title: Cosmetic gynecology in the view of evidence-based medicine and ACOG recommendations: a review.
abstract: OBJECTIVE
  To conduct a methodological review of the existing scientific literature within the field of cosmetic gynecology in the view of evidence-based medicine and to establish their relevance to the ACOG Committee Opinion No. 378.
  
  
  METHODS
  The appropriate medical subject heading terms were selected and applied in the search of the Internet multiple databases since 1900 until January 2010. Articles focusing on cosmetic gynecology were reviewed. Also, anecdotal and advertising literatures were analyzed. A methodological review of the literatures was conducted.
  
  
  RESULTS
  In peer review journals, 72 relevant articles related to cosmetic gynecology were identified. Anecdotal information was identified in 3 sources and over 1,100 published marketing literatures were identified on the Internet and no scientific journals. Among reviewed articles on cosmetic gynecology, only two articles met the level II-2 in evidence-based medicine. The absence of documentations on the safety and effectiveness of cosmetic vaginal procedures in the scientific literatures was ACOG's main concern.
  
  
  CONCLUSIONS
  Practicing cosmetic gynecology within ACOG recommendations is desirable and possible. Currently, the standard of practice of cosmetic gynecology cannot be determined due to the absence of the documentation on safety and effectiveness. Traditional gynecologic surgical procedures cannot be called cosmetic procedures, since it is a deceptive form of practice and marketing. Creating medical terminology trademarks and establishing a business model that tries to control clinical-scientific knowledge dissemination is unethical.
authors.affiliation: Institute of Gynecology, Inc, 7001 Central Ave, St. Petersburg, FL 33710, USA. ao@baymedical.com
authors.forename: Adam
authors.initials: A
authors.lastname: Ostrzenski
mesh_terms: D019317:Evidence-Based Medicine; D005260:Female; D006176:Gynecology / Q000941:ethics / Q000592:standards*; D006801:Humans; D019651:Plastic Surgery Procedures / Q000941:ethics / Q000592:standards*; D014621:Vagina / Q000601:surgery*; D014844:Vulva / Q000601:surgery*