Abstract
Vulvovaginal aesthetic (VVA) surgery has become increasingly popular, and there is anecdotal support for its enhancing effects on sexual functioning and self-concept. We conducted a prospective pilot study to evaluate the impact of VVA surgery on sexual response. A prospective cohort of women electing VVA cosmetic surgery completed questionnaires before VVA surgery (n = 33), after VVA surgery (n = 18), and again 6 to 9 months later (n = 12) using the Female Sexual Function Index, the Brief Symptom Inventory, and the Yale-Brown Obsessive-Compulsive Scale for Body Dysmorphic Disorder. No significant effect of VVA surgery was noted on Desire, Lubrication, Orgasm, Pain, or Total Score at either time point, but scores on Arousal and Satisfaction increased immediately after surgery, then fell back to baseline levels at follow-up. No significant effect of VVA surgery was seen on psychological functioning at either time point. According to established cut-off scores for body dysmorphic disorder (BDD), 61.1% of participants met criteria for BDD at baseline; this proportion significantly dropped to 11.1% after surgery, and to 8.3% at follow-up. Contrary to anecdotal claims, women in the present sample did not have symptoms of sexual dysfunction that may have motivated them to seek VVA surgery, nor was there any significant effect of surgery on sexual response. It is important to note that a high proportion of women seeking VVA met criteria for BDD; this has implications for surgeons and consenting patients for these cosmetic genital procedures.
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