What is the mission and vision of Aesthetic and Functional Gynecology?

Aesthetic and Functional Gynecology: Mission and Vision

The mission of aesthetic and functional gynecology is to restore pelvic floor function, enhance sexual health, and improve quality of life through evidence-based interventions that address both physical dysfunction and psychosocial well-being in women across the lifespan.

Core Mission Components

Functional Restoration as Primary Goal

The primary mission centers on treating pelvic floor dysfunction that causes urinary and bowel incontinence, pelvic pain, and sexual dysfunction, with quality of life improvement as the ultimate outcome measure. 1 This encompasses:

• Addressing dyspareunia (painful intercourse) resulting from vaginal atrophy, stenosis, or anatomical changes from surgery, radiation, or aging to restore sexual function and overall well-being 1
• Managing vulvar pain, postcoital bleeding, and difficulty with tampon insertion that interfere with daily activities to enhance sexual satisfaction and physical comfort 1
• Treating vestibular gland dysfunction and vaginal shortening that impair sexual activity to enhance genital sensation and reduce pain during intercourse 1

Sexual Function Enhancement

The vision includes comprehensive sexual health restoration, recognizing that enhancing sexual desire, arousal, lubrication, orgasm, and overall satisfaction represents a critical component of quality of life. 1 This involves:

• Addressing hormonal deficiencies causing vaginal dryness and reduced sensation through local estrogen therapy or other interventions 1
• Achieving overall patient satisfaction rates of 90-95% and sexual satisfaction over 80-85% as documented outcome benchmarks 2
• Treating both aesthetic and functional concerns that women present with, recognizing the overlap between cosmetic appearance and medical function 3, 4

Psychosocial Integration

Sexual rehabilitation must incorporate both physical and psychosocial aspects, as 80% of women desire to discuss sexual issues but both providers and patients tend to avoid this topic. 1 The mission includes:

• Addressing depression, poor body image, and psychoemotional issues through counseling and sex therapy to improve psychological well-being 1
• Providing psychoeducational interventions to help patients understand and cope with physical and sexual changes, enhancing patient autonomy and decision-making 1
• Screening for psychological conditions and ensuring women act autonomously without coercion from partners or surgeons with proprietary conflicts of interest 3

Vision for Comprehensive Care

Bridging Aesthetic and Medical Concerns

The field recognizes that the line between cosmetic and medically indicated surgical procedures is blurred, and many operations are performed for both purposes. 3 The vision encompasses:

• Delivering safe and effective procedures with minor and acceptable complications, as demonstrated by 92% of women experiencing no complications after procedures 5
• Treating the suite of conditions associated with course-of-life vulvo-vaginal changes with mounting scientific evidence supporting safety and efficacy 4
• Addressing both cosmetic reasons (appearance concerns) and functional reasons (chafing, interference with coitus, interference with athletic activities) that women present with 2

Patient-Centered Decision Making

The issue of requesting and providing aesthetic and functional gynecology services is essentially a matter of individual patient and physician decision-making. 4 This vision requires:

• Educating women about the range and variation of labia widths and genital appearance before proceeding with interventions 3
• Evaluating for true pelvic support disorders such as pelvic organ prolapse and stress urinary incontinence that may require different treatment approaches 3
• Ensuring women report overall satisfaction and improvement of sexual function, genital appearance, and self-esteem as primary outcome measures 5

Long-Term Quality of Life Focus

The broader vision aligns with gynecologic care principles that long-term survivors may be cured but still have ongoing health concerns and long-term side effects requiring attention. 6 This includes:

• Addressing sexual dysfunction (35.7%), neurologic symptoms (35.2%), and urinary dysfunction (33.0%) that persist as long-term treatment effects 6
• Recognizing that 55% of women experience changes in sexuality including distortion of self-image (45%), dry vaginal mucosa (25%), and dyspareunia (20%) 6
• Providing information regarding side-effects and different types of treatment to meet the high need for patient education 6

Critical Implementation Principles

The specialty must balance rapidly expanding patient demands with scientific rigor, ensuring reconstructive pelvic surgeons master cosmetic genital procedures to deliver what women want in the most scientific manner. 4 This requires:

• Maintaining outcome data demonstrating beneficial results with overall patient satisfaction in the 90-95% range and sexual satisfaction over 80-85% 2
• Avoiding proprietary conflicts of interest and ensuring autonomous patient decision-making 3
• Integrating contributions from gynecologists and reconstructive pelvic surgeons to maintain the distinction between legitimate pelvic floor disorders and purely aesthetic conditions 3