Daily Cosmetic Research Analysis

OBJECTIVES: To systematically review the literature on women's sexual quality of life after Transvaginal Natural Orifice Endoscopic Surgery (vNOTES) for gynecological and non-gynecological procedures, and to assess women's perceptions of vNOTES, the recommended duration of postoperative sexual abstinence (medically advised pelvic rest), the actual rate and timing of postoperative resumption of sexual activity (proportion of women resuming intercourse after surgery), and overall satisfaction. DATA SOURCES: PubMed, Google Scholar and the Cochrane Central Register of Controlled Trials (CENTRAL). METHOD OF STUDY SELECTION: We searched the three databases for studies published between 2010 and January 5, 2026, using the terms 'transvaginal natural orifice transluminal endoscopic surgery', 'transvaginal laparoscopic surgery' and 'vnotes' combined with 'sexual function', 'sexual quality of life' and 'dyspareunia'. We included studies evaluating women's sexual quality of life pre- and post-operatively. Exclusion criteria were vaginal surgery without vNOTES, vNOTES not used for the main procedure, hysterectomy, urogynecology and endometriosis surgeries, missing pre- or post-operative sexual function evaluation, full text unavailable in English or French, missing or unclear methodology, literature reviews, meta-analyses and protocols. TABULATION, INTEGRATION, AND RESULTS: We included 28 articles in the final systematic review: 5 randomized controlled trials, 17 prospective cohort studies, and 6 retrospective cohort studies, covering 9 gynecologic and 19 non-gynecologic indications (urology, gastrointestinal and endocrine surgery). Screening and data extraction were performed independently at all stages by two reviewers. Across all studies, over 1240 procedures were performed using vNOTES or hybrid vNOTES, several compared with conventional laparoscopy. Overall, vNOTES did not significantly impair female sexual function, except in two studies conducted in an oncologic context. Younger and nulliparous women expressed greater concerns regarding fertility and sexual outcomes, while postoperative sexual abstinence recommendation-highly variable across studies-was a key source of concern. Reduced morbidity and a high satisfaction rate favored acceptance, whereas the cosmetic advantage of scarless surgery showed variable influence. CONCLUSION: The transvaginal approach, in pure or hybrid vNOTES, across both gynecologic and non-gynecologic surgeries, appears to be safe regarding sexual function, with no meaningful difference compared with CL. SUMMARY: Transvaginal NOTES appears to preserve sexual function across procedures, with rare exceptions in oncologic settings. Fertility-related concerns (including infertility, pregnancy, and childbirth) and recommended sexual abstinence influence perceptions, while reduced morbidity and high satisfaction promote acceptance.

INTRODUCTION: Disorders of sex development (DSD) are characterized by atypical genital development, with significant physical and psychosocial impact. Feminizing genitoplasty is an important therapeutic option in selected cases, but remains controversial regarding functional preservation, particularly clitoral sensitivity. Corporoplasty is a simplified technique that preserves the corporal bodies and avoids dissection of the neurovascular bundle, prioritizing functional and cosmetic outcomes. MATERIALS AND METHODS: This multicenter cross-sectional study included 37 female patients with congenital adrenal hyperplasia, classified as Prader II-V, who underwent corporoplasty between 2014 and 2025. Patients with ≥6 months of postoperative follow-up were included. Genital sensitivity was assessed using Semmes-Weinstein monofilaments applied to the clitoris, labia majora, vaginal introitus, and thigh. Cosmetic evaluation was performed by independent pediatric urologists and caregivers. Additional instruments included PedsQL™ and PACE-F. RESULTS: Median age at surgery was 2.5 years (31.5 months), and median Prader stage was 3 (3-4). Sensitivity thresholds were preserved across all genital regions, with earlier age at surgery significantly associated with better tactile sensitivity (ρ = -0.38 to -0.46; p < 0.05). Median clitoral threshold was 0.07 g (IQR 0.07-0.20), with 59.3 % responding to the lowest filament. No patient reported pain or allodynia. Clitoral variation was perceived by 55.2 % of caregivers. Cosmetic outcomes were rated as good or satisfactory by all physicians (52.9 % and 47.1 %, respectively) and by 90 % of caregivers. Agreement between physicians and caregivers was moderate for clitoral appearance (Kappa = 0.401; p = 0.005). Caregivers reported high satisfaction rates (85.3 %) and low embarrassment (73.5 %), and PedsQL scores were high (median 95). DISCUSSION: The findings demonstrate that corporoplasty preserves genital sensitivity and has a favorable caregiver-reported psychosocial perception, with high satisfaction among patients and families. The absence of association between of virilization and sensitivity supports the applicability of the technique across different clinical scenarios. The negative correlation between age and sensitivity thresholds supports early surgical intervention. Limitations include relatively short follow-up and lack of assessment of sexual function in adulthood. CONCLUSION: Corporoplasty suggests being safe, effective, and reproducible, balancing functional preservation, cosmetic outcome, and favorable caregiver-reported psychosocial perception. It represents a promising option for patients with DSD, with early intervention favoring better long-term outcomes. Longitudinal studies are needed to confirm adult functional and quality of life outcomes.

PURPOSE: No Urethroplasty Techniques (NUTs) are technically simple, low-morbidity alternatives to urethroplasty for the correction of distal hypospadias. Along with functional outcomes, cosmetic results have become increasingly relevant in recent years. Despite the high number of techniques, some drawbacks remain in achieving these goals. The aim of this paper is to describe the Inverted V-I MeatoGlanuloplasty technique, developed at our center for the treatment of distal hypospadias and to evaluate its outcomes. MATERIALS AD METHODS: A retrospective, single-center study was conducted on patients with distal hypospadias treated with Inverted V-I MeatoGlanuloplasty between 2005 and 2024. The technique involves a triangular skin flap excision under the meatal apex, deep glanular dissection, meatoplasty, and glanuloplasty. Data on demographics, type of hypospadias, surgical details, complications, and follow-up were collected. RESULTS: During the study period, a total of 190 procedures were performed at a median age of 3.0 (1.2-17.2) years. Patients presented with 97 (51.1%) glanular, 84 (44.2%) coronal, and 9 (4.7%) distal penile hypospadias. Chordee was present in 122/190 (64.2%) patients and was corrected with spongioplasty. Complications were observed in 9 patients (4.7%): 5 meatal retractions (2.6%) and 4 fistulas (2.1%). No infections or meatal stenoses occurred. Aesthetic and functional outcomes were satisfactory in most patients. CONCLUSIONS: The IV-IMG technique is a well reproducible procedure that offers excellent functional and cosmetic outcomes in distal hypospadias, with a low complication rate. It represents a valid alternative to other non-urethroplasty techniques when glans anatomy and meatal position are favorable.