Browsing by Author "Stojanovic, B. (54390096600)"

Acceptable appearance of female genitalia have significant impact in functional, as well as in aesthetical sense, since there are many anomalies, either congenital or acquired, which require proper correction. Certainly, attention should be paid to the growing demands and needs for aesthetics in the field of genital surgery, and these women should be helped to prevent the development of genital dysmorphophobia. Various specialties are involved in the work in this specific field, from plastic surgeons, through gynecologists and urologists. The genital surgeon must have sufficient training in sexual medicine to withhold these procedures from women with sexual dysfunction, mental impairment, or body dysmorphic disorder. There is a variety of surgical procedures for better functioning of genitalia such as reduction of enlarged clitoris or creation of new vagina. Many new and redefined techniques are emerging, but very few long-term results and follow up studies are published. Also, reconstruction of missing organs due to trauma or mutilation injuries represents new challenges. Finally, new trends in cosmetic surgery offer better aesthetic appearance and recruit more and more new non-surgical procedures. Patients should always be made aware that the results of surgery or procedures to alter sexual appearance or function are always prone to subjectivism, and must be presented with realistic expectations. In our chapter we will evaluate all the modalities of treatment for this pathology, and we will also pay special attention to a new trend in cosmetic surgery, aesthetic correction of female genitalia. It will be an overview of the possible surgical procedures for women with congenital and functional disorders as well as general principles of aesthetic surgery of the female genitalia. Some details are already fully described in other chapters and will be poorly contributed in our chapter as a reminder of this very important issue. © Springer Nature Switzerland AG 2023.

Background: Urethral intercourse is a very rare entity which usually presents as urinary incontinence during and after intercourse and is most commonly seen in patients with vaginal agenesis (Mayer–Rokitansky–Hauser Syndrome) or hypoplasia, or other rear vaginal anomalies. Aim: To evaluate management and outcomes for vaginal and urethral consequences of urethral intercourse, including urinary incontinence. Methods: Between February 2006 and March 2021, 8 women aged from 17 to 22 years underwent genital and urethral reconstruction due to consequences of urethral sexual intercourse. Vaginal reconstruction included sigmoid vaginoplasty and introitoplasty with division of the vaginal septum in cases of vaginal agenesis (5 cases) and vaginal duplication (3 cases), respectively. Incontinence was treated by sling procedures in 5 women with longer history of urethral coitus and evident bladder neck prolapse. Outcomes: Sexual and psychosexual outcomes assessment was based on the Female Sexual Function Index and standardized questionnaires. Results: Follow-up ranged from 9 to 188 months (mean 78 months). Good esthetical and functional results were achieved in all 8 women. All patients reported satisfactory sexual intercourse. All 5 incontinent women who had underwent sling procedure were continent. In one of 3 nontreated cases, additional sling treatment was indicated 6 months after vaginal reconstruction with satisfactory outcome. One patient with vaginal duplication reported a successful pregnancy with a Caesarean section delivery. Clinical Implications: Urinary incontinence with megalourethra in young women, along with the presence of Mullerian anomalies should raise suspicion of urethral coitus. Surgical treatment includes correction of vaginal anomalies and management of consequences. Strengths and Limitations: This study represents one of the largest series for urethral intercourse, with assessment of psychosexual outcome. The limitation is the lack of statistical analysis due to small sample size. Conclusion: Urethral intercourse is very rare, but it can cause severe consequences. It is important to recognize this occurrence and treat it by well-known vaginal or urethral reconstructive procedures. Djordjevic ML, Bizic M, Stojanovic B, et al. Treatment of Urethral Intercourse and Impact on Female Sexual Function. Sex Med 2022;XX:XXXXXX. © 2022 International Society for Sexual Medicine

Background: Urethral intercourse is a very rare entity which usually presents as urinary incontinence during and after intercourse and is most commonly seen in patients with vaginal agenesis (Mayer–Rokitansky–Hauser Syndrome) or hypoplasia, or other rear vaginal anomalies. Aim: To evaluate management and outcomes for vaginal and urethral consequences of urethral intercourse, including urinary incontinence. Methods: Between February 2006 and March 2021, 8 women aged from 17 to 22 years underwent genital and urethral reconstruction due to consequences of urethral sexual intercourse. Vaginal reconstruction included sigmoid vaginoplasty and introitoplasty with division of the vaginal septum in cases of vaginal agenesis (5 cases) and vaginal duplication (3 cases), respectively. Incontinence was treated by sling procedures in 5 women with longer history of urethral coitus and evident bladder neck prolapse. Outcomes: Sexual and psychosexual outcomes assessment was based on the Female Sexual Function Index and standardized questionnaires. Results: Follow-up ranged from 9 to 188 months (mean 78 months). Good esthetical and functional results were achieved in all 8 women. All patients reported satisfactory sexual intercourse. All 5 incontinent women who had underwent sling procedure were continent. In one of 3 nontreated cases, additional sling treatment was indicated 6 months after vaginal reconstruction with satisfactory outcome. One patient with vaginal duplication reported a successful pregnancy with a Caesarean section delivery. Clinical Implications: Urinary incontinence with megalourethra in young women, along with the presence of Mullerian anomalies should raise suspicion of urethral coitus. Surgical treatment includes correction of vaginal anomalies and management of consequences. Strengths and Limitations: This study represents one of the largest series for urethral intercourse, with assessment of psychosexual outcome. The limitation is the lack of statistical analysis due to small sample size. Conclusion: Urethral intercourse is very rare, but it can cause severe consequences. It is important to recognize this occurrence and treat it by well-known vaginal or urethral reconstructive procedures. Djordjevic ML, Bizic M, Stojanovic B, et al. Treatment of Urethral Intercourse and Impact on Female Sexual Function. Sex Med 2022;XX:XXXXXX. © 2022 International Society for Sexual Medicine