title: Attitudes Regarding Labial Hypertrophy and Labiaplasty: A Survey of Members of the Society of Gynecologic Surgeons and the North American Society for Pediatric and Adolescent Gynecology.
abstract: The aim of this study was to describe gynecologists' attitudes toward labial hypertrophy and explore possible differences among providers for pediatric/adolescent patients.
  
  
  
  This was an institutional review board-approved, cross-sectional survey of physician attendees at 2 national meetings in 2014: the Society of Gynecologic Surgeons (SGS) and the North American Society for Pediatric and Adolescent Gynecology (NASPAG). The survey was designed to query demographics and impressions regarding labial hypertrophy and labiaplasty.
  
  
  
  Three hundred sixty-five surveys were completed (response rate, 50%); 268 were analyzed: 55% from SGS and 45% from NASPAG. Most were older than 41 years; 170 (63%) were women, and 93 (35%) were men. More men than women attended SGS (60%); however, women were the majority at NASPAG (94%).Most respondents believed labial hypertrophy to be infrequently reported and "a condition that impacts body image." Common symptoms were "discomfort with exercise" and "dissatisfaction with appearance naked." The majority felt this to impact sexual function "in some cases," citing "self-esteem" and "comfort" most often.Concerning therapies for provided labial hypertrophy, 83% of practitioners provide reassurance, whereas 77% would offer labiaplasty. Expertise with labiaplasty varied; 28% felt "very comfortable," and 11% felt "very uncomfortable."Provider preference for treatment differed based on meeting attendance. After logistic regression controlling for sex and age, attendance at SGS remained associated with offering labiaplasty (P = 0.001; odds ratio, 4.1; 95% confidence interval, 1.8-9.3), whereas NASPAG attendance was associated with providing reassurance (P = 0.008; odds ratio, 0.30; 95% confidence interval, 0.10-0.70).
  
  
  
  Although the majority surveyed view labial hypertrophy to be bothersome, gynecologists caring for our youngest patients are more likely to provide reassurance. Consensus guidelines are needed to aid practitioners in appropriate management of labial hypertrophy.
authors.affiliation: From the *Division of Urogynecology, Department of Obstetrics and Gynecology, and †Hatton Research Institute, TriHealth Good Samaritan Hospital, Cincinnati, OH.
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Westermann
authors.forename: Susan H
authors.initials: SH
authors.lastname: Oakley
authors.forename: Donna
authors.initials: D
authors.lastname: Mazloomdoost
authors.forename: Catrina C
authors.initials: CC
authors.lastname: Crisp
authors.forename: Steven D
authors.initials: SD
authors.lastname: Kleeman
authors.forename: Janine M
authors.initials: JM
authors.lastname: Benbouajili
authors.forename: Rachel N
authors.initials: RN
authors.lastname: Pauls
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006176:Gynecology; D006801:Humans; D006984:Hypertrophy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D019651:Plastic Surgery Procedures / Q000523:psychology*; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014621:Vagina / Q000601:surgery*; D014844:Vulva / Q000473:pathology* / Q000601:surgery*