Résumé
Labiaplasty is the most common genital surgery, increasing since the last 10 years. This study analyzes the long-term impact of labiaplasty on sexual function and self-esteem and searches body dysmorphic disorders (BDD). Materials and methods: this was a prospective monocentric study of 49 patients operated on at the Saint Roch polyclinic in Montpellier between 2016 and 2019. Each patient answered 3 self-questionnaires: the FSFI (Female Sexual Function Index), the BES (Body Esteem Scale) and the BDDQ (Body Dismorphic Disorder Questionnary) preoperatively, at 3 months, 1 year and at more than 3.5 years. FSFI and BES scores were compared using the Wilcoxon signed rank test for paired samples. Subgroup analysis was performed according to type of surgeon, history of cosmetic surgery and psychological follow-up. A quantitative analysis with the calculation of a cumulative score was used to identify patients at risk of developing BDD, and we conducted a thematic qualitative analysis with a categorization of the BDDQ. Results: 28 patients were included. Mean follow-up time was 5.6 years (3.5-7.1). FSFI was increased between inclusion and long-term follow-up (20.1/36 to 27.8/36, p=0.0001). The dimensions "lubrication", "orgasm", "satisfaction" and "pain" were improved (p<0.05). Self-esteem remained unchanged (77.4/115 to 75.7/115, p=0.7111). Only patients operated on by a plastic surgeon had a significant improvement in BES (p=0.0138). 4/28 patients were at risk of developing BDD at inclusion, and none in the long term.Conclusion: labiaplasty surgery has a positive impact on sexual health over the long term. It does not alter self-esteem, and body dysmorphic disorders improve after surgery.