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Background: This study aims to document a woman's external genitalia data in the form of a labiogram and investigate whether variations in the size of specific components of a woman's external genitalia can influence her overall satisfaction with the esthetic appearance of her genitalia. Methods: A cross-sectional observational study was carried out on a sample of 500 Iranian women. Socio-demographic information was collected for all participants, and they completed the Female Genital Self-Image Scale (FGSIS) questionnaire. Measurements of different external genitalia components were obtained for all participants. Results: The findings revealed that there was no significant association between the measurements of the external genitalia and age or BMI. However, a significant negative correlation was observed between the total score on the FGSIS and specific parameters related to the width of different sections of the labia minora. The correlations were as follows: left lower third (r = − 0.305), lower right third (r = − 0.302), left middle third (r = − 0.365), right middle third (r = − 0.435), left upper third (r = − 0.397), and right upper third (r = − 0.407) (P value< 0.001). Moreover, cutoff points of 1.95 cm on the left side and 1.90 cm on the right side were identified through analysis as thresholds for predicting dissatisfaction among women. Conclusion: This study suggests that the width of the labia minora might influence certain women's motivation to undergo labiaplasty, a surgical procedure designed to modify the labia minora. To help women make informed decisions, it is crucial for those considering the procedure to have a comprehensive understanding of different labia minora types, potential benefits, and associated risks. By being well-informed, individuals can make choices that align with their personal preferences and priorities. Level of Evidence IV: 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. [ABSTRACT FROM AUTHOR]

Objectives: Hypertrophy of the labia minora and majora, or a prominent clitoral hood, are the primary reasons why women, particularly those seeking cosmetic gynecologists, may experience limitations in their social environments. At the same time, modern trends have made labiaplasty popular in recent years. This study investigated the effect of labiaplasty on women's genital self-perception and sexual functions. Material and methods: The composite reduction labiaplasty technique was performed on 33 women aged 18--50 with Grades 2--4 labia minora hypertrophy. The exclusion criteria included menopausal and sexually inactive women, as well as women with vulvar disorders, a history of vaginal or labial surgery, other gynecological disorders, psychological disorders, and malignancies. The Female Sexual Function Index (FSFI) and Female Genital Self-Image Scale (FGSIS) questionnaires were administered to the study subjects before and three months after their surgery, during their follow-up appointments. Results: The mean age of the subjects was 30.73 ± 3.94 years. Their mean parity was 1.12 ± 0.82. Almost 70% of them had a university degree. Their most common reason for desiring labiaplasty was aesthetic concerns (48.48%). Their total FGSIS scores were 11.85 ± 1.35 preoperatively and 24.48 ± 1.66 postoperatively, and their total FSFI scores were 13.29 ± 1.68 preoperatively and 24.48 ± 1.66 postoperatively. Conclusions: Labiaplasty surgery is a safe surgical procedure. It has a positive effect on women's genital self-image and sexual functions. [ABSTRACT FROM AUTHOR]

Hair thread tourniquet syndrome occurs when tissue is strangulated by a hair thread. It occurs most commonly in the digits of infants and young children, but can also occur in the genitalia. A 13-year-old postmenarchal girl with several days of severe vulvar pain and swelling presented to the emergency department. Diagnosis was unclear and she was referred to pediatric and adolescent gynecology. Pelvic examination under anesthesia revealed a hair thread tourniquet involving the bilateral labia minora. The hair tourniquet and portions of bilateral labia minora were excised. Why Should an Emergency Physician Be Aware of This? Genital hair thread tourniquet syndrome is uncommon but must be considered in patients with severe genital pain and swelling. Prompt diagnosis and treatment are important to prevent tissue necrosis and may be facilitated by means of a pelvic examination with sedation. [ABSTRACT FROM AUTHOR]

Cosmetic labiaplasty is focusing on the deliberate alteration of external genitalia without medical reasons. It highlights the growing understanding of diverse genital anatomy, suggesting that the labia minora innervation contributes to sexual arousal and pleasure. The measurement of female vulva structure is crucial for aesthetic standards and surgical planning. Past research gathered labia minora measurements from various countries, races, and age groups. As women's expectations for vulva appearance increase, the demand for labia minora plastic surgery rises, emphasizing the importance of safety and effectiveness. To enhance surgical planning, this article addresses the histology, anatomy, data measurement, aesthetics, blood supply, and nerve innervation of the labia minora, considering both its morphological beauty and functional requirements. [ABSTRACT FROM AUTHOR]

[Display omitted] • Amputation of the labia minora predisposes to over-resection. • Central wedge resection predisposes to ischemic complications. • Modified delamination predisposes to clitoral compression and atrophy. • The association between the concept of operation and severe complication is strong. • A surgeon should consult women about labia minora cosmetic surgery severe complications. Gynecologists need resources related to labia minora, severe cosmetic surgical complications currently unavailable in the medical literature. Women's requests for genital cosmetic surgery significantly increased within the last two decades; however, the medical literature does not report severe complications and their causes. Therefore, the author hypothesizes that currently used surgical concepts for labia minora reduction are partially responsible for cosmetic surgical debilitating complications. This clinical research aims to present photo documentation of severe surgical complications associated with various cosmetic surgical interventions. A prospective case series study was conducted in a single gynecologic corrective surgical practice to show different debilitating symptoms associated with labia minora cosmetic surgery. Primary data sources were obtained from direct clinical examinations. Secondary data sources were acquired from scientific-clinical and psychological medical literature articles, websites, medical records, procedure reports, statistical data, and recommendations. Data collection was done prospectively, and data analysis performed retrospectively included variable clinical observations and the severity of symptoms related to different surgical technique concepts. Patients were exposed to medical interviews, examinations, discussions, and validated questionnaires. In addition, an analysis of commonly used surgical cosmetic intervention concepts scrutinized (labia minora amputation, central wedge resection, and labial delamination). The single practice center for corrective cosmetic surgery. The study's sample size was 110 women with severe cosmetic surgical complications of labia minora. The primary outcome measures the prior cosmetic surgical intervention outcomes of the labia minora, and the secondary outcome measures the occurrence of symptoms. Procedure duration was measured from the initial incision to the last suture placement. The follow-up study was conducted at a one-year interval for three years. The labia minora cosmetic severe complications were associated in 76 % with labial amputation, 21% with central wedge resection, and 3% with modified delamination. The most common symptomatic complication in labia minora amputation was over-resection. In all subjects, debilitating physical pain, neurological pain, psychological disorders, and sexual dysfunction were observed. Current labia minora cosmetic surgical concepts contribute to severe surgical complications with debilitating physical, emotional, and sexual dysfunction. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the motivations for Chinese patients seeking operative labiaplasty. Data was collected from January 2018 to December 2019 using a standardized questionnaire, which examined factors influencing patients' motivations, including aesthetic and functional reasons, as well as psychological factors. Of the 216 patients who responded to the questionnaire within 24 months, 22.2% cited cosmetic reasons, while 38.4% reported functional discomfort. Both functional and aesthetic reasons were cited by 35.2% of patients, while 4.2% reported psychological troubles. It is noteworthy that patients who sought surgical intervention for physical complaints did so as a personal decision, and only 6.3% of patients seeking labiaplasty for cosmetic reasons were influenced by their sexual partner. Additionally, 7.9% and 66.7% of patients with other motivations were influenced by their male spouse, while 2.6% and 33.3% were influenced by the media. In conclusion, this study suggests that most Chinese patients seek labiaplasty for functional reasons, with few being influenced by sexual partners or media. What is already known on this subject? The growing demand and interest in labiaplasty surgery has been widely acknowledged. Existing reports from western countries have highlighted that aesthetic concerns are the primary motivations behind patients' requests for this surgical intervention. However, there is limited information available regarding the factors influencing Chinese patients' decisions to undergo labiaplasty, as China has a large population. Therefore, the specific reasons behind Chinese patients' requests for labiaplasty are not well understood. What do the results of this study add? This clinical study focuses on the perspectives of eastern women regarding labia reduction surgery, contributing to the existing literature on this topic. Notably, this study is one of the few that examines the request for surgical reduction of hypertrophy of the labia minora and highlights that not all patients undergo surgical intervention purely for personal reasons. What are the implications of these findings for clinical practice and/or further research? The implications of these findings for clinical practice and further research are significant. Given the increasing demand for labiaplasty, gynecologists in Australia, Western Europe, the United States, and New Zealand are likely to encounter a rising number of women seeking labial reduction surgery. Similarly, labiaplasty has become an increasingly popular cosmetic surgery procedure in China. This study's results differ from previous research, which suggested that functional concerns were the primary motivation for women seeking to undergo labiaplasty. The request for pursuing labiaplasty is influenced not only by personal preferences but also by external factors. Therefore, a comprehensive evaluation before considering the procedure is crucial, and if practitioners are unsure, multidisciplinary specialized evaluation should be considered. [ABSTRACT FROM AUTHOR]

Introduction: A vulvar hematoma is a hemorrhagic fluid collection in the female external genitalia. The majority occur as an obstetrical complication, especially during labor. Non-obstetrical vulvar hematomas are usually the result of trauma, with coitus being the most common etiology.Case Report: We present the case of a 25-year-old woman with significant vaginal pain and swelling after vigorous sexual intercourse. She exhibited tenderness and swelling of the left labia majora and minora. The differential diagnosis included bleeding, abscess, and deep venous thrombosis. Laboratory studies were normal and computed tomography of the pelvis indicated the swelling was most likely due to blood. The patient was taken to the operating room, and approximately 150 cubic centimeters of clot was evacuated. The patient had an uneventful recovery and was discharged home the next day.Conclusion: This case illustrates the unique presentation and challenges in making the diagnosis of vulvar hematoma.

This study aimed to investigate the motivations for Chinese patients seeking operative labiaplasty. Data was collected from January 2018 to December 2019 using a standardized questionnaire, which examined factors influencing patients’ motivations, including aesthetic and functional reasons, as well as psychological factors. Of the 216 patients who responded to the questionnaire within 24 months, 22.2% cited cosmetic reasons, while 38.4% reported functional discomfort. Both functional and aesthetic reasons were cited by 35.2% of patients, while 4.2% reported psychological troubles. It is noteworthy that patients who sought surgical intervention for physical complaints did so as a personal decision, and only 6.3% of patients seeking labiaplasty for cosmetic reasons were influenced by their sexual partner. Additionally, 7.9% and 66.7% of patients with other motivations were influenced by their male spouse, while 2.6% and 33.3% were influenced by the media. In conclusion, this study suggests that most Chinese patients seek labiaplasty for functional reasons, with few being influenced by sexual partners or media.Impact statement What is already known on this subject? The growing demand and interest in labiaplasty surgery has been widely acknowledged. Existing reports from western countries have highlighted that aesthetic concerns are the primary motivations behind patients' requests for this surgical intervention. However, there is limited information available regarding the factors influencing Chinese patients' decisions to undergo labiaplasty, as China has a large population. Therefore, the specific reasons behind Chinese patients' requests for labiaplasty are not well understood. What do the results of this study add? This clinical study focuses on the perspectives of eastern women regarding labia reduction surgery, contributing to the existing literature on this topic. Notably, this study is one of the few that examines the request for surgical reduction of hypertrophy of the labia minora and highlights that not all patients undergo surgical intervention purely for personal reasons. What are the implications of these findings for clinical practice and/or further research? The implications of these findings for clinical practice and further research are significant. Given the increasing demand for labiaplasty, gynecologists in Australia, Western Europe, the United States, and New Zealand are likely to encounter a rising number of women seeking labial reduction surgery. Similarly, labiaplasty has become an increasingly popular cosmetic surgery procedure in China. This study's results differ from previous research, which suggested that functional concerns were the primary motivation for women seeking to undergo labiaplasty. The request for pursuing labiaplasty is influenced not only by personal preferences but also by external factors. Therefore, a comprehensive evaluation before considering the procedure is crucial, and if practitioners are unsure, multidisciplinary specialized evaluation should be considered.

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 (p 0.001) and discomfort symptoms (p 0.001). 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. [ABSTRACT FROM AUTHOR]

Background: In this study, we aimed to introduce a new technique of labiaplasty and to evaluate the effect of this novel technique on female genital self-images, and sexual outcomes and to assess the feasibility of this novel technique. Methods: We conducted a single-center, retrospective study in 59 women who underwent labiaplasty and vaginoplasty (29 Freya approach technique, 30 classic technique) from 2020 to 2022. Both groups evaluated before (within 7 days) and after (1 month after) surgery with Female Sexual Function Index (FSFI) and Female Genital Self-Image Scale (FGSIS) questionnaires and all the patients received postoperative care and follow-up assessments for complications 7 days and 1 month after surgery. Results: The Freya approach technique was associated with a shorter operation time (p < 0.05) and significantly lower postoperative Visual Analogue Scale (VAS) scores (p < 0.001). Both techniques increased FSFI scores (p < 0.001) and total FGSIS scores (p < 0.001). With the exception of a few cases of wound dehiscence that necessitated surgical correction (n = 1), wound healing occurred without complications. The outcomes were deemed highly satisfactory both aesthetically and functionally (p < 0.001). Conclusions: Freya approach technique is a simple and safe technique. It is effective in improving genital appearance and sexual satisfaction. Although this novel approach has similar satisfaction rates with other surgical techniques, it could be useful to reduce surgery time and postoperative pain.

Epidermal cysts are intradermal or subcutaneous tumors that can develop as a result of female genital mutilation (FGM) procedures or other traumatic events. The differential diagnosis of epidermal cysts in the vulvar or clitoral region depends on the age of presentation, with non-hormonal conditions like neurofibromatosis and nevus lipomatous cutaneous superficiality being considered in pediatric patients. A 54-year-old female presented with urinary retention and a large vulvar mass. Imaging confirmed an epidermal cyst, which was surgically excised with successful resolution of the patient's symptoms and normal cosmetic appearance. Epidermoid cysts are common benign lesions that can rarely occur on the vulva, including the labia minora. These cysts may be congenital or acquired and can cause discomfort or urinary obstruction when large. Thorough clinical evaluation and imaging are crucial for accurate diagnosis and surgical planning. Excision is often recommended, especially for large, symptomatic cysts, to manage the condition and obtain a definitive diagnosis. Vulvar epidermoid cysts, though rare, can occur on the labia minora. Differentiating these from other vulvar lesions and managing large, symptomatic cysts is challenging due to limited literature. This case highlights the need for comprehensive clinical evaluation, including history, exam, and imaging, to accurately diagnose and manage these rare cysts. Surgical excision is often recommended, considering potential complications. Further documentation is needed to improve the diagnosis and management of vulvar epidermoid cysts. • A 54-year-old virgin female had a large vulvar epidermal cyst causing urinary issues • successfully managed via surgical excision. [ABSTRACT FROM AUTHOR]

PurposeTo investigate the shape of labia minora in Chinese adult women.MethodsWomen who visited the Genital Plastic Surgery Center from January 2021 to February 2022 were included and the vulvar regions were photographed. The shape of the labia minora was converted into quantifiable values [left side line segment 1–9 (L1–L9 values) and right side line segment 1–9 (R1–R9 values)]. The 400 enrolled patients were grouped by age, parity, and the types of vulvar surgeries they planned to undergo.ResultsAfter a graphic-to-digital and digital-to-graphic conversion, the simulated average image of the labia minora in Chinese adult women was constructed based on the mean values of L1–L9 and R1–R9. Comparing the values of Ln and Rn in the four age groups revealed that the mean values of Ln and Rn gradually decreased with age, but only two subgroups showed statistically significant differences (P-value 0.05).ConclusionTo measure and evaluate the labia minora, a new assessing method was used. It is an innovative attempt to transform the simple rough description of the shape of the labia minora into more precise data reflecting the shape features. It allows the comparison of labia minora shape between individuals by comparing quantifiable values. Besides, the average shape of labia minora in Chinese adult women was provided visually. Factors including age, parity, and whether the patient planned to undergo labiaplasty were not significantly associated with the shape of the labia minora.

Hair Tourniquet Syndrome (HTS) is defined as strangulation by a hair thread of the appendage of the human body, especially in the children population, it rarely occurs in external genitalia (clitoris, labia majora and minora). Herein, we aimed to present a rare occurrence of HTS around the labia minora in a 12-year-old child treated by excision of the cystic lesion with an uneventful follow-up. Special care should be given to every swollen appendage in children to avoid severe consequences such as amputation and disfigurement. [ABSTRACT FROM AUTHOR]

Introduction: Labia minora hypertrophy can be characterized by the labial tissue extending beyond the labia majora; however, the exact definition of hypertrophy is a matter of debate. While the prevalence of labia hypertrophy is very common among women, taboo/controversial attitudes and surgical interventions still dominate. The recognition and study of labia minora hypertrophy will increase our knowledge of this underrepresented anatomic diversity., Objectives: To provide a report of the current literature on labia hypertrophy and discuss the definition, etiology, attitudes, management, and medicalization surrounding labia minora hypertrophy and the implications., Methods: Comprehensive review of literature pertaining to labia minora hypertrophy., Results: Labia minora appearance and measurements vary extensively, and hypertrophy is extremely prevalent in the population and largely nonpathologic. There remains a lack of standardized criteria to define labia hypertrophy. Attitudes surrounding labia hypertrophy differ globally, but in Western nations the overwhelming sentiment toward labia hypertrophy has largely been medicalized., Conclusion: Negative attitudes and unnecessary medicalization of nonpathologic instances of labia hypertrophy is unjustifiable and comes with potential risks. There remains an impending need to demedicalize nonpathologic elongated labia, educate the public on diverse genital appearance, and improve understanding of the long-term outcomes and risks of genital cosmetic surgery., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.)

Female genital mutilation (FGM) includes all procedures that involve partial or total removal of the female external genitalia or any other injury of the female genitalia that is performed for nonmedical reasons. FGM is classified into 4 types. Surgical clitoral reconstruction was first described by Thabet and Thabet in Egypt and subsequently by Foldès in France. The technique was then modified by different authors. This article aims to provide a detailed description of clitoral surgical reconstruction and the modifications which have been made over time to improve the procedure while recalling current knowledge in the anatomy of the clitoris. We performed a broad systematic search in PubMed/Medline and EMBASE bibliographic databases for studies that report the surgical technique of clitoral reconstruction. From the anatomical point of view, we examined available evidence (from 1950 until 2020) related to clitoral anatomy, the clitoral role in sexual functioning, female genital mutilation/cutting, and surgical implications for the clitoris. A review of the surgical techniques for clitoral reconstruction after female genital mutilation/cutting We described the current anatomical knowledge about the clitoris, and the procedures based on the surgical technique by Pierre Foldès, We included the technical modifications and contributions described in articles published subsequently. Surgical repair of the clitoris for FGM offers anatomical and functional results although they still have to be evaluated. However, it should not be the only therapeutic solution offered to women with FGM. Botter C, Sawan D, SidAhmed-Mezi M, et al. Clitoral Reconstructive Surgery After Female Genital Mutilation/Cutting: Anatomy, Technical Innovations and Updates of the Initial Technique. J Sex Med 2021;18:996–1008. [ABSTRACT FROM AUTHOR]

Labia minora hypertrophy is the prolongation of these beyond the anatomical limits of the labia majora. The belief in simplicity in the reduction of the labia minora and the failure to observe important aspects of the surgical technique that lead to total lip resection. In such cases, reconstructive surgery is the only possible way to rectify the situation. A 36-year-old woman with medical history of labia minora amputation secondary to labiaplasty surgery for hypertrophy of the labia minora performed by a beautician. The labia minora reconstruction is performed in two surgical stages. The V-Y advancement flaps of the clitoral hood with remnants of tissue from the posterior fork can be achieved with satisfactory results and allow adaptation to the genital anatomy and unique aesthetic wishes of each woman. [ABSTRACT FROM AUTHOR]

The fibroepithelial polyps (FEPs) of vulva are uncommon tumours. They are benign in nature and mainly found in reproductive years. They are mostly solitary, pedunculated, and small in size. Histopathologically underneath the hyperplastic, surface epithelium stellate and multinucleated stromal cells are present, the central core is fibrovascular. Presenting symptoms usually include cosmetic concerns, sensation of a mass, bleeding, and discharge. For confirmation and to exclude malignancy biopsy is required. In literature, there is no mention of time taken for progression of polyp. We present a case of rapidly growing large fibroepithelial polyp of vulva. [ABSTRACT FROM AUTHOR]

Genital dissatisfaction in healthy young women is on the rise. Pubic hair removal reveals genital tissue previously hidden, while social trends promote the absence of any protruding genital tissue as the feminine ideal. Information with regard to the natural diversity of external genitalia anatomy, and lifestyle changes to improve physical symptoms related to labial tissue may suffice to reassure a distressed adolescent. Female genital cosmetic surgery is rarely supported, before attaining genital maturity. However, genital dissatisfaction may lead to significant embarrassment and anxiety, requiring formal psychological counselling. Sexual education needs to counterbalance perceived normal anatomy, portrayed in pornography or female genital cosmetic surgery advertisements. [ABSTRACT FROM AUTHOR]

Objective: To describe the novel surgical technique of urethral lengthening in anterolateral thigh and superficial circumflex iliac artery perforator flap phalloplasty with a pedicled labia minora flap (PLMF) and report on the clinical outcomes.Methods: Between March 2014 and August 2018, 16 transgender men underwent phalloplasty with a PLMF for urethral lengthening at the Amsterdam UMC (VU university), the Netherlands and the Belgrade University Hospital, Serbia. Patient demographics, surgical characteristics, neourethra characteristics, intra- and postoperative complications, pre-and postoperative voiding evaluation, and the length of hospital stay were retrospectively identified from chart reviews.Results: The mean neourethral length was 16.8 ± 2.3 cm, and the pars pendulans 11.7 ± 2.2 cm. The neomeatus was localized on top of the neophallus in 12 (75%) patients. No intraoperative complications occurred. Urethral fistula formation occurred in 4 (25%) patients and strictures in 6 (37.5%) patients. In 3 (18.7%) patients a (temporary) perineostomy had to be performed. Voiding from a standing position was possible in 9 (56.3%) patients.Conclusion: The PLMF for urethral reconstruction, both pars fixa and pars pendulans, in phalloplasty is a feasible surgical technique in transgender men undergoing anterolateral thigh or superficial circumflex iliac artery perforator flap phalloplasty with sufficient labia minora tissue. [ABSTRACT FROM AUTHOR]

Background: Several studies have been published to present normal values of female genitalia in different age and racial groups., Aim: The primary objective of our study was to measure the parameters of the external genitalia in adult Iranian women, record the data using the Labiagram system (the first national Labiagram design in Iran), and establish a preliminary database., Methods: A descriptive study was conducted from March 2022 to December 2022, involving 220 nonpregnant adult women who presented to the gynecology clinic. Women who met the inclusion criteria for the study underwent a comprehensive examination of the external genitalia. The data collected during the examinations were recorded in electronic files and the Labiagram system., Outcomes: The data showed the diversity of external genital parameters of nonpregnant adult Iranian women., Results: In this descriptive study, the mean ± SD age of the participants was 51.5 ± 13.44 years, ranging from 15 to 84 years. A total of 192 women (87.3%) had a history of vaginal delivery. There was no statistically significant difference observed in the average measurements of the vulva among the 4 age groups ( P  < .05). The Pearson correlation coefficient test indicated a statistically weak correlation between body mass index and perineum length ( r  = 0.174, P  = .010). Additionally, a weak correlation was found between body mass index and the width of the labia minora at the left-lower point ( r  = 0.143, P  = .030) and the right-middle point ( r  = 0.146, P  = .031). Furthermore, the results demonstrated that women with a history of vaginal delivery had a significantly longer introitus (49.3 vs 44.3 mm, P  = .037), longer labia majora (91.3 vs 87.3 mm, P  = .046), and longer labia minora (56.8 vs 50.9 mm, P  = .008) when compared with women without prior labor experience., Clinical Implications: The data will be used as a basis for future studies., Strengths and Limitations: The use of simple tools for the measuring, data recording, and digital drawing of female external genital anatomy, along with privacy protection, is one of the strengths of this research. The weakness is the small sample size, which is the reason for piloting the Labiagram chart for more extensive studies., Conclusion: Increasing age and the number of births had no statistically significant effect on the size of external genital parameters among Iranian women. Despite the considerable diversity in these parameters, it has not resulted in a significant demand among Iranian women for female cosmetic surgery., Competing Interests: No financial aid was received from any institution, organization, or person to conduct this study., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society of Sexual Medicine.)

La nymphoplastie est une chirurgie actuellement en plein essor. Le nombre de publications concernant ce sujet est aussi en nette augmentation. Avec l'augmentation des cas opérés, nous constatons de plus en plus de consultations pour des reprises après nymphoplastie, appelées nymphoplasties secondaires. L'auteur rapporte ici son expérience concernant la nymphoplastie secondaire à propos de 44 cas. L'étude réalisée par l'auteur reporte 44 cas répartis en deux catégories de nymphoplasties secondaires. La première catégorie est caractérisée par les désunions, dont celles suite aux opérations lambda laser réalisées par l'auteur réparées sous anesthésie locale après avivement des berges et suture. La deuxième catégorie est caractérisée par des over -résections ou des amputations voire, des reliquats de lambeaux atypiques. L' over -résection est une faute technique. Dans ce cas, la technique employée pour améliorer l'aspect esthétique, fonctionnel et psychologique est l'utilisation des restes de petite lèvre sous forme de lambeau pour éviter un aspect en bec à la partie antérieure et postérieure. L'utilisation du lipofilling des grandes lèvres permet de masquer la zone et d'améliorer la fonction. L'avenir de cette chirurgie est probablement à la reconstruction des petites lèvres par lambeau local. La conclusion de l'étude est qu'il faut impérativement que les chirurgiens réalisant des nymphoplasties soient formés tant en anatomie, qu'aux techniques de nymphoplastie et évitent le plus possible des résections excessives voir des amputations, la réparation étant souvent difficile. Labiaplasty is a surgery currently booming. The number of publications on this subject is also increasing significantly. With the increase of the operated cases, we see more and more consultations for revisions after a labiaplasty, called secondary labiaplasty. The author reports here his experience with secondary labiaplasties in 44 cases. The study carried out by the author reports 44 cases divided into two categories of secondary labiaplasties. The first category is characterized by a wound dehiscence, including those following the author's lambda laser procedures, which are easily repaired under local anesthesia after border cutting and suture. The second category is characterized by over-resections or real amputations or even remains of atypical flaps. The over-resection is a technical fault. In this case, the technique used to improve the aesthetic, functional and psychological aspect is the use of the remains of labia minora in the form of a flap to avoid a dog-ear appearance at the anterior and posterior part. The use of lipofilling of the labia majora is to mask the area and improve the function. The future of this surgery is probably the reconstruction of the labia minora by local flaps. The conclusion of the study is that it is imperative that surgeons performing labiaplasties be trained in both anatomy and labiaplasty techniques and avoid as much as possible over-resections and amputations, mending being often difficult. [ABSTRACT FROM AUTHOR]

Purpose: To report current results of vaginoplasty using the mucosa of the prepuce, and creating labia minora by penile skin in children with disorders of sex development (DSD).Methods: In 10 years, we have performed 22 vaginoplasties using the described technique of vaginoplasty, 21 patients with 46, XX DSD and 1 ovotesticular DSD. The assessment of the results of this technique of vaginoplasty was undertaken in several stages: (a) The evaluation of the cosmetic result. (b) The research for a urinary incontinence and urethrovaginal fistulas. (c) The research for a vaginal stenosis by the introduction of a lubricated feeding tube into the vaginal cavity.The labia minora was evaluated by three criteria: its skin should be thin and very supple, it should have a free edge which partially or totally covers the clitoris, urethral meatus, and vaginal orifice; and it is preferable that its color be darker than the rest of the skin.Results: The cosmetic outcome was considered by parents and the surgeon as very satisfactory in 11 patients (50% of cases), satisfactory in 4 patients (18.2%), and unsatisfactory in 7 patients (31.8%). The postoperative complications were five cases of proximal stenosis (22.7%), one distal stenosis (stenosis of introitus) and two necrosis of the preputial flap. No urethrovaginal fistula and urinary incontinence were reported.Conclusions: In infant and young child, when it is difficult to make use of complete urogenital mobilization, the mucosa of the prepuce can be an alternative to create a neovagina, its histological constitution is identical to a vaginal wall, and it does not prevent to have a good labia minora. [ABSTRACT FROM AUTHOR]

Labia minora hypertrophy is a relatively uncommon surgical entity being popularised in the realm of vulvovaginal plastic surgeries. Apart from the unaesthetic appearance of the hypertrophied minora, these cases are also associated with itching, hygiene problem, pain while sitting down, sports activities, difficulty in wearing tight clothing, bleeding and discomfort while or after sexual intercourse, social embarrassment, insecurity and psychological diminution of confidence and self-esteem. In a country like India, due to sociocultural reasons, patients hesitate to consult a doctor for such deformities. Most of the patients suffer in silence for years. Although common in the west, very few surgeons in the country perform this simple and rewarding surgery. Here, we are presenting a case of premenarchal juvenile labia minora hypertrophy (JLMH) in an 8-year-old child. Labial hypertrophy in this age group is uncommon. We were unable to find hypertrophy of labia minora in the eight-year-old child on English literature search.