Outpatient Female Genital Cosmetic Surgery: A Systematic Review and Meta-Analysis.

Abstract

Demand for female genital cosmetic surgery (FGCS), primarily labiaplasty, is increasing globally because of aesthetic and functional concerns. Although traditionally performed in hospital settings, these procedures are increasingly transitioning toward outpatient, office-based care under local anesthesia. This study aimed to evaluate whether the transition to outpatient care maintains high standards of patient satisfaction, safety, and sexual function compared with traditional hospital-based interventions. A systematic review and meta-analysis were conducted following PRISMA guidelines. Searches were performed in Medline, Embase, Cochrane, and ClinicalTrials.gov through November 2025. Primary outcomes included the Female Genital Self-Image Scale (FGSIS), Female Sexual Function Index (FSFI), and Sexual Quality of Life-Female (SQoL-F). Fourteen studies were included. Meta-analysis demonstrated significant postoperative improvements in FGSIS, total FSFI, and SQoL-F. Notably, SQoL-F showed zero heterogeneity, indicating uniform benefits across both outpatient and hospital settings. Significant improvements were observed in individual FSFI domains, including lubrication, satisfaction, arousal, orgasm, and desire (all statistically significant), whereas sexual pain showed no significant pooled difference. Functional gains were more closely linked to surgical technique than clinical infrastructure. FGCS reliably improves genital self-image and sexual quality of life in both outpatient and hospital environments. Success is primarily determined by surgical technique and patient selection rather than the facility type or anesthetic protocol. Level of Evidence 3 (Therapeutic).