alexa Labia Minora Reduction Patients Symptoms and Satisfaction in Short and Long Term | OMICS International
ISSN: 2161-0932
Gynecology & Obstetrics

Like us on:

Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Labia Minora Reduction Patients Symptoms and Satisfaction in Short and Long Term

Leif Messerschmidt2 and Pernille Ravn1*

1Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark

2Department of Gynecology and Obstetrics, Hospital of Southern Jutland Aabenraa, Denmark

*Corresponding Author:
Pernille Ravn
Department of Gynecology and Obstetrics
Odense University Hospital, Sdr. Boulevard 29
Odense, 5000, Denmark
Tel: +45 66113333
E-mail: [email protected]

Received date: September 22, 2015; Accepted date: October 06, 2015; Published date: October 15, 2015

Citation: Messerschmidt L, Ravn P (2015) Labia Minora Reduction – Patients Symptoms and Satisfaction in Short and Long Term. Gynecol Obstet (Sunnyvale) 5:327. doi:10.4172/2161-0932.1000327

Copyright: © 2015 Messerschmidt L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Visit for more related articles at Gynecology & Obstetrics

Abstract

Labia minora reduction has gained more prominence in the recent decade and more women are seeking professional opinions. Unfortunately only a few studies have researched the long-term specificity and functional assessment endpoints. This study was a retrospective questionnaire study where we asked about complications, symptoms, labia sensitivity, influence on sex-life and patient satisfaction. Even though the general patient satisfaction was high, complications such as pain (23%), hematoma (11%) infection (9%) and healing problems (6%) were common. 36% experienced a change in sensitivity; less feeling/ numbness as the main complaint. Sex-life was reported to be better in 59%, while 39% experienced no change. It is important to know about possible complications and changes in sensitivity after reduction of labia minora. It is the responsibility of the consultant to inform women seeking operation in order to facilitate a well-informed decision.

Keywords

Labia; Surgery; Reduction; Complications; Sexuality

Introduction

Surgical reduction of labia minora has gained more attention in the recent decade [1]. Surgery only for cosmetic reasons is forbidden by law in Denmark, but still an 11- fold increase in referrals to public gynaecologic clinics has been observed between 1996 and 2010 (data from Danish Health and Medicines Authority).

Generally, there are three major surgical techniques to reduce labia minora [2]: longitudinal resection, wedge resection and deepithelisation. Studies to date have not been able to indicate any differences in results after these three surgical techniques. In Denmark the longitudinal resection method is favoured (www.dsog.dk: guideline: labiareduktion 2011).

At present, there are no national or international guidelines for reduction of labia minora. Surgery thus relies on the evaluation of the consultant and the women’s symptoms [3,4], but the decision making is complicated by the subjective physical and psychological reason, that also drives women to seek this operation [5-9]. The lack of uniform objectivity and the patient`s subjectivity induce heterogeneity in evaluation of indication for surgery and operative results and potentiate the risk of suboptimal outcome measures. Clearly, evidence based guidelines would help to facilitate that surgery is reserved for women truly helped with surgery with a minimal risk of harm in this delicate area. In this process, it is important to define what is the range of normal of the labia majora and minora, and different endpoint or classifications has been proposed [2,5,10-12]. Further, it is important to know the complications and success rates following such operations. To date there are only a few studies on the subject matter, published in English, which have long term specificity and functional assessment endpoints. Especially knowledge about sensitivity and consequences for women’s sex-life is missing.

The aim of this study was therefore to examine complications and the general satisfaction after reduction of labia minora in short and long term assessed by a questionnaire, including questions about sensitivity and sex-life.

Materials and Methods

The study was based on a retrospective questionnaire sent out by mail. The approval for the study was given by the Danish Data Protection Agency (July 18th 2012, J.nr. 2012-41-0748). Patients were identified in hospital records by the diagnosis code for labia hypertrophy (DN906) combined with the operative procedure code for the vulva region (KLFC00/KLFC96) at the Odense University Hospital or Sønderborg Regional Hospital, between January 1st 2000 and November 31st 2012. In this way 87 women were included. To obtain the highest possible feedback, the questionnaire was designed short and simple with nine multiple choice questions. The questionnaire included reasons (physical, psychological, cosmetic) for seeking the operation and how the results met expectations. In addition, questions were asked about complications and symptoms (infection, wound healing, haematoma, pain) that did or did not result in admission to the hospital. To assess the long term satisfaction rates, women were asked questions about labia sensitivity (less, more, changes) and influence on sex- life. Furthermore, a general assessment was asked to be completed on a scale from 1-10; and whether the woman would recommend this operation to another. For the statistics Excel has been used.

Results

The study group consisted of 87 women in the age range 12 to 61 years; 29.5 years in average. Follow-up time between the operation and the questionnaire was between 4 and 153 months; 68 months in average. Sixteen women received unilateral labia resection, 71 bilateral, and all were performed as day surgery. One patient was lost to follow up due to low IQ, and another 7 were lost to follow up due to missing personal data. Seventy nine women were sent a questionnaire in the mail and 47 answered after the first attempt. The remaining 32 were sent a second questionnaire, and of these, 7 answered. There was a completed returned questionnaire for 54 women (68%) (Figure 1).

gynecology-obstetrics-patients-enrolled

Figure 1: Flow sheet of patients enrolled.

Forty nine subjects (92%) answered that they sought treatment due to physical reasons while 17 (32%) answered psychological and 24 (45%) cosmetic reasons (Figure 2A). Seventeen (32%) answered that they had one or more complications. The most frequent complication was pain (23%), hematoma (11%) infection (9%) and wound healing problems (6%) (Figure 2B). For 3 women (6%), admission was necessary and 2 women (4%) were re-operated because of bleeding the same day as the primary operation. Twenty women (36%) answered that they had experienced changed sensitivity after the operation. Of these, 60% had less feeling, or numbness, as main complaint; however 21% reported more sensation (Figure 2C). Eighty- nine percent thought the precipitating factor for wanting the operation was eliminated by the operation, or else became better, 9% thought it was not changed, and 2% thought it was worse. Sex-life was reported to be better or much better in 59% of the women, while 39% experienced no change, and 2% experienced worsening (Figure 2D). Ninety one percent answered that they would recommend the procedure to another. General satisfaction was a scored average of 7.7. Three women got a second surgery of the labia in a different clinic and at least three more are considering this as well.

gynecology-obstetrics-answer-possible-5-327-g002

Figure 2: (a) Answers given on the question (reasons for surgery) in %. More than one answer possible. (b) Answers given on the question (complications right after the operation) in %. More than one answer possible. (c) Answers given on the question (changes in sensitivity after surgery) in %. More than one answer possible. (d) Answers given on the question (changes in sex-life after surgery) in %.

Comment

The primary aims of earlier published studies focused on comparing specific operation methods of labia majora reduction. All studies had high patient satisfaction and low complication rates. It is also evident from these studies, that independent of the different operative methods, a high patient satisfaction is associated with labia size and personal perceptions of the labia. Our study did not focus on operative methods, but on general complications and satisfaction both short and long term.

Patient demographics in this study were comparable to the other larger studies [5,7,13,14]. This applies to both age, average age, and whether the operation was uni- or bilateral. Reasons for obtaining the operation were also comparable in the light of the restrictions in Denmark with respect to labia reduction for cosmetic purposes.

Similar to findings in earlier studies, our results showed that women in general are satisfied with the procedure. A percentage of 91% that would recommend the operation to another is comparable to previous findings (92-100%) [14]. It is difficult to compare symptoms and complications as many studies used only healing and satisfaction surveys as endpoints [13]. In these larger studies, pain was a well described symptom. Frequency of pain symptoms varies greatly from 1% (13) to 64% (10), which is believed to be caused by the inherent difficultly in assessing subjective pain. Postoperative infection has seldom been described or reported in larger studies [14]. In two studies, prophylactic antibiotics were used [8,15]. This seem to be the only significant difference from our study where 5 women required antibiotic treatment following surgery.

Our study, unlike few of the larger studies, included questions about postoperative sensitivity of the labia and long term effect on sex-life. Gress et al. reported that none of their subjects had developed problems with sexual stimulation, while 35% had increased sexual excitability [15]. Alter et al. reported that 28% described changed sensitivity: either positive (23%) or negative (5%) and 71% experienced improvement of their sex-life while for 24% there was no difference [13]. Both of these studies had a general satisfaction of 9.4 and 9.2, which is significantly higher than 7.7 in our study. This might invite speculation of superiority of the different operative methods compared, the difference in follow-up intervals, or reporting bias. Sensibility takes many months to recover which may influence the overall assessed satisfactory levels. A strength in our study is the average follow-up time of 68 months. A high rate of completed questionnaire return rates (68%) is another obvious strength and the combination of a long follow-up time, a high rate of returned questionnaire and specific questions about sensitivity and consequences for sex-life is unique for our study. Our data are collected from two different hospitals, with different surgeons, but probably with only minor differences in procedure technique as the longitudinal resection method is generally favoured in Denmark. However, the possibility of minor differences can be seen as a limitation of our study.

In conclusion, reduction of labia minora has experienced increased interest among women within the last years. Even though the method is generally met with satisfactory results, operative complications such as pain, infection, bleeding and hematoma can occur. The most substantial finding in our study is the long term changes in sensibility. Our result underlines the responsibility of the consultant to inform women about the natural variation in labia anatomy plus the risk of complications and long term results of this surgery. Only after weighing subject matters thoroughly, can women be expected to be enough wellinformed for optimal decision making.

References

Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Relevant Topics

Recommended Conferences

  • 7th International Conference on Clinical and Medical Case Reports June 01-02, 2018 Osaka, Japan Theme: Focusing the breakthroughs of case reports in Clinical & Medical Research
    June 01-02, 2018 Osaka, Japan
  • 7th International Conference and Exhibition on Surgery June 21-23, 2018 Dublin, Ireland Theme: Advancements and Endeavours in the Field of Surgery
    June 21-23, 2018 Dublin, Ireland Dublin, Ireland
  • Annual Congress on Research and Innovations in Medicine July 02-03, 2018 Bangkok, Thailand Theme: Current Research and Innovations in Medicine to Improve Human Health
    July 02-03, 2018 Bangkok, Thailand
  • International Conference on Medical and Health Science August 24-25, 2018 Tokyo, JAPAN Theme: Scrutinize the Modish of Medical and Health Science
    August 24-25, 2018 Tokyo, Japan
  • World Summit on Trauma and Reconstructive Surgery Sep 10-11, 2018 Singapore Theme: Expanding new horizons in Trauma and Surgery
    Sep 10-11, 2018 Singapore City, Singapore
  • 6th American Gynecological Surgery Conference September 28-29, 2018 San Antonio | Texas | USA
    September 28-29, 2018 San Antonio, USA
  • World Congress on Fetal and Maternal Medicine October 15-17, 2018 Osaka, Japan Theme: A New Beginning on Fetal, Maternal & Neonatal Medicine
    October 15-17, 2018 Osaka, Japan
  • International Conference on Reproduction and Fertility October 18-19, 2018 Abu Dhabi, UAE
    October 18-19, 2018 Abu Dhabi, UAE

Article Usage

  • Total views: 12647
  • [From(publication date):
    October-2015 - May 21, 2018]
  • Breakdown by view type
  • HTML page views : 8847
  • PDF downloads : 3800
 

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2018-19
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

neurop[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

 
© 2008- 2018 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
Leave Your Message 24x7