Surgical Interventions on the External Female Genitalia in Switzerland

Abstract

Introduction: With this online survey, data on surgical interventions on the external female genitalia in Switzerland, differentiated according to functional, aesthetic and psychological reasons, were collected for the first time. Materials and Methods: In September 2013 an invitation to respond to the quantitative and qualitative questions of a comprehensive, anonymous online survey was sent by e-mail to a total of 1740 members of the Swiss Society of Gynaecology and Obstetrics (Schweizerische Gesellschaft für Gynäkologie und Geburtshilfe) and the Swiss Society of Plastic Surgery (Schweizerische Gesellschaft für Plastische Chirurgie). Follow-up enquiries were made in June 2014. Results: By far the most frequently requested intervention was, as expected, reduction of the labia minora. The numbers of this operation had increased significantly between 1992 and 2012 (p = 0.003). Reduction of the labia minora for functional reasons decreased continuously in this period (from 50 to 40 %) while interventions for aesthetic reasons increased continuously (from 20 to 40 %). The proportion of interventions for psychological reasons remained surprisingly low during the entire investigated period of time (highest value in 2012 of 3.5 %). Evaluation of the quantitative results on the most frequently stated aesthetic, functional and psychological reasons, however, revealed a high overlap especially in the field of aesthetic and psychological reasons. This overlap points to considerable uncertainties in the medical indications for treatment. Conclusion: The most interesting results of this study concerns the empirical evidence that it is often difficult in clinical routine to come to a clear aesthetic, functional or psychological indication and thus there is a need for an instrument to facilitate and improve the indication-making process.

Keywords: aesthetic genital surgery; age and genital surgery; female genital plastic surgery; functional genital surgery; motives for female genital surgery; reduction of labia minora.

Fig. 1

Regression analysis for the total number of interventions on the external female genitalia for the three investigated time periods (1992, 2002, 2008–2012).

Fig. 2

Regression analysis for the total number of reductions of the labia minora (1992, 2002, 2008–2012).

Fig. 3

Changes of the reasons over the last 20 years (average percentage values in the years1992, 2002, 2008–2012).

Fig. 4

Changes of the reasons given over the last 20 years to 24 surgeons performing 10 or more operations per year.

Fig. 5

Development of the interventions in the various age groups.

Fig. 6

Statistically not significant increases in the number of resections of hypertrophic labia minora for functional reasons according to health insurance figures for the years 2006–2012.