalence (77%) of FGM among 15 to 49 years old women and described the commitment of the government of Burkina Faso to end this practice. Little is known about the effect of this effort on the trend of FGM in the country. This study examined whether the prevalence of FGM changed overtime and identified the factors associated with this practice. Data from the 2010 multistage household survey of 15 to 49 years old Burkinabe women were analyzed. Simple frequency and logistic regression were used to meet the study objectives. Of the 3,289 women who participated in the survey, 68.1% had undergone FGM. Among those who had a daughter (n = 2258), 18.7% had a circumcised daughter. Young age [15 to 24 years (odd ratio (OR): 0.26. 95% confidence interval (CI) 0.21 to 0.31) or 25 to 34 years (OR 0.59, 95%CI 0.48 to 0.72)], ethnicity [Gourmatche ethnic group (OR: 0.48, 95%CI 0.31 to 0.73)], religion [Muslim (OR: 1.53, 95%CI 1.09 to 2.14)], and social support from community leaders (OR: 1.37, 95%CI 1.07 to 1.75) were significantly associated with the FGM among women in Burkina Faso. Although, FGM is associated with serious health risks, its prevalence remains unacceptably high in Burkina Faso. Social marketing interventions targeting community social norms, raising the community awareness about FGM, and empowering women to make informed decisions for their daughters are needed in order to end this deeply rooted tradition. Key words: Female genital mutilation, prevalence, predictors, social norms, Burkina Faso.

Female genital mutilation (FGM), the partial or total removal of the external genitalia for non-medical reasons, can affect female sexuality. However, only few studies are available, and these have significant methodologic limitations. To understand the impact of FGM on the anatomy of the clitoris and bulbs using magnetic resonance imaging and on sexuality using psychometric instruments and to study whether differences in anatomy after FGM correlate with differences in sexual function, desire, and body image. A cross-sectional study on sexual function and sexual anatomy was performed in women with and without FGM. Fifteen women with FGM involving cutting of the clitoris and 15 uncut women as a control group matched by age and parity were prospectively recruited. Participants underwent pelvic magnetic resonance imaging with vaginal opacification by ultrasound gel and completed validated questionnaires on desire (Sexual Desire Inventory), body image (Questionnaire d'Image Corporelle [Body Image Satisfaction Scale]), and sexual function (Female Sexual Function Index). Primary outcomes were clitoral and bulbar measurements on magnetic resonance images. Secondary outcomes were sexual function, desire, and body image scores. Women with FGM did not have significantly decreased clitoral glans width and body length but did have significantly smaller volume of the clitoris plus bulbs. They scored significantly lower on sexual function and desire than women without FGM. They did not score lower on Female Sexual Function Index sub-scores for orgasm, desire, and satisfaction and on the Questionnaire d'Image Corporelle but did report significantly more dyspareunia. A larger total volume of clitoris and bulbs did not correlate with higher Female Sexual Function Index and Sexual Desire Inventory scores in women with FGM compared with uncut women who had larger total volume that correlated with higher scores. Women with FGM have sexual erectile tissues for sexual arousal, orgasm, and pleasure. Women with sexual dysfunction should be appropriately counseled and treated.

Female genital cosmetic surgery procedures have gained popularity in the West in recent years. Marketing by surgeons promotes the surgeries, but professional organizations have started to question the promotion and practice of these procedures. Despite some surgeon claims of drastic transformations of psychological, emotional, and sexual life associated with the surgery, little reliable evidence of such effects exists. This article achieves two objectives. First, reviewing the published academic work on the topic, it identifies the current state of knowledge around female genital cosmetic procedures, as well as limitations in our knowledge. Second, examining a body of critical scholarship that raises sociological and psychological concerns not typically addressed in medical literature, it summarizes broader issues and debates. Overall, the article demonstrates a paucity of scientific knowledge and highlights a pressing need to consider the broader ramifications of surgical practices. "Today we have a whole society held in thrall to the drastic plastic of labial rejuvenation."( 1 ) "At the present time, the field of female cosmetic genital surgery is like the old Wild, Wild West: wide open and unregulated"( 2 ).

Plain Language SummarySurgery with digit preservation is the recommended treatment for early forms of nail melanoma (a type of skin cancer that affects the nails). When the melanoma is very thin or limited to the surface of the nail, allowing the wound to heal on its own (known as secondary intention healing or SIH) can be a good alternative to closing the wound after surgery. This method has shown good cosmetic and functional results, fewer complications, and high patient satisfaction. In this study, we evaluated 6 patients who underwent this type of surgery with SIH. We focused on how long it took for their wounds to heal, how much pain they experienced, cosmetic results, finger function, complications, and overall satisfaction. The wounds took around 8.5 weeks to heal completely. Patients reported good functional and cosmetic results. Their quality of life was minimally affected, with high satisfaction scores (9.8 out of 10). Importantly, no recurrences of melanoma or skin discoloration were observed. In conclusion, healing with SIH is a safe and effective option. It also allows flexibility if more tissue needs to be removed later while still providing excellent cosmetic and functional results.

Introduction: Epidermoid cysts are nodular structures lined with stratified squamous epithelium. In most cases, epidermoid cysts arise in the head and neck region, or in extremities, with their occurrence in the female genital tract being rare. Cases of epidermoid cysts in the female genital tract tend to have a history of trauma—mostly surgical or due to female genital tract mutilation. We present a case of biopsy proven vulvar epidermoid cyst which arose without a background of prior surgical history, female genital mutilation, or other trauma. Case Report: A 25-year-old multigravida female with two children presented with progressive painless vulvar swelling for around two years, without any history of trauma or prior surgery. Vulvar ultrasound examination revealed a well-circumscribed, ovoid subcutaneous tissue mass arising from the labia majora with internal linear echogenic and anechoic foci, as well as raised through-transmission. Magnetic resonance imaging (MRI) examination revealed an exophytic, round-to-ovoid subcutaneous mass lesion in the vulvar region which returned iso- to hyperintense signals on T1, hyperintense signals on T2-weighted images, and hyperintense signals on diffusion weighted imaging (DWI), while demonstrating a peripheral rim of enhancement on T1 post-contrast images. The patient underwent surgical excision without any complications and histopathology reaffirmed the diagnosis of vulvar epidermoid cyst having a stratified squamous epithelial lining. Conclusion: While epidermoid cysts of the female genital tract are rare occurrences in patients lacking prior surgical or traumatic history, they need to be considered as possible differential diagnoses in patients presenting with characteristic symptoms and imaging findings. Further evaluation of the clinical course and imaging findings of epidermoid cysts in the female genital tract, as well as the efficacy of different imaging modalities and interventions is essential to improve their diagnosis and management.

Normal 0 14 false false false IT X-NONE X-NONE MicrosoftInternetExplorer4 This article examines the nexus between female genital mutilation (FGM) and theory of promiscuity among ever-married women in Oworonshoki community of Lagos State, Nigeria. To achieve the objectives of the study, a non-experimental research design was adopted using a cross-sectional survey research method. Findings of the study reveal that the practice of FGM is widespread in the study location. Specifically, 76.0 percent of the respondents were circumcised. Reasons adduced for the practice include reduction of female sexual urge and promiscuity (61.4%), beautification of female sexual organ (14.9%), avoidance of pre-marital sex (10.0%), and tradition/custom (3.7%). The study discovered a negative significant relationship between women’s FGM status and various sexual health indicators. There is also a negative significant relationship between women’s socio-economic status and their plan to circumcise their daughters in the future. Based on the findings of the study, there is a need for the state and non-state actors in Nigeria to redesign their strategies and enforce all existing legislations in order to eradicate the harmful traditional practices FGM among women in the study location. Lekan John OYEFARA, Senion Lecturer, Department of Sociology, Faculty of Social Sciences, University of Lagos, Akoka, Yaba, Lagos, Nigeria. E-mail: oyefara@gmail.com /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabella normale"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabella normale"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

Over the past two decades, cosmetic labiaplasty surgery has increased in popularity and become more highly publicised. Labiaplasty is a procedure that involves cutting back large and protuberant labia minora so that they are either entirely hidden by or sit flush with the lips of the labia majora. Labia minora that protrude beyond the labia majora are described in the medical literature as ‘hypertrophied’, which simply means that the labia are large in size. Even though ‘hypertrophy’ is a denotative description of a structure and not a clinical pathology, it is presented to women as a medical diagnosis. This chapter introduces the argument in the book that ‘hypertrophy of the labia minora’ pathologises normal female anatomy and that it has a history. It sets out the central research questions that have inspired the book: To what extent is the genital shame driving female uptake of labiaplasty surgery strictly contemporary? How far back does the diagnosis of labial hypertrophy go? And where do our ideas about genital normality come from? The chapter explains what female genital cosmetic surgery is and the rationale for it before moving on to provide an overview of the feminist literature on female genital cosmetic surgery by medical practitioners and scholars in the humanities. It argues that the contribution of the present volume is its attempt to uncover hitherto unexplored narratives that situate cosmetic labiaplasty within a larger medical history of the vulva.

In its most extreme form, female genital cutting (FGC) removes a woman’s clitoris and severely narrows the vaginal opening to the size of a dime. However, in its most minor form, a woman’s clitoris is scratched or minimally excised resulting in little permanent damage. Between 100 and 140 million women have undergone some form of FGC worldwide and this number is expected to increase by a projected number of two million every year.1 Doctors, lobbyists, journalists, NGOs and other interest groups in their discussion of FGC demand complete eradication of the practice due to its observable short-term and long-term health implications. Often, demands for complete eradication are coupled with the criticism of FGC as a practice which oppresses women. Internationally, any compromise, including harm-reduction policies, is condemned by the media and by western audiences. The most prominent of such policies is institutionalization in hospitals and medicalization, the education of doctors about FGC.

Cosmetic genital surgery in children and adolescents