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IMCAS World Congress 2020
Program

FOCUS ON S097

Female genitalia: cultural practices

Partner of the session

ISGAR

International Society of Gynecology, Aesthetic and Research

International

Focus program

Room: Room 351 - level 3
Date: Thursday 30 January 2020 at 08:30 to 09:30
Format: FOCUS SESSION > lectures covering a major topic of the congress

Chairs

Dr Zuramis ESTRADA BLANCO

Gynecologist

Spain

Dr Marwan NUWAYHID

Gynecologist

Germany

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
08:30	Dr Zuramis ESTRADA BLANCO	Introduction of ISGAR		98983
08:33	Dr Zuramis ESTRADA BLANCO	AVIVA protocol: vulvar harmonization & beauty without surgery in millennial generation	View	99091
08:45	Dr Suleyman ESERDAG	The past, present and future of cosmetic gynecology	View	93221
08:57	Dr Abdelilah LAHLALI	Hymenoplasty: techniques, tips and tricks	View	93219
09:09	Dr Stephane CRISTINELLI	Phimosis of the clitoral gland: how to manage	View	93218
09:21		Q&A		93222

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Recommended sessions

Vaginal surgery (labiaplasty, etc)

Vaginal rejuvenation (non-surgical)

Anatomy

Combined treatments

Radiofrequency (RF)

Dr Zuramis ESTRADA BLANCO

Gynecologist

Spain

Other author(s) :

Introduction of ISGAR

Dr Zuramis ESTRADA BLANCO

Gynecologist

Spain

Other author(s) :

AVIVA protocol: vulvar harmonization & beauty without surgery in millennial generation

Objectives: To discuss the case of a 20 year old woman with hypertrophy of the labia minora and mild ptosis of the labia majora that requested non-surgical correction for body image disorder and discomfort with underwear.
-

Introduction: Aviva protocolo is a new minimally invasive procedure to correct hypertrophy or lipodystrophy vulvar area and restore the appearance of a woman's intimate . This innovative procedure is performed under local anesthesia, in less than 30 minutes and without removing excess excess skin.
This non-surgical procedure consists in inserting the thin and small bipolar radiofrecuency cannula into the skin to deliver uniform and focused heat in the matrix of all the soft tissue of the labia minora, labia majora, clitoris hood, and perineal body with great precision producing maximum skin contraction

Materials / method: Bipolar radiofrecuency machine . We used cannula device and skin device (frac technology ) together in the same session.
2% lidocaine with epinephrine local anesthesia was administered. Radiofrecuency with cannula technology was applied with the control of external and internal temperature.
Skin technology with 24-coin and control of temperature and energy.
I have applied three times in each area, symmetrically and no more than five min each.

Results: It was achieved in a single session, the reduction of the size of the labia minora in 3 cm aproximately (similar to a surgical labiaplasty) and general vulvar harmonization.
Four weeks later, the patient felt comfortable with the results.
Six month later the patient maintains an excellent degree of satisfaction.
We checked in different times the evolution of our technique through advanced ultrasound with elastography to measure the degree of elasticity the tissue after radiofrecuency.

Conclusion: AVIVA protocol is the non-surgical alternative to conventional labiaplasty.
AVIVA protocol it is a safe, effective treatment, quick to perform and with an appropriate learning curve.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Suleyman ESERDAG

Gynecologist

Turkey

Other author(s) :

The past, present and future of cosmetic gynecology

Objectives: Where are we now in cosmetic gynecology? While the knowledge and technology are evolving so fast, what are we expecting in the future?

Introduction: In 1976, labia minoraplasty for labial hypertrophy was first published by Radman. In 1984, Hodgkinson and Hait first presented labia minora labioplasty for aesthetic motives. For present, labiaminora and majoraplasty, vaginal tightening and reconstruction, perineoplasty, hymenoplasty and monsplasty are the major surgical procedures in cosmetic gynecology, while genital laser, RF, HIFU, Filler, PRP, and thread applications take part in non-surgical side. Stem cell applications from amnion, bone marrow and adipose tissue seem to open new windows in the future.

Materials / method: Personal experience in conjunction with updated literature knowledge is discussed in this presentation

Results: The perception of ‘ideal vulva concept’ differs between countries. Labiaplasty is the most commonly applied aesthetic genital surgery and aims at improving the appearance of the external genitalia. Vaginal tightening can be performed surgically or by EBDs as laser, RF or HIFU. The method should be tailored according to patient’s complaints and expectations. EBDs have been used for sexual enhancement and stress urinary incontinence as well. On the other hand PRP, Fillers and Threads have been used single or as a combination to other procedures for antiaging and different functional reasons.

Conclusion: Cosmetic gynecology is a new and very developing field in medicine. If trained physicians are involved, minimal complication rates and maximum patient satisfaction can be obtained. To achieve the best outcomes in both functional and aesthetic purposes, patients should be informed by the surgeons regarding anatomic variations, and unrealistic expectations should be excluded. And also, the technique of surgery should be individualized with great consideration of the patient’s realistic expectations. Nevertheless, further studies are needed on the long-term efficacy, safety and reliability.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Abdelilah LAHLALI

Gynecologist

Morocco

Other author(s) :

Hymenoplasty: techniques, tips and tricks

Objectives: The technique of Hymenoplasty is not taught, and given the small number of publications, we describe our personal techniques about 518 cases over a period of 10 years (April 2010 / April 2019).
We distinguish the hymenorraphy which is the temporary restoration of the hymen of the hymenoplasty which is the definitive restoration of the hymen.
The objective is to demonstrate that the techniques used give safer results, little complication and with a total satisfaction of the patients.
The desired result is bleeding during penetration is the basis and purpose of our techniques

Introduction: Virginity before marriage is traditionally associated with the integrity of the hymen and the loss of blood, in some cultures. As a result, virginity has acquired social, religious and moral importance.
It is admitted that a woman who has never had sex, has an intact hymen. According to the dictionary the term virgin means that a person has never had sex. Hymenoplasty is performed not only for reasons of cultural and religious traditions, but also for social status and interpersonal relations.
Hymenoplasty helps restore the hymen's ability to bleed during intercourse on a wedding night

Materials / method: In a retrospective study (April 2010 / April 2019) the data of 518 patients who underwent a restoration of the hymen were collected.
518 patients were operated between April 2010 and April 2019, 222 for a hymenorraphy and 296 for a hymenoplasty where two personal techniques were used:
- Hymenoplasty by hymenal flaps (201 patients) if the hymenal caruncle are sufficient. (Vidéo 1)
- Hymenoplasty by vaginal flaps (95 patients) in case of absence of hymenal caruncle. (Video 2)
All interventions were performed on an outpatient basis and lasted on average 25 minutes (10 to 40 minutes)

Results: A total of 518 patients were operated for hymenoplasty :
- 222 underwent hymenography (42%), 296 hymenoplasty (57%), of which 201 (39%) hymenoplasty by hymenal flap and 95 (18%) hymenoplasty by vaginal flap.
- The average age of the patients was 32 years
- Of the 518 patients operated on alone 3 (0.5%) had an early complication in the form of uncontrollable haemorrhage requiring surgical revision.
- Of the 222 hymenorraphies no failure was reported,
- Of the 201 hymenoplasty with hymenal flaps, there were 5 failures (0.1%)
- Of the 95 vaginal flap hymenoplasties, only one failure was reported

Conclusion: Our study of a series of 518 patients having undergone a restoration of their hymen, made it possible to evaluate the various techniques used according to the context and this with a detailed description of each of them. Short-term and long-term follow-up data were able to show the effectiveness of hymen restoration, since there is little failure of the method and very few reported complications.
The large majority of our patients were satisfied with their intervention since almost all those who got married bled on their wedding night

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Stephane CRISTINELLI

Gynecologist

France

Other author(s) :

Phimosis of the clitoral gland: how to manage

Objectives: We suggest an easy surgical technique that achieves excellent functional results with low morbidity in clitoral phymosis.

Introduction: The clitoris has a crucial role in the feminine pleasure. Chronic inflammatory dermatosis along with post-menopausal atrophy of the vulva and obstetrical traumas can cause clitoral phimosis, thereby compromising its function. Medical treatments exist depending on the etiology, but when irreversible scarring occur, a surgical treatment can be necessary to regain its function.

Materials / method: The clitoral glans is unburried from its hood and adherences through an incision under local anesthaesia. The efficiency of this technique could be objectivated by a pre-and post-operative questionnaire.

Results: The surgical technique decribed is simple, generates few complications and constitutes a safe way to treat female sexual dysfunction like the decrease of sexual pleasure and orgasm secondary to sclerosis and atrophia of the post menopausal clitoral hood. As a radical treatment, it avoids the burdain of an everyday topical treatment, or multiple laser sessions.

Conclusion: Female sexual dysfunction caused by the burrying of the clitoris due to post menopausal hood atrophy is a frequent and handicapping phenomenon. These women are, for the majority, asking for a therapeutic solution. The surgical technique described answers to this problem with a low morbidity rate and an excellent functional outcome. However, this technique needs to be evaluated by a pre and post operative questionnaire to objectivate the results.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

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IMCAS World Congress 2020 Program

FOCUS ON S097

Female genitalia: cultural practices

Chairs

Lectures of the session

Recommended sessions

IMCAS World Congress 2020
Program