The Role of Surgery in Sexual Medicine

Abstract

From the realms of quackery, to Viagra®, inflatable penile prostheses, and stem cell research, our understanding of sexual medicine has come a long way over the years. The current status of surgical intervention in sexual medicine is presented in this lecture. Broadly, surgery in sexual medicine may be classified as under: (I) Surgery for male sexual dysfunction (II) Surgery for female sexual dysfunction (III) Gender reassignment surgery (IV) Others. Surgery for male sexual dysfunction includes vascular surgery for erectile dysfunction, penile prosthetic implantation surgery, surgery for penile curvature, Peyronie's disease, priapism, ejaculatory disorders, etc. Surgery for female sexual dysfunction includes surgery for vulvar vestibulitis, Bartholin's gland cysts, clitoral phimosis, hypertrophic Skene's glands, urethral prolapse, labiaplasty, reversal of clitoral circumcision and infibulations, and excision of benign and malignant vulvar lesions that interfere with sexual function. Gender reassignment is usually performed on adults with gender dysphorias and children with intersex disorders. The last group includes all other operations. Sexual surgery encompasses many specialties, including urology, andrology, gynecology, plastic and reconstructive surgery, pediatric surgery, etc. With the emergence of sexual medicine as a separate specialty, it is hoped that all these interventions will someday soon be possible in stand-alone sexual medicine departments, under one roof.