Genital imperfections

What is it?

Genital imperfections are anatomical and sometimes functional imperfections that involve the external female genitalia, altering what is considered the "normal" genital anatomy and creating discomfort, with consequences on the intimate and personal sphere of patients.
This condition includes all congenital genital anatomical variations, but also changes that occur as a result of aging, pregnancy, childbirth, or surgery.
The most frequent genital imperfections include hypertrophy of the labia minora, hypotrophy and loss of turgor of the labia majora and mons pubis, hypotonicity of the vaginal musculature and atrophy of the mucous membranes. In addition, patients with postpartum anatomical alterations, due to spontaneous lacerations or episiotomies with suboptimal healing, and genital abnormalities in the aftermath of female genital mutilation surgery should also be considered.

Which are the symptoms?

Symptoms related to the presence of genital imperfections include physical complaints such as vaginal dryness and pain during intercourse, but especially psychological disorders related to the discomfort caused by anatomical imperfections that affect the intimate and sexual sphere.

  • Pain during intercourse
  • Vaginal dryness
  • Feeling of genital discomfort
  • Decreased self-esteem
  • Psychic discomfort
  • Social impact

How is it diagnosed?

The diagnosis of genital imperfections is fundamentally clinical and is based on the mixture of an objective assessment performed by a specialist gynecologist and a subjective assessment of the patient on the impact of these disorders.
With regard to symptoms such as dyspareunia and vaginal dryness, there are validated questionnaires useful for the evaluation of their severity. In addition, given the predominant role of the psychological component of this condition, it is important to integrate the diagnosis with a specific psychological assessment.

How is it treated?

Vaginal laser: The treatment with fractionated CO2 laser represents a valid therapy for the treatment of vulvo-vaginal atrophy symptoms, thanks to its regenerative action on tissues. While it is a non-invasive treatment, it can provide significant improvement in the appearance of genital tissues and their functionality.
Surgical treatment: one of the most practiced surgical alternatives is the vulvar labiaplasty for the correction of the hypertrophy of the labia minora, which can also be performed with laser instrumentation. For the hypotrophy of labia majora and mons pubis, instead, it is possible to propose a lipofillig with autologous adipose tissue graft, performed under local anesthesia or an injection of hyaluronic acid. Suboptimal healing of episiotomies or high-grade lacerations during delivery is addressed by colpoperineoplasty, performed vaginally under loco-regional anesthesia. Finally, the correction of surgical outcomes from female genital mutilation is done through vestibular and/or clitoral plastic surgery, which aims to correct the anatomy and ensure better sexual function.
Psychological therapy: the specific treatment of genital anatomy and function supplemented by psychological assessment, aimed at improving the aspect of personal and social discomfort that frequently accompanies these disorders.

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