Guideline No. 423: Female Genital Cosmetic Surgery and Procedures

Area of Science:

• Gynecological Surgery
• Female Genital Cosmetic Surgery (FGCS)
• Evidence-Based Medicine

Background:

• Increasing demand for FGCS and related procedures outside traditional medical indications.
• Need for evidence-based guidance for healthcare providers and patients.
• Focus on vaginal and vulvar surgeries and procedures.

Framework:

• Comprehensive literature search (MEDLINE, Scopus, Cochrane Library) from 2012 onwards.
• Inclusion of systematic reviews, RCTs, and observational studies.
• Keywords included FGCS terms (labiaplasty, laser vaginal therapy) and related concepts (counselling, body dysmorphia).

Implementation:

• Utilized the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
• Assessed quality of evidence and strength of recommendations.
• Guideline development for Canadian surgeons, providers, and referring practitioners.

Implications:

• Most women seeking FGCS have normal genitalia and benefit from counselling.
• Lack of rigorous evidence on short- and long-term efficacy and safety of non-medically indicated FGCS.
• FGCS primarily offered in the private sector, with patient-borne costs.