Female Sexual Function After Labiaplasty: A Systematic Review and Meta-analysis

BackgroundLabiaplasty often motivated by aesthetic and/or sexual and/or functional concerns, but with contradictory outcomes. The documentation regarding the safety and efficacy of these elective procedures is limited, primarily consisting of clinical case reports and retrospective studies. ObjectivesThis systematic review aimed to investigate the effect of labiaplasty on sexual function. MethodsAn electronic search in PubMed, Web of Science, Scopus, PsycINFO, Embase, the Cochrane Library, and ClinicalTrials.gov from 2000 to 2024 was performed. Articles that focused on labia minora surgeries performed for cosmetic, and/or sexual, and/or psychological, and/or functional reasons (excluding medical indications like reversing female genital cutting, straddle injuries, or other genital injuries) were considered. Additionally, selected articles were required to evaluate post-operative sexual function using a quantitative tool. A meta-analysis using a random-effects model was used to derive weighted pooled estimates of sexual function after labiaplasty. ResultsThe authors identified a total of 11 articles (with 671 participants) that evaluated sexual function after labiaplasty. Based on the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies (EPHPP), out of the 11 articles reviewed, 7 were categorized as weak, 4 as moderate, and none as strong. Of the studies reviewed, 6 studies used Female Sexual Function Index (FSFI). A meta-analysis of these six studies (with eight groups) revealed that labiaplasty was associated with an 18.8% improvement in the FSFI score, P < 0.001. ConclusionLabiaplasty appears to have a positive impact on women's sexual function, at least in the short term. However, inconsistencies in procedures, study design, and scales have limited this conclusion. In pre-surgery counseling, patients must be informed about the limited knowledge on labiaplasty's impact on sexual function. Level of Evidence IIIEvidence obtained from well-designed analytic studies. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.