Presentation Authors: Paige Kuhlmann*, Carrie Stewart, Colby Souders, Ariel Moradzadeh, Justin Houman, Lenore Ackerman, Jennifer Anger, Karyn Eilber, Los Angeles, CA
Introduction: "Vaginal rejuvenation", or "&[ne]vejuvenation" as referenced on social media, is a phrase frequently encountered in popular culture today. However, there is no widely accepted definition for what this phrase encompasses, and there is no ICD-10 diagnosis or procedure code under which to bill for this treatment. Additionally, the FDA recently issued a statement warning against certain devices marketed specifically for this purpose. We aimed to investigate how individuals working in the healthcare profession and the general population interpret "vaginal rejuvenation."
Methods: We administered a standardized survey to 40 people, including 22 healthcare professionals in urology, gynecology, plastic surgery, internal medicine, or nursing, as well as 18 lay people. We inquired as to whether they had heard the term "vaginal rejuvenation," whether it was a surgery/procedure or non-procedural treatment, what it is, how it helps, when it should be used, why people have vaginal rejuvenation, and how vaginal rejuvenation is performed.
Results: Thirty-three of respondents (82.5%) were familiar with the term, 31 (77.5%) thought it was a surgery/procedure, and 13 (32.5%) thought it was a non-procedural treatment."Vaginal rejuvenation" as a catch-all phrase for a myriad of procedures was a commonly shared opinion among medical professionals to include vaginal procedures with varied energy sources (laser, thermal, ultrasound) and pelvic reconstructive procedures ( perineoplasty, perineorrhaphy, prolapse repair, labioplasty). Use of vaginal laser was by far the most commonly mentioned procedure. The phrase was called "colloquial" and "loose," and repeatedly described as a marketing strategy. In regards to how "vaginal rejuvenation" helps patients, there were the following main themes: anatomic alteration (vaginal tightening, repairing prolapse, improving cosmetic appearance); symptomatic improvement (relieving atrophy/dyspareunia, restoring normal sexual/urinary/defecatory dysfunction, enhancing sexual pleasure); placebo effect; no help at all. It was almost unanimous among healthcare providers that patients should only pursue "vaginal rejuvenation" procedures when symptomatic or medically indicated.In contrast to healthcare professionals, lay people tended to think of "vaginal rejuvenation" in terms of results as opposed to a specific procedure: treatment to address vaginal "dryness," "painful sex," and "incontinence." The large majority mentioned improved cosmesis, increased sexual sensation, and particularly "tightening" of the vagina. Five (12.5%) lay people mentioned a medical reason for receiving "vaginal rejuvenation" (dyspareunia, incontinence), and five also thought it was a procedure performed with a laser, although eight (20%) had no idea how it was done.
Conclusions: The term "vaginal rejuvenation" is ill-defined and elicits a highly variable description among healthcare professionals and lay persons alike. Indications for receiving it are not well aligned between providers and patients. Knowledgeable providers should use this information to counsel against widespread misunderstanding in popular culture.