Department of Obstetrics & Gynecology, Division of Female Pelvic Medicine & Reconstructive Surgery, Louisiana State University Health Sciences Center, 5th Floor Department of OB/GYN, 1542 Tulane Ave, New Orleans, LA, 70124, USA.
Department of Obstetrics & Gynecology, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Int Urogynecol J. 2020 Oct;31(10):1979-1995. doi: 10.1007/s00192-020-04294-5. Epub 2020 May 8.
Cosmetic gynecology, a field which has garnered substantial attention over recent years, lacks a universally accepted nomenclature. The aim of this systematic review is to evaluate techniques, outcome measures reported, and adverse events in patients undergoing cosmetic gynecology procedures and offer recommendations to improve reporting metrics.
A systematic literature search was performed using electronic databases from inception to April 2019. The search was based on 51 unique cosmetic gynecology keywords such as: "labiaplasty," "vaginal rejuvenation," and "liposuction mons pubis." All English full-text prospective and retrospective observational and interventional studies with at least five subjects that describe a cosmetic gynecology procedure were included. Only full-text articles were included. This protocol has been registered with PROSPERO (CRD 42019131860).
A total of 1837 articles were identified from the search strategy with 42 included in the quantitative synthesis. Procedures described included: labia minora reduction with or without clitoral hood reduction, labia majora augmentation, surgical vaginal caliber reduction, mons pubis reduction/suspension, and energy-based therapy for vaginal laxity or vulvar laxity. Efficacy and satisfaction metrics were highly variable ranging from validated questionnaires to no outcome subjectively or objectively quantified. Complication rates varied by procedure but were generally low and ranged between Clavien-Dindo grades I-III.
Although there is a breadth of literature on cosmetic gynecology surgical techniques and short-term complication rates, the terminology and outcome measures utilized are heterogeneous. To address this, standardized terminology along with uniform cosmetic and functional endpoints must be developed.
近年来，美容妇科领域备受关注，但该领域缺乏被普遍认可的命名法。本系统评价旨在评估行美容妇科手术患者的技术、报告的结局指标和不良事件，并提出改善报告指标的建议。
我们采用电子数据库进行了系统的文献检索，检索时间从建库开始至 2019 年 4 月。检索基于 51 个独特的美容妇科关键词，如：“阴唇整形术”、“阴道年轻化”和“耻骨上脂肪抽吸术”。所有包含至少 5 例患者的描述美容妇科手术的英文全文前瞻性和回顾性观察性及介入性研究均被纳入。仅纳入全文文章。本方案已在 PROSPERO（CRD42019131860）注册。
从检索策略中共确定了 1837 篇文章，其中有 42 篇被纳入定量综合分析。描述的手术包括：小阴唇缩小术（伴或不伴阴蒂包皮缩小术）、大阴唇增大术、阴道口径缩小术、耻骨上脂肪抽吸术/悬吊术，以及能量治疗阴道松弛或外阴松弛。疗效和满意度指标差异很大，从经过验证的问卷到没有主观或客观量化的结局。并发症发生率因手术而异，但通常较低，范围在 Clavien-Dindo I-III 级之间。
尽管有大量关于美容妇科手术技术和短期并发症发生率的文献，但所使用的术语和结局指标存在异质性。为了解决这个问题，必须制定标准化的术语和统一的美容和功能终点。
