目标:为加拿大外科医生和其他提供女性生殖器整容手术(FGCS)和程序的提供者,和他们的推荐从业者,以证据为基础的方向,以响应越来越多的请求,和可用性,阴道和外阴手术和程序,不属于传统的医学指示重建领域。
方法:所有年龄的女性寻求FGCS或手术。
结果:医疗保健提供者在教育女性了解其解剖结构并帮助她们欣赏个体差异方面发挥着重要作用。大多数要求FGCS和手术的女性生殖器正常,高达87%的人通过咨询得到了安慰。此时,由于缺乏严格的短期和长期疗效和安全性的临床或科学证据,不支持FGCS和非医学适应症的程序。FGCS和程序通常在私营部门提供,费用由患者承担。
方法:通过搜索MEDLINE检索文献,Scopus,和Cochrane图书馆使用适当的受控词汇和关键字。所选搜索词代表FGCS的关键词(阴唇成形术,手术,阴道激光治疗,激光阴道紧缩术,阴道激光,阴道恢复活力,阴道松弛综合征,处女膜成形术,阴道整容手术)与女性生殖器咨询相结合,同意,满意,后续行动,青春期,和身体畸形或身体畸形。搜索仅限于2012年以后的出版物,以更新自先前关于该主题的指南以来的文献。结果仅限于系统评价,随机对照试验,和观察性研究。研究仅限于涉及人类的研究,没有语言限制。搜索于2020年5月20日完成,并于2020年11月10日更新。
方法:作者使用建议分级评估对证据质量和建议强度进行了评估,开发和评估(等级)方法。见在线附录A(表A1的定义和A2的强和弱的建议的解释)。
未经授权:妇科医生,初级保健提供者,执行FGCS和/或手术的外科医生。
结论:
OBJECTIVE: To provide Canadian surgeons and other providers who offer female genital cosmetic surgery (FGCS) and procedures, and their referring practitioners, with evidence-based direction in response to increasing requests for, and availability of, vaginal and vulvar surgeries and procedures that fall outside the traditional realm of medically indicated reconstructions.
METHODS: Women of all ages seeking FGCS or procedures.
RESULTS: Health care providers play an important role in educating women about their anatomy and helping them appreciate individual variations. Most women requesting FGCS and procedures have normal genitalia, and up to 87% are reassured by counselling. At this time, due to lack of rigorous clinical or scientific evidence of short- and long-term efficacy and safety, FGCS and procedures for non-medical indications cannot be supported. FGCS and procedures are typically provided in the private sector, where costs are borne by the patient.
METHODS: Literature was retrieved through searches of MEDLINE, Scopus, and The Cochrane Library using appropriate controlled vocabulary and keywords. The selected search terms represented keywords for FGCS (labiaplasty, surgery, vaginal laser therapy, laser vaginal tightening, vaginal laser, vaginal rejuvenation, vaginal relaxation syndrome, hymenoplasty, vaginal cosmetic procedures) combined with female genital counselling, consent, satisfaction, follow-up, adolescent, and body dysmorphic or body dysmorphia. The search was restricted to publications after 2012 in order to update the literature since the previous
guideline on this topic. Results were restricted to systematic reviews, randomized controlled trials, and observational studies. Studies were restricted to those involving humans, and no language restrictions were applied. The search was completed on May 20, 2020, and updated on November 10, 2020.
METHODS: The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations).
UNASSIGNED: Gynaecologists, primary care providers, surgeons performing FGCS and/or procedures.
CONCLUSIONS: