ABBREVIATIONS ACHI Australian Classification of Health Interventions ACOG American College of Obstetricians and Gynecologists ACT Australian Capital Territory AIHW Australian Institute of Health and Welfare BDD Body dysmorphic disorder CMFM Comprehensive Management Framework of the MBS DRG Diagnosis Related Group EMSN Extended Medicare Safety Net FGCS Female genital cosmetic surgery GP General Practitioner HTA Health Technology Assessment MBS Medicare Benefits Schedule MOOSE Meta-analysis of Observational Studies in Epidemiology MSAC Medical Services Advisory Committee NHMD National Hospital Morbidity Database NHMRC National Health and Medical Research Council NHS National Health Service (United Kingdom) NSW New South Wales PASC Protocol Advisory Sub-Committee (of MSAC) PICO Population, Intervention, Comparator, Outcomes QUOROM Quality of Reporting Meta-analyses RANZCOG Royal Australian and New Zealand College of Obstetricians and Gynaecologists RCC Review Consultation Committee RCT Randomised controlled trial SD Standard deviation TGA Therapeutics Goods Administration
Figure 3.9: Number of separations for ACHI code 35533-00 by female age category, 2007/08 to 2011/12 Source: Department of Health, NHMD data 3.2.2 Principal diagnosis (ICD codes) for vulvoplasty Table 3.4 shows the number and percentage of separations for vulvoplasty (ACHI code 35533-00) from 2007/08 to 2011/12 by principal diagnosis. In each year, the most common principal diagnosis was ‘hypertrophy of vulva’, which increased from 23% in 2007/08 to 33% in 2011/12. The second most common principal diagnosis was ‘non-inflammatory disorders of vulva and perineum’ (17% of all separations from 2007/08 to 2011/12), followed by ‘other plastic surgery for unacceptable cosmetic appearance’ (7%). Overall, there was a broad range of principal diagnosis codes used, with 31% of all separations being classified as ‘other’, of which the majority represented ≤1% of all separations. Table 3.4: Principal diagnosis for ACHI code 35533-00 by percentage, 2007/08 to 2011/12 Number of separations (%) Source: Department of Health, NHMD data
2003() resection of the labia minora with a 90-degree that all patients were fully satisfied with the aesthetic appearance. Munhoz et al. 2005() Inferior wedge resection and superior pedicle flap reconstruction 21 Questionnaire 21 (100%) Authors reported 20 patients ‘very satisfied’ and one patient ‘satisfied’. Pardo et al. 2006() Laser 55 All patients completed a satisfaction and acceptance questionnaire Not reported Not reported Rezai et al. 2007() De-epithelialised reduction (n=50) Running resection (n=50) 100 Not reported Not reported Anecdotal reporting by authors that patients in both groups experienced improvement in chronic irritations, sexual intercourse, hygiene. Alter et al. 2008() Extended central wedge resection 407 Post-operative mailed questionnaire 166 (41%) 71.6% (106/148) of patients seeking surgery for discomfort pre-operatively reported it had resolved. Ellsworth et al .2010() 3 techniques used based on degree of hypertrophy 12 Yes – method unclear Not reported One patient not satisfied as felt labia minora had been overly reduced. Authors report that all women who had previously had discomfort with clothing or sexual intercourse had their symptoms resolved. Goodman et al. 2010() Not reported 177a Yes – questionnaire 177 (100%) 97% satisfied Trichot et al. 2010() Labioplasty with pedicle flap reconstruction 18 Yes – mailed questionnaire 18 (100%) All patients reported overall satisfaction with the outcome mean rating 8.7 on a scale ranging from 0-10. All patients who previously reported discomfort reported improvement. Solanki et al. 2010() Not reported 12 Yes – method unclear 9 (75%) Anecdotal reporting by authors that all patients were very satisfied with the functional and aesthetic outcome of the surgery. Cao et al. 2012() De-epithelialised technique 167 Yes – method unclear Not reported Two patients not satisfied and underwent further reduction surgery. Anecdotal reporting by authors that all other patients satisfied. Gress (2013)() Composite reduction technique 812 Yes – mailed questionnaire Not reported Functional problems resolved in 92.3% of patients. Psychological distress completely relieved in 89.7% of patients. a 24 patients with clitoral hood reduction only are included in this group as results were reported together with 153 patients having labioplasty.