title: Vulvoplasty in New South Wales, 2001-2013: a population-based record linkage study.
abstract: OBJECTIVE
  To compare the characteristics of women who have undergone vulvoplasty with those of other women of reproductive age; to quantify short term adverse events and complications; to determine any association between vulvoplasty and subsequent outcomes for women giving birth.
  
  
  METHODS
  A population-based record linkage study, analysing New South Wales Admitted Patient Data Collection and NSW Perinatal Data Collection data. The characteristics of all women who had vulvoplasties in NSW hospitals during 2001-2013 were compared with those of all women of reproductive age.
  
  
  METHODS
  Admissions for vulvoplasty and repeat vulvoplasties; serious complications or adverse events after vulvoplasty; birth mode and perineal outcomes for primiparous women with and without vulvoplasty.
  
  
  RESULTS
  4592 vulvoplasty procedures were performed on 4381 women in NSW hospitals and day-stay centres; the annual rate increased by 64.5% between 2001 and 2013. Compared with the reference population, women who had vulvoplasty were more likely to have been born in Australia (74.6% v 67.6%), to have other cosmetic surgery (10.1% v 1.7%), and to have never been married (43.0% v 33.1%). The serious short term adverse event rate was 7.2%. Of 257 women who had a first birth after their vulvoplasty procedure, 40.0% had caesarean deliveries, compared with 30.3% of other women (P < 0.001). There were no significant differences in the rates of perineal outcomes for women who had vaginal births.
  
  
  CONCLUSIONS
  The number of vulvoplasties performed in NSW has increased dramatically since 2001. The procedure is not without serious complications that can necessitate re-admission to hospital. We provide objective information about outcomes for counselling women who are contemplating vulvoplasty.
authors.affiliation: Kolling Institute of Medical Research, Sydney, NSW christine.roberts@sydney.edu.au.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Ampt
authors.affiliation: Royal North Shore Hospital, Sydney, NSW.
authors.forename: Vijay
authors.initials: V
authors.lastname: Roach
authors.affiliation: Kolling Institute of Medical Research, Sydney, NSW.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Roberts
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014844:Vulva / Q000601:surgery*; D014845:Vulvar Diseases / Q000601:surgery; D055815:Young Adult