The Effect of Vaginal Tightening Surgery on Sexual Function: A Systematic Review.

Introduction and hypothesis: Lifetime physiological or pathological events, such as vaginal delivery and menopause, may change vaginal structure and appearance, owing to local tissue expansion and separation of the pelvic floor muscles, which can affect a woman's sexual relationships. This systematic review was aimed at exploring the effect of vaginal tightening surgery on female sexual function.

Methods: Articles that had measured female sexual function after vaginal tightening were considered eligible. Articles on vaginal tightening surgeries conducted only for cosmetic and/or sexual and/or functional reasons (not for medical indications) and which evaluated postoperative sexual function by a quantitative tool were included. A literature review was conducted by searching databases such as PubMed, Web of Science, Scopus, PsycINFO, Embase, the Cochrane Library, and ClinicalTrials.gov from the beginning of 2000 until 1 February 2024.

Results: The authors identified 11 studies that had evaluated sexual function after vaginal reconstructive procedures designed to adjudicate sexual issues involving loss of friction, orgasmic, and aesthetic concerns. Although most of the studies implied that vaginal tightening could improve sexual function, more meticulous assessment of the studies' methodology challenged the robustness of these findings in clinical decision making.

Conclusions: Although on the surface, it can be concluded that vaginal tightening surgery improves women's sexual function, the conclusion is severely restricted owing to the absence of the precise measurement of vaginal laxity, as well as the inconsistency in surgical techniques, methods, and tools employed in the research.