CC BY 4.0 · Arch Plast Surg 2023; 50(05): 452-462
DOI: 10.1055/a-2113-3202
Review Article

Current Perspectives in Vaginal Laxity Measurement: A Scoping Review

1   External Genitalia Section, Division of Plastic Reconstructive and Aesthetic Surgery, Department of Surgery, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
1   External Genitalia Section, Division of Plastic Reconstructive and Aesthetic Surgery, Department of Surgery, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
› Author Affiliations


This scoping review aimed to identify and categorize the available measurement options for vaginal laxity (VL), their indications of use, and whether these measurements can sufficiently provide objective clinical judgment for cases indicated for vaginal rejuvenation with many treatment options nowadays. Systematic searches were conducted on five electronic databases, manually searching articles' bibliographies and predetermined key journals with no date or study design limitations. We included all studies involving VL in their inclusion criteria, treatment indications, and outcome parameters. We used the Arksey and O'Malley frameworks as the guideline in writing this scoping review. Of the 9,464 articles identified, 66 articles and 11,258 subjects were included in the final analysis. The majority of studies were conducted in obstetrics and gynecology (73%), followed by plastic surgery (10%), medical rehabilitation (4.5%), dermatology (4.5%), and others (8%). Most studies originated from the North American region (30%). The following measurement tools were used: (1) interviews, (2) questionnaires, (3) physical/digital examinations, (4) perineometers, and (5) others. Our results suggested that subjective perception of laxity confirmed by directed interview or questionnaire is sufficient to confirm VL. Additional evaluation of pelvic floor muscle through digital examination or perineometer or other preferred tools and evaluation of sexual function through validated questionnaire (Female Sexual Function Index, Female Sexual Distress Scale-Revised, etc.) should follow to ensure holistic care to patients. Future research on the psychometric properties (reliability and validity) of commonly used measurements and the correlation in between subjective and objective measurements should be initiated before their clinical applications.


This paper was accepted for the Oral Presentation and presented at the PRS Korea 2021 (November 12–14, 2021).

Authors' Contributions

I.A.: Conceptualization, investigation, validation, writing-reviewing and editing, supervision, and project administration.

M.V.: Methodology, data curation, writing-original draft preparation, and visualization.

Ethical Approval

This scoping review did not require ethical approval because this study extracted and synthesized data from published studies.

Patient Consent

This scoping review did not require patients' concern because this study extracted and synthesized data from published studies.

Supplementary Material

Publication History

Received: 09 October 2022

Accepted: 15 June 2023

Accepted Manuscript online:
20 June 2023

Article published online:
31 August 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

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