Mounting evidence indicates that female genital aesthetic complaints impact sexual relationships.
The study sought to determine the strength of the correlation between genital self-image and sexual function.
Electronic databases were comprehensively searched including PubMed, Web of Science, Scopus, PsycINFO, Embase, and the Cochrane Library from January 2000 to December 2022. After duplicate removal, 146 articles were retrieved by searching keywords in titles and abstracts.
A positive correlation is noted between genital self-image and sexual function; the strength of this correlation was 0.375.
By omitting irrelevant articles according to the eligibility criteria, 16 articles remained for a total of 13 505 participants. All but 1 of them indicated a statistically significant positive correlation between genital self-image and sexual function. For a more accurate result, a meta-analysis was conducted noting a considerable heterogeneity.
The results of this study may be used in counseling women with sexual dysfunction who are dissatisfied with their genital appearance.
This study is the first systematic review to reveal the strength of the correlation between genital self-image and sexual function. The most important limitation of this study is the heterogeneity of the studies reported.
This systematic review indicates a positive correlation between genital self-image and sexual function. The results are restricted by inconsistency of the articles considered. Using different tools in different cultural contexts without considering confounding factors leads to a wide range of correlation sizes and significant heterogeneity is evident.

BACKGROUND: Research on long-term results of hypospadias has focused on surgical techniques and functional outcomes, and it is only recently that patient satisfaction with appearance and psychosocial outcomes have been considered. The aim of this study was to provide an evidence-based systematic review of adolescent and adult patient perceptions of cosmetic outcomes following childhood surgery for hypospadias.
METHODS: A systematic review was performed in accordance with the PRISMA and PICO guidelines, and studies assessed using the Oxford Centre for Evidence-Based Medicine system. MEDLINE, PsycInfo, EMBASE, and CINAHL databases were searched from 1974 to 2014 for clinical studies containing patient perceptions of appearance, deformity, and social embarrassment following hypospadias surgery.
RESULTS: A total of 495 publications were retrieved, of which 28 met the inclusion criteria. Due to study design/outcome measure, heterogeneity data were synthesized narratively. Results indicate (i) patient perceptions of penile size do not differ greatly from the norm; (ii) perceptions of appearance findings are inconsistent, partially due to improving surgical techniques; (iii) patients who are approaching, or have reached, sexual maturity hold more negative perceptions and are more critical about the cosmetic outcomes of surgery than their prepubertal counterparts; (iv) patients report high levels of perceptions of deformity and social embarrassment; and (v) there is a lack of data using validated measurement tools assessing long-term patient perceptions of cosmetic outcomes, particularly with patients who have reached genital maturity.
CONCLUSIONS: Protocols for clinical postpuberty follow-up and methodologically sound studies, using validated assessment tools, are required for the accurate assessment of cosmetic and psychological outcomes of hypospadias surgery.