Labia Minora Surgery in the Adolescent Population: A Cross-Sectional Satisfaction Study.

Background: Labia minora surgeries are gaining popularity and we have limited data available to help counseling patients, especially in the adolescent population.

Aim: This study is meant to assess the complications and satisfaction of patients who had the surgery as adolescent.

Methods: We identified and reviewed all labia minora surgeries performed to address symptoms within the adolescent population from 2006 to 2016. A cross-sectional study was then performed. Questionnaires were sent through an Internet-based survey. Adolescent and adult populations from the literature were used for comparison.

Outcomes: A three-part questionnaire assessed surgical indications, current satisfaction regarding the surgery, and the sexual function, including the Female Sexual Function Index (FSFI) and the Female Genital Self-Image Scale (FGSIS).

Results: A total of 44 cases, from 12 to 18 years old, were included for the retrospective review. The major complaint leading to surgery was described as daily basis discomfort (39%) and aesthetics (33%). Surgical indications were similar for the survey responder group. 3 patients (6.8%) underwent redo surgery. We were able to reach 28 of the 44 potential participants for the cross-sectional study. A total of 17 questionnaires were completed (39%). We found a 20.5% rate of complication with 14% dehiscence, 9.3% significant bleeding, and 1 case of wound infection. This complication rate is higher than what has been found in the literature so far. All responders were partially (53%) or fully (47%) satisfied with the surgery. Results of FSFI were different in two of the 6 domains: lower lubrification (P = .0416) and higher orgasm (P = .0495) score compared to adolescent controls. The cutoff criteria for Hypoactive Sexual Desire Disorder was met by 75%. Patients responded positively to the FGSIS questionnaire (M = 21.65, 95% CI: 20.31-22.98).

Clinical Implications: This study helps to identify specificities of the adolescent population who underwent labia minora surgery, potential increased complication rates compared to the adult population, even with overall significant postoperative satisfaction.

Strengths & Limitations: Lack of adequate control group for the FSFI and FGSIS, a small sample size, and a low response rate could have biased our results. To our knowledge, this is the biggest study to date to address this issue exclusively within the adolescent population, with the addition of validated questionnaires. The long delay since surgery (Mean = 8.3 yrs) permits to highlight temporal changes and potential long term complications.

Conclusions: Patients seem to have no regret about the surgery and sexual dysfunction rate comparable to the literature data, except for possible increased hypoactive sexual desire disorder. Jodoin A, Dubuc E. Labia Minora Surgery in the Adolescent Population: A Cross-Sectional Satisfaction Study. J Sex Med 2021;18:623-631.