The Effect of Female Genital Cosmetic and Reconstructive Procedures on Body and Genital Self-Image: A Systematic Review and Meta-Analysis.

Abstract

Performance of female genital cosmetic and reconstructive procedures (FGCRP) has been increasing over the past decades. Appearance and functional concerns are the most common reasons for seeking FGCRP. Poor body and genital self-image may contribute to the increase in demand for surgery. The aim of this systematic review is to explore outcomes of FGCRP in the domains of body and genital self-image. A systematic literature review of PubMed (National Institutes of Health, Bethesda, MD), Web of Science (Clarivate, London, UK), Scopus (Elsevier, Amsterdam, the Netherlands), PsycINFO (American Psychological Association, Washington, DC), Embase (Elsevier, Amsterdam, the Netherlands), and the Cochrane Library (Wiley, Hoboken, NJ) was conducted to identify articles that measured body and genital self-image in women after FGCRP. The authors identified 5 articles for a systematic review of body image and 8 studies for a systematic review of genital self-image. The most common procedure performed was labia minora labiaplasty. Instruments for body image evaluation were Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS), and the Body Image Quality of Life Inventory (BIQLI). Genital image was assessed with the Female Genital Self-Image Scale (FGSIS) and Genital Appearance Satisfaction (GAS) scale. Most of the studies indicated that FGCRP can improve both body image and genital self-image; meta-analysis revealed that FGCRP improved GAS scores by 17.96 (range: 0-33) (p < 0.001). It appeared that FGCRP led to improvements in women's body and genital self-image. Inconsistencies in study design and measures however limit this conclusion. Future research should involve more rigorous study designs (for example randomized clinical trials with large sample sizes) for a more accurate assessment of FGCRP's consequences.