背景:这篇综述研究了外阴阴道美容手术的原理和结果。
方法:使用术语阴唇成形术对现有文献进行Medline搜索,阴蒂罩减少,处女膜成形术,阴道成形术,会阴成形术,女性生殖器手术,性满意度/身体形象,和前/后阴道修补术;参考文献从文献目录中找到的文献通过文献检索和作者阅读的现有文献,直到2012年1月。收到患者对此类手术的请求的临床医生应与患者讨论请求的原因,并对可能表明需要手术干预的任何体征或症状进行评估。
结果:在女性生殖器整容手术之前,必须进行生理心理和性别评估。在对患者进行仔细评估后,应提出宽阴道感觉的围手术期。由训练有素的外科医生,在多学科方法的一部分,特别是性,经过保守治疗(盆底康复)。应告知患者结果和并发症。女性生殖器切割手术修复是可能的,并改善大多数患者。改善机制复杂,临床试验正在进行中。要求这个手术,对于整合自己和家人的故事的病人来说,更多的时候是深刻反思的结果。她应该被倾听,在参考中心受到尊重和管理。应该系统地提出性疗法。关于处女膜成形术,该程序被医生认为是“合法的”。有几种技术可用,很少有人描述,并且没有基于证据的出版物。唇成形术是一种手术,其患者的期望应由外科医生正确评估,并应告知收益风险。应该尝试围绕“常态”和心理治疗进行初步讨论,为了不通过手术治疗畸形恐惧症。阴道“年轻化”和G点放大的原理和技术是非常有争议的,没有基于证据的研究。
结论:女性生殖器的整容手术涵盖了与极其不同的情况相对应的多种技术。它需要仔细和多学科的评估以及患者的清晰和诚实的信息。女性生殖器切割和性犯罪的重建手术在适应症或正当理由方面并不构成真正的问题。
BACKGROUND: This review studies rationale and outcome of vulvovaginal aesthetic surgery.
METHODS: Medline search of the existing literature utilizing terms labiaplasty, clitoral hood reduction, hymenoplasty, vaginoplasty, perineoplasty, female genital surgery, sexual satisfaction/body image, and anterior/posterior colporrhaphy; references from bibliographies of papers found through the literature search and in the author\'s reading of available literature until January 2012. Clinicians who receive requests from patients for such procedures should discuss with the patient the reason for request and perform an evaluation for any physical signs or symptoms that may indicate the need for surgical intervention.
RESULTS: A physical psychological and sexological evaluation is mandatory before a procedure of female cosmetic genital surgery. Perineoplasties in wide vagina sensations should be proposed after careful evaluation of patients, by trained surgeons, in part of a multidisciplinary approach especially sexologic, after attempt of conservative treatments (pelvic floor rehabilitation). Patients should be informed of results and complications. Female genital mutilation repair with surgery is possible and improve majority of patients. Improvement mechanism is complex and clinical trials are ongoing. Asking for this surgery, is more often result of a deep reflexion for patient who integrate his own story and those of her family. She should be listened to, respected and managed in a reference center. Sexotherapy should be systematically proposed. Concerning hymenoplasty, the procedure is considered as \"legally\" by medical doctors. Several techniques are available, few described, and there is no evidence-based publication. Labioplasty is a procedure whose patient expectations should be properly evaluated by surgeon and benefits risks should be informed. A preliminary discussion around \"normality\" and a psychotherapy should be tried, in order to not treat a dysmorphobia by surgery. Vaginal \"rejuvenation\" and G spot ampliation principles and techniques are very controversial and there is no evidence-based study.
CONCLUSIONS: Cosmetic surgery of the female genitalia covers a variety of techniques corresponding to extremely diverse situations. It requires careful and multidisciplinary evaluation as well as clear and honest information of patients. Reconstructive surgery of female genital mutilation and sexual crimes does not pose a real problem in term of indication or justification.