Female Genital Self-Image Scale Score Research Articles

Comparison of Fat Transfer Combined with Plasma Energy and Only Fat Transfer Methods for Genital Rejuvenation.

To compare the fat transfer combined with plasma energy and only fat transfer methods for genital rejuvenation and to investigate the efficacy enhancing properties of plasma energy. Forty-six patients were equally divided into two groups according to the surgical method as the group A (n = 23) and the group B (n = 23). The patients in the group A received only fat transfer, while the patients in the group B received fat transfer combined with plasma energy. Both groups were scheduled for postoperative follow-up at 1, 3, 6, and 12 months. The lifting effect on the labia majora after the procedure was evaluated with photographs and patient satisfaction questionnaires including the female genital self-image scale (FGSIS). The mean age of all participants was 32.8 ± 5.1 years, and the mean body mass index (BMI) was 24.7 ± 3.4kg/m2. The mean preoperative FGSIS scores were similar between the groups (p = 0.542). The mean total FGSIS score was 18.8 ± 1.4 in the group A and 18.3 ± 1.5 in the group B in the preoperative period. However, the mean FGSIS scores at 1, 3, and 6 months were significantly higher in the group B than the group A (p = 0.032, p = 0.012, and p = 0.009, respectively). At 6 months of follow-up, the mean total FGSIS score was 20.7 ± 1.4 in the group A and 22.3 ± 1.5 in the group B, indicating a statistically significant difference (p = 0.028). This novel technique is a more minimally invasive technique compared to other energy modalities with lower lateral and vertical energy dissipation than other conventional methods, and labia majora fat filling augmentation application can be performed with more permanent and longer-lasting outcomes than fat transfer only. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

The Effect of Menopause Symptoms on Female Genital Self-Perception in Postmenopausal Women

Objective: This study aimed to investigate the effects of menopausal symptoms on Female Genital Self-Perception (FGSP) in postmenopausal women.
 Methods: This descriptive and relationship-seeking study was conducted with women aged 40 and above who applied to the Family Medicine Outpatient Clinic of a tertiary hospital between June and December 2022, who have not had a menstrual period for at least 12 months, and who met the inclusion criteria. The Patient Information Form, The Menopause Rating Scale (MRS), Vulvovaginal Symptom Questionnaire (VSQ), and the Female Genital Self-Image Scale (FGSIS) were used to obtain the data.
 Results: The mean age of 203 women included in the study was 57.53±6.70. The total mean scores obtained from the scales was 15.40±7.7 for MRS, 3.75±3.96 for VSQ, and 18.99 ±4.34 for FGSIS. An inverse and statistically significant relationship were found between MRS and VSQ total and sub-dimension scores and FGSIS scores (p:0.001 for all). A significant relationship was found between FGSIS score and body mass index and parity (r:-0.154, p:0.028 and r:-0.258, p:0.001). University graduates, those who had regular gynecological examinations, and people with a very good perception of general health status had significantly higher FGSIS scores (p:0.001 for all).
 Conclusion: According to the scale scores, the FGSP of postmenopausal women was moderate and negatively affected by the increase in menopausal symptoms. Obesity, an increase in the number of parities, low education level, and poor health perception were the factors that negatively affected FGSP.

The relationship between women's mode of delivery, body image, self-respect, and genital self-image.

Many factors affect women's genital self-image. This study was conducted to investigate the relationship between women's mode of delivery, body image, self-esteem, and genital self-image. The research was carried out in two public hospitals between 15 January 2022 and 30 June 2022. The study sample consisted of a total of 197 multiparous women in the early postpartum period. They were asked to fill out a Personal Information Form, the Rosenberg Self-Esteem Scale (RSES), the Body-Esteem Scale (BES), and the Female Genital Self-Image Scale (FGSIS), based on self-report. The Chi-squared, Pearson's correlation, and multiple linear regression analysis were used. Of the participants, 49.50% had a vaginal delivery, and 50.50% had a cesarean section. Their mean scores were 0.64 ± 0.62 on the RSES, 155.01 ± 24.40 on the BIS, and 20.97 ± 4.39 on the FGSIS. As the women's age increased, their mean FGSIS score also increased. There was negative correlation between women's mean RSES and FGSIS scores. A positive, significant correlation was found between the mean FGSIS and BES scores of the women. Of the variables included in the multiple linear regression model, age, self-esteem, and body image were statistically significant predictors 19.5% of the FGSIS score (p < 0.005). Mode of delivery was not a predictor of female genital self-image in the early postpartum period. Women with high self-esteem had a positive body image and genital self-image. Age, self-esteem, and body image were influential on female genital self-image. On the other hand, age, self-esteem, and body image predicted about 19.5% of female genital self-image according to multiple linear regression.

Labiaplasty in Asian women: Motivation, technique feasibility, and patient reported outcomes

Labiaplasty is an increasingly popular aesthetic procedure. However, there is a lack of information regarding different surgical procedures and Asian patients' motivations and outcomes. This study aimed to understand patients' motivations for seeking labiaplasty and to examine surgical outcomes of different procedures. This retrospective study enroled patients between August 2016 and May 2021. Patient demographics, surgical procedures, complications, and revision surgeries were reviewed. Responses to questionnaires regarding patient motivations for undergoing labiaplasty, pre- and postoperative discomfort and aesthetics, Rosen's Self-Esteem Scale (RSES) scores, and Female Genital Self-Image Scale (FGSIS) scores were recorded. One hundred thirty-one patients were included, with an average age of 30.3±7.78 years. Eighty-seven (66.4%) patients underwent bilateral labiaplasty, and 44 (33.6%) underwent unilateral labiaplasty. The surgical techniques included 61 (46.6%) direct resections, 50 (38.2%) wedge resections, and 20 (15.3%) "hockey stick" procedures. Wound dehiscence occurred in 37 (28.2%) patients. A significant increase in complications occurred after the hockey stick procedure and wedge resection. Patients' motivation for surgery included aesthetic reasons in 62.0%, symptom relief in 91.5%, and repeated infection in 4.2%. There was a significant difference between pre- and postoperative genital aesthetics (p0.001) and discomfort symptoms (p0.001). The average RSES score was 19.68±4.03, and the average FGSIS score was 20.77±3.20. Pain and discomfort remained the most important motivations for Asian women to seek labiaplasty, followed by aesthetic reasons. With good preoperative consultation and surgical planning, satisfaction can be achieved concerning functional and aesthetic aspects.

Preferred mode of delivery association with the body image and genital image in pregnant women - a cross-sectional study

BackgroundPregnant women experience several changes in their appearance, body shape and body image. In some studies, there has been a relationship between these changes and the type of delivery. This study aimed to investigate the relationship of the prenatal body image and genital image with the mode of delivery preferred by pregnant women in Gorgan in 2020.MethodsIn this cross-sectional study, 334 pregnant women were selected by stratified sampling. The Prenatal Body Image Questionnaire (PBIQ), Female Genital Self-Image Scale (FGSIS), pregnant women’s preferences for mode of delivery questionnaire (PPMDQ) and DASS-21 were completed on line. The data was analyzed using Spearman test and linear regression.ResultsThe average score of PBIQ, FGSIS, and PPMDQ was 68.24 (standard deviation = 17.71), 19.25 (standard deviation = 3.3), and 63.12 (standard deviation = 3.3) respectively. Vaginal delivery as a preferred mode of delivery was inversely correlated with dissatisfaction with body image (r=-0.32, P < 0.001), and directly correlated with satisfaction with the genital image (r = 0.19, P < 0.001). There was a significant inverse correlation between prenatal body image dissatisfaction and genital image satisfaction (r=-0.32, P < 0.001). While FGSIS score could not predict PPMDQ, PBIQ score could.ConclusionsSatisfaction with the prenatal body image or genital image is associated with the choice of vaginal delivery. These results can be the basis for prenatal care and childbirth counselling.

(028) A Comparison of Genital Self-Image and Sexual Functioning among Women with Vulvar and Non-Vulvar Dermatologic Disease

Abstract Introduction Inflammatory dermatologic diseases of the vulva represent a significant morbidity burden for affected women. Genital itching, pain, and skin changes have a profound impact on sexual function. Research also suggests women with generalized, non-vulvar dermatologic diseases have impaired sexual function. The Female Genital Self-Image Scale (FGSIS) was developed and validated in a large sample of American women a decade ago. Despite developers’ suggestion that the FGSIS could be used to further understand the burden of genital disease, there remains a paucity of research in this area. Both vulvar and non-vulvar inflammatory skin disease have yet to be fully characterized with regards to impact on genital self-image (GSI), a key mediator in sexual health and behavior. Objectives The present study describes GSI, sexual function, and sexual behaviors among women with vulvar and non-vulvar inflammatory dermatoses. Methods A 20-minute Qualtrics survey was distributed between September and November 2020 through three primary means: 1) targeted social media ads, 2) relevant social media support groups, and 3) online research volunteer recruitment services. Women in the US over age 18 who have ever been diagnosed with an inflammatory dermatosis persisting longer than one month were eligible to participate. The present data were collected as part of a larger study examining sexual health, quality of life, and health care experiences of women with skin disease. Survey items analyzed included the FGSIS, the Female Sexual Function Index (FSFI), and sexual behavior histories. Results The sample consisted of 320 women with a mean age of 42.7±15.5 (Range=19-81). Most participants were pre-menopausal (n=200; 62.5%), Caucasian (n=278; 86.9%), and heterosexual (n=263; 82.2%). Nearly one-third of women (n=98; 30.6%) reported inflammatory dermatologic disease isolated to the vulva, while 150 (46.9%) had strictly non-vulvar disease, and 72 (22.5%) experienced both vulvar and non-vulvar manifestations. The average FGSIS score among women with any vulvar disease was 16.9±4.1 (range=7-28) and was significantly (p&amp;lt;.01) lower than that of women with non-vulvar disease (M=21.2±4.3; range=9-28), with a higher score indicating a more positive FGSIS. A similar trend was seen with the FSFI, which was significantly (p&amp;lt;.01) different among women with vulvar disease (M=15.4±9.7, range=2.0-35.1) compared to women with non-vulvar disease (M=21.2±10.1, range=2.0-35.1), with higher scores indicating better functioning. When stratified by category, FSFI remained significant for desire (p=.04) and pain (p&amp;lt;.01), but not for arousal, lubrication, orgasm, or satisfaction. Women with vulvar disease were significantly less likely to receive (p=.02) or give (p=.04) oral sex or to engage in vaginal intercourse (p&amp;lt;.01) during the last four weeks. Conclusions This study demonstrates severe sexual health morbidity associated with inflammatory vulvar dermatoses, characterized by very low FGSIS and FSFI scores. Pain and desire shaped sexual function for women with vulvar disease, despite non-significant differences in other domains including satisfaction. Results also indicated low FSFI scores in women with non-vulvar disease, with FGSIS scores similar to previously-described healthy controls. A more precise understanding of the role of GSI in both vulvar and non-vulvar disease will provide opportunities for improved patient-centered disease management in the realm of sexual health. Disclosure No.

(191) A Systematic Review of Sexual Health Consequences among Women with Vulvar Lichen Sclerosus

Abstract Introduction Lichen Sclerosus (LS) is a chronic, inflammatory skin condition that predominantly affects the vulva. This condition often leads to scarring involving the clitoris, labia minora, vaginal introitus, and perineum, leading to clitoral phimosis and introital stenosis. Women with LS are less likely to be sexually active than those without the condition. Studies have shown a high rate of sexual dysfunction in vulvar LS; however, the sexual effects of the condition are still poorly acknowledged. Objective To identify sexual health consequences of vulvar lichen sclerosus among women with vulvar lichen sclerosus through systematic review of available literature. Methods A systematic review of the literature was conducted on sexual health consequences of lichen sclerosus among women with lichen sclerosus. PubMed, MEDLINE, and Scopus were queried and results were screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies are observational studies evaluating women of premenopausal or postmenopausal status with clinical or biopsy confirmed lichen sclerosus and sexual health, or randomized controlled trials or comparative studies utilizing a validated sexual function measure to evaluate sexual health prior to intervention among the same population. Manuscripts included must have been written in English from January 1991 to April 2022. Selection of studies was done by three independent reviewers and conflicts were resolved by discussion. Systemic reviews and committee guidelines were identified for references review. Results The search produced 683 references for title and abstract screening. Of these, 32 articles met criteria for full-text review. After full-text review, 20 studies met inclusion criteria and were evaluated. Three systematic reviews and three committee guidelines were identified and all references had been identified in the initial search. Eight publications yielded qualitative data regarding sexual health consequences of LS. A negative impact of sexual dysfunction was reported in 16-60% of affected women, and dyspareunia reported by 22-56.7%. LS is also associated with decreased sexual frequency and satisfaction, a negative impact on romantic relationships, and feelings of inadequacy as a sexual partner. Eight publications evaluated the Female Sexual Function Index (FSFI), and all demonstrated a central tendency less than 26.55 among those with LS. Four publications evaluated the Female Sexual Distress Scale (FSDS), and all demonstrated a score greater than 12 among women with LS. Two publications evaluated Female Genital Self-Image Scale (FGSIS) scores in women with LS, and both found decreased FGSIS scores compared to controls. Four publications evaluated the Dermatology Quality of Life Index (DQLI), with LS causing a small to very large impact on quality of life. The subcategory with the greatest impact of quality of life is sexual difficulties. One publication evaluated the Vulval Quality of Life Index (VQLI) in women LS, and found sexuality to be the second highest scoring subgroup. Conclusions The sexual health consequences of LS include sexual pain symptoms, all facets of female sexual function, sexual distress, negative genital self-image, and negative impact on romantic relationships. Women with LS experience a significant impact on quality of life, particularly in relation to sexual functioning. Disclosure No

Retrospective comparative cohort study of neovagina creation by modified Vecchietti-laparoendoscopic single-site surgery for Mayer-Rokitansky-Küster-Hauser syndrome.

Although traditional multi-incision laparoscopic surgery is minimally invasive, it can still leave surgical scars on the lower abdomen. This study reports a modified Vecchietti-laparoendoscopic single-site (MVLESS) procedure using self-made instruments to create a neovagina for Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) and to determine the efficacy and safety. We conducted a retrospective comparative cohort study analysis of the clinical data from MRKHS patients treated in the Department of Difficult Gynecological Disease at Xi'an People's Hospital between January 2010 and December 2020.Women who were diagnosed with MRKHS and underwent a MVLESS procedure using self-made instruments to create a new vagina were selected as the study group (n=14). Patients who underwent a traditional multi-incision Vecchietti (TMV) procedure were selected as the control group (n=22). All participants in both groups were required to complete a Female Sexual Function Index (FSFI) and Female Genital Self-Image Scale (FGSIS) questionnaire. All patients in the study group were diagnosed with type I MRKHS and 3 (21.43%) were sexually active. Twenty-one patients in the control group were diagnosed with type I (95.45%) MRKHS, 1 (4.55%) had type II MRKHS (absent left kidney), and 6 (27.27%) were sexually active. The neovaginas in both groups were wide with good elasticity, softness, smoothness, and lubrication. There were no significant differences in operative time (37±6 vs. 39±4 minutes, P=0.98), intraoperative bleeding (28.32±9.82 vs. 29.45±3.84 mL, P=0.86), postoperative anal exsufflation time (18±4 vs. 20±4 hours, P=0.82), and postoperative hospital stay (7±2 vs. 8±2 days, P=0.84) between the MVLESS and TMV groups. The FSFI and FGSIS scores in both groups showed participants had a good quality of sexual life based on the 12-month follow-up data; however, sexual function was significantly better in the study group than in the control group [lubrication (4.72±0.86 vs. 4.64±1.01, P=0.023), visual analog scale (VAS; 4.26±0.52 vs. 4.45±0.39, P=0.041), total FSFI scores (30.21±4.32 vs. 28.42±2.21, P=0.048), and FGSIS score (23.21±1.98 vs. 22.14±2.04, P=0.012)]. The MVLESS procedure is a simple, safe, and minimally invasive procedure that provides an anatomical and functional neovagina for MRKHS patients. It is an alternative method for creating a neovagina to achieve satisfactory anatomic and sexual function. However, it is still a difficult problem to solve fertility problems for patients with congenital absence of vagina.

Genital Self-Image, Sexual Function, and Quality of Life Among Individuals with Vulvar and Non-Vulvar Inflammatory Dermatoses.

Vulvar inflammatory dermatoses (VID; e.g., lichen sclerosus, lichen planus, vulvar dermatitis) can significantly impact sexual function. Both vulvar and non-vulvar inflammatory dermatoses (NVID; i.e., skin conditions not impacting vulvar skin, such as non-genital psoriasis and eczema/dermatitis) have yet to be fully characterized with regard to impact on genital self-image. A 20-min web-based survey was distributed September–November 2020 through social media ads, support groups, and online research recruitment services. Individuals in the USA over age 18 who were assigned female at birth and self-reported having been diagnosed with an inflammatory dermatosis were eligible. The primary outcome was the Female Genital Self-Image Scale (FGSIS). Secondary outcomes included the Female Sexual Function Index (FSFI), the Skindex-16 (a skin-related quality of life measure), the PROMIS Global-10 (assessing global physical/mental health), and sexual behavior histories. Participants (n = 348) reported mean age of 43.1 ± 15.5 (range = 19–81). Nearly one-third (n = 101; 29.0%) reported VID, 173 (50%) had NVID, and 74 (21%) experienced both vulvar and non-vulvar symptoms; they were analyzed as part of the VID group. The mean FGSIS score among participants with VID was 16.9 ± 4.1 and was significantly (p < .01) lower than that of participants with NVID (M = 21.2 ± 4.3), indicating lower genital self-image. Mental health (as measured by PROMIS-Global 10) was also impaired in VID. Rates of sexual dysfunction were high in both groups (> 60%). Findings suggest that in VID, lower genital self-image is correlated with poorer sexual function, quality of life, and global physical and mental health. Additional recommendations for VID management are proposed.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10508-022-02353-0.

360 Genital Fat Transfer.

This study was designed to evaluate utility of transferring autologous adipose-derived mesenchymal stem cells with high regenerative capacity and adipose tissue derived-stromal vascular fraction, so-called 360 Vaginal Beautification technique, in labia majora augmentation and vaginal tightening operation. A total of 97 female patients who underwent labia majora augmentation and vaginal tightening operation with 360 Vaginal Beautification technique were included. Post-discharge early (3rd and 7th postoperative day) and late (1st and 3rd postoperative month) surgical complications were assessed , while the Female Genital Self-Image Scale (FGSIS) was applied before surgery and also during postoperative 6-12 months. All complications noted on postoperative 3rd day (ecchymosis of labia majus, ecchymosis of clitoral hood, tenderness in the pubic area and pain at the vaginal entrance points) regressed on postoperative 7th day with no infection, edema, lipoma or granuloma formation in any patient. Total mean FGSIS score was 17.7±1.6 in the pre-operative period, and increased significantly to 20.9±1.4 and 22.2±1.8 in the postoperative 6th month (p<0.001) and 12th month (p=0.013), respectively. The use of autologous fat, called 360 vaginal beautification, in the labia majora augmentation and vaginal tightening appears to be a safe technique due to use of autologous tissue transfer and to be associated with high satisfaction rate and an advantage of being more minimally invasive than surgical labia majora augmentation and vaginal tightening. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .

The perceptions of female genital self-image and its associations with female sexual distress.

To evaluate the perception of women living in Puerto Rico regarding their genitalia and explore the associations of those perceptions with female sexual distress. Women from Puerto Rico willing to complete a self-administered online survey from June 2018 through July 2020 were included in this cross-sectional study. Inclusion criteria included being between 21 and 65years of age, living in Puerto Rico, having identified as heterosexual, bisexual, or lesbian, and having been sexually active. Descriptive statistics were calculated. The Mann-Whitney test, Pearson's correlation, and robust linear regression were used to associate female genital self-image and sexual distress. The most common negative thought and perception within women was dissatisfaction with the size of their genitalia (21.9%), and 21.3% of women contemplated undergoing cosmetic surgery, mainly to increase and improve sensation. For each 1-unit increase in the Female Genital Self-Image Scale score, the Female Sexual Distress Scale-Revised score decreased by 1.24 units (95% confidence interval -1.67 to -0.82). A better genital self-image perception might lower levels of sexual distress. Screening instruments could help to identify poor genital perception and sexual distress.

QS7: Does Genital Self-image Correspond With Sexual Health Before And After Vaginoplasty

Purpose:Improvements in mental health and quality of life are well documented for transgender patients following vaginoplasty. Patient-reported outcomes (PROs) regarding sexual health are lacking in this intervention, or have not been validated in transgender patients.Methods:A community advisory board of transgender women informed an anonymous online survey utilizing PROs for those who were contemplative of (pre-) and post-vaginoplasty. They were recruited on online platforms not associated with an individual institution. Survey measures included the Female Genital Self-Image Scale (FGSIS) and Patient-Reported Outcomes Measurement Information System (PROMIS) sexual health measures. Welch approximation t-tests were performed for FGSIS and PROMIS questions using Bonferroni correction.Results:687 transgender patients pre-vaginoplasty (n = 522, 76%) and post-vaginoplasty (n = 165, 24%) responded. In PROMIS measures, the postoperative cohort reported higher ability to orgasm (p = 0.0003), satisfaction with sex life (p = 0.001), pleasure in sex life (p = 0.002), use of lubricant (p < 0.0001), and scar interfere with sexual satisfaction (p < 0.0001). FGSIS total score was higher among postoperative patients (27.8 ± 6.0) than preoperative patients (17.8 ± 5.3) (p < 0.0001). Using Spearman’s rho, no significant correlation between FGSIS total score and any PROMIS sub-sectional measures was observed for either cohort. 193 patients (133 preoperative, 60 postoperative) reported their responses about sex being influenced by the Covid-19 crisis.Conclusion:Patients who are contemplating vaginoplasty have worse sexual health and genital self-image than those who have had vaginoplasty. FGSIS scores did not correlate with PROMIS sexual health measures when controlling for prior vaginoplasty, demonstrating that sexual health is multimodal for each individual patient.

Effects of water pilates on urinary loss, genital self-image and sexual function of elderly women

Descriptive, quasi experimental study with pre and post-test, which aimed to investigate the effects of Water Pilates (PA) on urinary incontinence, genital self-image and sexual function of elderly women. The sample consisted of seventeen elderly women aged 60 years or over, from a city in the interior of Rio Grande do Sul. The International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) was used as instruments to assess the impact of UI in quality of life and qualify urinary loss, the Female Sexual Function Index (FSFI) to assess sexual function and Female Genital Self-Image Scale (FGSIS) to assess women's perception of their own genitalia. The PA protocol was performed twice a week for 50 minutes performed for eight weeks, totaling 16 sessions. The protocol was divided into warm-up, strengthening exercises and stretching. It was observed that the sample was composed of young elderly women (69.5 ± 5.9 years), overweight and with low FSFI and FGSIS scores. There was no significant change in the mean values before and after the intervention of the ICIQ-SF, FGSIS and FSFI scores. It was concluded that the PA method had no effect on urinary loss, sexual function and genital self-image.

Evaluation of genital self-image and sexual dysfunction in women with vulvar lichen planus or lichen sclerosus

Introduction Vulvar lichen planus (LP) and vulvar lichen sclerosus (LS) are chronic inflammatory diseases that affect women’s sexual health. In this study, our aim was to investigate sexual function, anxiety level and genital self-image in vulvar LP and vulvar LS patients. Methods This study was conducted on a total of 178 women who presented to the gynecology clinic between February 2019 and January 2020. The patients were divided into the following groups: group 1, vulvar LP (n = 21); group 2, vulvar LS (n = 59); group 3, fungal vulvitis controls (n = 48); and group 4, healthy controls (n = 50). The validated Female Sexual Function Index (FSFI), Beck Anxiety Index (BAI), and Female Genital Self-Image Scale (FGSIS) questionnaires were assessed in all women. Results There were no significant differences among the groups with respect to age, parity, menopausal status, body mass index (BMI), vaginal intercourse past 1 month, marital status or educational status (p > .05). There were statistically significant differences between the vulvar LP and vulvar LS groups compared to control groups in terms of FSFI total scores and subscores (p < .001). When FGSIS and BAI scores were analyzed, significant statistical differences were found among the study groups (p < .001). A positive correlation was found between the FSFI and FGSIS scores in patients with vulvar LP and LS. Additionally, a negative correlation was found between the FSFI and BAI scores in patients with vulvar LP and LS. Conclusions Our study showed that sexual function, genital self-image and anxiety level were associated in vulvar LP and vulvar LS patients. Vulvar LP and vulvar LS patients with worse genital self-image have more sexual problems and anxious conditions.

Do external female genital measurements affect genital perception and sexual function and orgasm?

Objective:To provide baseline data for the anatomy of the external female genitalia and to investigate the correlation between those measurements and sexual function and genital perception.Materials and Methods:This prospective cohort study consisted of 208 healthy premenopausal women. The Female Sexual Function index (FSFI) and the Female Genital Self-image scale (FGSIS) questionnaires were administered. Participants were divided into two groups according to their female sexual dysfunction (FSD) status. External genital measurements and anterior and posterior vaginal length were measured.Results:The external female genital measurements were (cm, mean ± standard deviation): clitoral prepuce length 2.05±0.48; clitoral glans length 0.87±0.21; clitoral glans width 0.60±0.15; clitoris to urethra 2.24±0.55; anterior fornix depth 7.75±0.92; posterior fornix depth 9.25±0.75; labia minora width, right 2.12±0.86, left 2.20±0.96. A weak negative correlation was found between total FGSIS scores and clitoral prepuce length (p=0.01, r=-0.17), whereas a weak positive correlation was seen between total FGSIS scores and anterior-posterior vaginal lengths (p=0.04, r=0.13; p=0.02, r=0.15, respectively). No statistically significant difference was found between the genital measurements of participants with FSD (n=82, 39.4%) and those without FSD (n=126, 60.6%), and the total FSFI scores and orgasm subdomain scores.Conclusion:The female genital measurements were found to be distributed over a wide range. Although the relationship between genital measurements and genital perception varied, no significant relationship was found between genital measurements and sexual functions or orgasm. These findings suggest that a more cautious approach should be taken towards genital surgeries for cosmetic purposes.

Autoimagem genital de mulheres com incontinência urinária atendidas em um serviço de fisioterapia ambulatorial

Objetivo: Este artigo tem por objetivo analisar a autoimagem de mulheres com incontinência urinária atendidas no ambulatório de fisioterapia. Métodos: Estudo transversal, descritivo, quantitativo realizado a partir de uma análise documental de prontuários de fisioterapia de um serviço secundário de média complexidade de uma cidade do interior do Rio Grande do Sul. Os prontuários continham dados sociodemográficos, dados sobre a incontinência urinária, bem como, a utilização do questionário Female Genital Self-Image Scale (FGSIS). Utilizou-se análise estatística descritiva em frequência absoluta e relativa e teste de normalidade de Shapiro-Wilk. Resultados: A amostra foi de oito mulheres com média de idade de 52,75±13,5 anos, com predomínio de multíparas, partos vaginais e que realizavam reposição hormonal. Em relação a incontinência urinária, houve predomínio do tipo mista, na forma de jato, provocada por esforço e com o uso de proteção permanente. A pontuação média do FGSIS foi de 19,25±3,95 pontos, apresentando uma autoimagem genital negativa. Os domínios mais afetados foram funcionamento (2,25±0,88 pontos) e cuidado (média 2,25±0,46 pontos). Não houve diferença significativa entre os domínios do FGSIS. Considerações finais: Os achados do presente estudo demonstram que as mulheres apresentaram uma autoimagem negativa com piores resultados nos domínios funcionamento e cuidado.

Female Genital Self-Image in Women With and Without Female Genital Mutilation/Cutting in Jeddah, Saudi Arabia.

IntroductionThe consequences of female genital mutilation/cutting (FGM/C) on female genital self-image are not known.AimTo assess whether women with and without FGM/C differed with regard to female genital self-image.MethodsA survey was administered to a group of women attending the King Abdulaziz University Hospital obstetrics and gynecology clinic from December 2016 to August 2017. 963 consecutive adult women seen at the clinic completed the survey.Main outcome measuresThe main outcome measure of this study was female genital self-image being assessed with the female genital self-image scale (FGSIS).ResultsOne-fifth (18.2%) of the women self-reported having undergone FGM/C as young girls. Women with FGM/C had a similar FGSIS score as women with no FGM/C (21.3 ± 4.6, n = 175 vs 21.6 ± 4.8, n = 756, analysis of variance, P = .37). In multivariate regression analysis, only level of education remained independently associated with the FGSIS score. Women with some university education had a greater mean FGSIS score than women with no university education (22.1 ± 4.49, n = 564 vs 20.8 ± 5.03, n = 399, P < .0001).ConclusionsWomen with and without FGM/C in a Saudi Arabian clinic generally had a similarly positive genital self-image. Only level of education was independently associated with the FGSIS score.Rouzi AA, Berg RC, Alamoudi R, et al. Female Genital Self-Image in Women With and Without Female Genital Mutilation/Cutting in Jeddah, Saudi Arabia. Sex Med 2020;8:752–756.

How Does Labia Minora Labiaplasty Surgery Impact Patients' Perceptions of Their Genitals? [20B

INTRODUCTION: Labia Minora Labiaplasty (LmL) surgery is sought after for comfort, function and appearance concerns but little is documented on how these surgeries affect women's perceptions of their genitals. METHODS: The impact of LmL on patients' perceptions of their genitals was evaluated using the Female Genital Self-Image Scale (FGSIS). Patients who underwent LmL were asked to fill out the FGSIS before and after surgery from August 2011 to May 2019. The Scores ranged from 7 to 28. The higher the score the more positive the perception. Pre- and Post-op scores were directly compared. Testimonials were collected. RESULTS: N=231 underwent LmL surgery and filled out the Pre-Op Questionnaires (Qs). The pre-op scores ranged from 7 to 26, mean score equaled 15.02 and the median pre-op score was 15. For N=217 who completed the Post-Op Qs, post-op scores ranged from 14 to 28 with mean post-op score of 25.45 and median score of 27. Twenty-one patients required a second procedure with higher FGSIS scores after the second procedure. The difference between the pre-op (CI 14.51, 15.52) and post-op (CI 25.02, 25.95) scores was strongly statistically significant (on the average 10 points higher) with a P-value=2.2 × 10−16. CONCLUSION: Labiaplasty surgery appears to have a positive impact on patients' perceptions of their genitalia using the FGSIS and testimonials. Labiaplasty surgery improves quality of life for women of all ages. The FGSIS can be a useful tool for practitioners to assess the success of LmL surgery.

The Female Genital Self-image Scale in Adult Women With Vulvar Lichen Sclerosus.

There is no agreed upon standard way to measure vulvar lichen sclerosus disease severity. The Female Genital Self-Image Scale (FGSIS) is a validated survey tool assessing female genital self-image and is positively correlated with women's sexual function. A lower score represents a negative genital self-image. We evaluated the FGSIS in women with vulvar lichen sclerosus. Women with biopsy-proven lichen sclerosus and women presenting for routine gynecologic care without lichen sclerosus matched by age were surveyed with the 7-item FGSIS. National surveys of healthy women in the United States have shown the mean 7-item FGSIS score is 21. To detect one standard deviation (20% absolute difference) between groups with a power of 80% at p < .05, 15 women would are needed in each group. Sixteen women with lichen sclerosus and 16 matched controls were surveyed between February and July 2018. The mean ± SD age of women with lichen sclerosus was 56.8 ± 13.5 years, 94% were white, 69% married, 81% college educated, 69% postmenopausal, and 18% on hormone replacement therapy. None of these differences were statistically different from control women. Women with vulvar lichen sclerosus had a significantly lower median 7-item FGSIS when compared with control subjects, 18 (interquartile range = 16-21) versus 25 (interquartile range = 23-27), respectively, Mann-Whitney U test, p < .001. Women with vulvar lichen sclerosus have a lower score on the 7-item Female Genital Self-Image Scale compared with healthy controls.

Clitoral Phimosis: Effects on Female Sexual Function and Surgical Treatment Outcomes

BackgroundSurgery is the optimal treatment for a severe form of clitoral phimosis (CP) that is initiated by lichen sclerosus (LS) and causes female sexual dysfunction. AimWe aimed to determine the etiology of clitoral phimosis, its influence on sexual function, and outcomes after surgical treatment. MethodsIn this prospective cohort study, we observed the occurrence of clitoral phimosis and related changes in a group of 3,650 sexually active heterosexual women with a mean age of 34.8 ± 14.9 years (20–45 years) from September 2014 to September 2016. Ultimately, we compared the changes in sexual function and distress and satisfaction with postoperative genital appearance in 9 patients with severe clitoral phimosis at 12 months after surgical treatment. Main Outcome MeasuresSexual function was evaluated using the Female Sexual Distress Scale–Revised and the Female Sexual Function Index, and the patient’s genital self-image was evaluated using the Female Genital Self-Image Scale; gynecologic examinations were performed on all patients. ResultsVarious forms of CP were found in 46 of 3,650 patients (1.3%). Severe forms of CP were found in 9 cases, but it was complicated by stenosis of vaginal introitus in only 2 cases. These 9 patients underwent circumcision, and 2 of them underwent perineoplasty. Female sexual dysfunction occurred mainly in those with LS and severe forms of phimosis. Sexual function, as indicated by the total Female Sexual Function Index score, was significantly improved at 12 months after surgery (17.9 ± 0.9 vs 26.6 ± 0.5; P < .001). The Female Genital Self-Image Scale score assessing genital perception was significantly higher after surgery than before in women who underwent clitoral circumcision (20 ± 3.0 vs 12.3 ± 3.3; P < .001). The Female Sexual Distress Scale–Revised score was significantly lower after surgery than before (21.3 ± 6.2 vs 33.8 ± 6.9; P < .001). Sexual function in 2 women with CP and stenosis of vaginal introitus improved after surgery, but the sexual distress level did not decrease significantly. Clinical ImplicationsThe results of this study will help clinicians to centralize treatment methods and advise patients on the management of clitoral phimosis. Strengths & LimitationsThis is a study evaluating postoperative results of sexual function, distress, and satisfaction with genitalia in women with severe CP, using validated questionnaires. However, the small number of patients and the absence of an appropriate control group are limitations. ConclusionSurgical treatment of clitoral phimosis can improve sexual function, but because LS—a common underlying cause—is chronic in nature, patients may experience recurrence.Chmel R, M Nováčková, Fait T, et al. Clitoral Phimosis: Effects on Female Sexual Function and Surgical Treatment Outcomes. J Sex Med 2019;16:257–266.