Awareness about Vulvovaginal Aesthetics Procedures among Medical Students and Health Professionals in Saudi Arabia

Abstract

Objective The present study aimed to explore the opinion and ethical consideration of vulvovaginal aesthetics procedures (VVAPs) among health professionals and medical students in Saudi Arabia.

Methods This is a cross-sectional study performed between January 2020 and April 2020. Data was collected through electronic media, WhatsApp, and emails. The results were analyzed by applying the Students t-test, and correlations were considered significant if they presented a p-value < 0.05.

Results There is significant demand to educate doctors, health professionals, medical students, and gynecologists for the VVAPs to have a solid foundation, justified indications, and knowledge about various aesthetic options. Although female doctors, medical students, young doctors, and gynecologists have more knowledge about VVAPs, all health professionals ought to be aware of recent trends in vulvovaginal aesthetics (VVA). The present analysis determined that VVA should be under the domain of gynecologists, rather than under that of plastic surgeons, general surgeons, and cosmetologists. The majority of the participants considered that vaginal rejuvenation, “G-spot” augmentation, clitoral surgery, and hymenoplasty are not justifiable on medical grounds.

Conclusion The decision to opt for different techniques for vaginal tightening and revitalization should be taken very carefully, utilizing the shared decision-making approach. Ethical aspects and moral considerations are important key factors before embarking in the VVAPs purely for cosmetic reasons. Further research is required to determine the sexual, psychological, and body image outcomes for women who underwent elective VVAPs. Moreover, medical educators must consider VVAPs as part of the undergraduate and postgraduate medical curriculum.

Keywords

vulvovaginal cosmetic procedures - vulvovaginal aesthetics procedures - awareness about aesthetic surgery among health professionals - aesthetic gynecology - sexual and reproductive health

Contributors

All authors were involved in the design and interpretation of the analyses, contributed with the writing of the manuscript, read and approved the final manuscript.

Publication History

Received: 27 May 2020

Accepted: 03 December 2020

Article published online:
15 April 2021

• References

• 1 Alvisi S, Gava G, Orsili I, Giacomelli G, Baldassarre M, Seracchioli R. et al. Vaginal health in menopausal women. Medicina (Kaunas) 2019; 55 (10) 615 DOI: 10.3390/medicina55100615.
• 2 Caruso S, Cianci S, Fava V, Rapisarda AMC, Cutello S, Cianci A. Vaginal health of postmenopausal women on nutraceutical containing equol. Menopause 2018; 25 (04) 430-435 DOI: 10.1097/GME.0000000000001061.
• 3 Cox P, Panay N. Vulvovaginal atrophy in women after cancer. Climacteric 2019; 22 (06) 565-571 DOI: 10.1080/13697137.2019.1643180.
• 4 Desai SA, Dixit VV. Audit of female genital aesthetic surgery: changing trends in India. J Obstet Gynaecol India 2018; 68 (03) 214-220 DOI: 10.1007/s13224-018-1115-7.
• 5 Benincà G, Bosoni D, Vicariotto F, Raichi M. Efficacy and safety of dynamic quadripolar radiofrequency, a new high-tech, high-safety option for vulvar rejuvenation. Obstet Gynecol Rep 2017; 1 (03) 1-5 DOI: 10.15761/OGR.1000115.
• 6 Yodplob T, Sirisopana K, Jongwannasiri M, Sirisreetreerux P, Viseshsindh W, Kochakarn W. Local treatment with a polycarbophil-based cream in postmenopausal women with genitourinary syndrome of menopause. Int Urogynecol J Pelvic Floor Dysfunct 2020; ••• DOI: 10.1007/s00192-020-04282-9.
• 7 Goldstein AT, Mitchell L, Govind V, Heller D. A randomized double-blind placebo-controlled trial of autologous platelet-rich plasma intradermal injections for the treatment of vulvar lichen sclerosus. J Am Acad Dermatol 2019; 80 (06) 1788-1789 DOI: 10.1016/j.jaad.2018.12.060.
• 8 Amori P, Di Nardo V, Vitiello G, Franca K, Hercogova J, Wollina U. et al. Primavera: A new therapeutical approach to vulvo-vaginal atrophy. Dermatol Ther (Heidelb) 2018; 31 (06) e12678 DOI: 10.1111/dth.12678.
• 9 Cohen PR. Genital rejuvenation: the next frontier in medical and cosmetic dermatology. Dermatol Online J 2018; 24 (09) 13030
• 10 González IP, Leibaschoff G, Esposito C. et al. Genitourinary syndrome of menopause and the role of biostimulation with non-cross-linked injectable hyaluronic acid plus calcium hydroxyapatite. J Biol Regul Homeost Agents 2019; 33 (06) 1961-1966 DOI: 10.23812/19-251-L.
• 11 Figo Committee For The Ethical Aspects Of Human Reproduction And Women's Health. Ethical considerations regarding requests and offering of cosmetic genital surgery. Int J Gynaecol Obstet 2015; 128 (01) 85-86 DOI: 10.1016/j.ijgo.2014.10.003.
• 12 Hodžić S. Ascertaining deadly harms: aesthetics and politics of global evidence. Cult Anthropol 2013; 28 (01) 86-109 DOI: 10.1111/j.1548-1360.2012.01174.x.
• 13 Vieira-Baptista P, Lima-Silva J, Fonseca-Moutinho J, Monteiro V, Águas F. Survey on aesthetic vulvovaginal procedures: what do Portuguese doctors and medical students think?. Rev Bras Ginecol Obstet 2017; 39 (08) 415-423 DOI: 10.1055/s-0037-1603967.
• 14 Weinberger JM, Houman J, Caron AT, Anger J. Female sexual dysfunction: a systematic review of outcomes across various treatment modalities. Sex Med Rev 2019; 7 (02) 223-250 DOI: 10.1016/j.sxmr.2017.12.004.
• 15 Royal College of Obstetricians and Gynaecologists. Ethical opinion paper: ethical considerations in relation to female genital cosmetic surgery (FGCS) [Internet]. London:: RCOG Ethics Committee;; 2013 Oct [cited 2020 May 27]. Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/ethics-issues-and-resources/rcog-fgcs-ethical-opinion-paper.pdf
• 16 Weinberger JM, Houman J, Caron AT, Patel DN, Baskin AS, Ackerman AL. et al. Female sexual dysfunction and the placebo effect: a meta-analysis. Obstet Gynecol 2018; 132 (02) 453-458 DOI: 10.1097/AOG.0000000000002733.
• 17 Moss H, O'Neill D. Aesthetic deprivation in clinical settings. Lancet 2014; 383 (9922): 1032-1033 DOI: 10.1016/s0140-6736(14)60507-9.
• 18 Preti M, Vieira-Baptista P, Digesu GA, Bretschneider CE, Damaser M, Demirkesen O. et al. The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document. Neurourol Urodyn 2019; 38 (03) 1009-1023 DOI: 10.1002/nau.23931.
• 19 Peiretti M, Corvetto E, Candotti G, Angioni S, Figus A, Mais V. New Keystone flap application in vulvo-perineal reconstructive surgery: A case series. Gynecol Oncol Rep 2019; 30: 100505 DOI: 10.1016/j.gore.2019.100505.
• 20 Rubinsak LA, Christianson MS, Akers A, Carter J, Kaunitz AM, Temkin SM. Reproductive health care across the lifecourse of the female cancer patient. Support Care Cancer 2019; 27 (01) 23-32 DOI: 10.1007/s00520-018-4360-5.
• 21 Pinto H, Fontdevila J. Eds. Regenerative medicine procedures for aesthetic physicians. Cham: Springer; 2019
• 22 Placik OJ, Devgan LL. Female genital and vaginal plastic surgery: an overview. Plast Reconstr Surg 2019; 144 (02) 284e-297e DOI: 10.1097/PRS.0000000000005883.
• 23 Rabley A, O'Shea T, Terry R, Byun S, Louis Moy M. Laser therapy for genitourinary syndrome of menopause. Curr Urol Rep 2018; 19 (10) 83 DOI: 10.1007/s11934-018-0831-y.
• 24 Schiavi MC, Di Tucci C, Colagiovanni V, Faiano P, Giannini A, D'Oria O. et al. A medical device containing purified bovine colostrum (Monurelle Biogel) in the treatment of vulvovaginal atrophy in postmenopausal women: Retrospective analysis of urinary symptoms, sexual function, and quality of life. Low Urin Tract Symptoms 2019; 11 (02) O11-O15 DOI: 10.1111/luts.12204.
• 25 Royal Australian College of General Practitioners. Female genital cosmetic surgery - A resource for general practitioners and other health professionals [Internet]. Melbourne: RACGP; 2015 [cited 2020 May 5]. Available from: https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/female-genital-cosmetic-surgery
• 26 VanderBrink BA, Stock JA, Hanna MK. Aesthetic aspects of reconstructive clitoroplasty in females with bladder exstrophy-epispadias complex. J Plast Reconstr Aesthet Surg 2010; 63 (12) 2141-2145 DOI: 10.1016/j.bjps.2010.02.005.
• 27 Reichman O, Margesson LJ, Rasmussen CA, Lev-Sagie A, Sobel JD. Algorithms for managing vulvovaginal symptoms-a practical primer. Curr Infect Dis Rep 2019; 21 (10) 40 DOI: 10.1007/s11908-019-0693-6.