Incidence of Obstetric Lacerations and Episiotomy Following Labiaplasty

BACKGROUND: A significant proportion of patients seeking labiaplasty are nulliparous and may experience later changes to their labia following vaginal delivery. OBJECTIVES: In the present study, we report the long-term outcomes of a single surgeon's patient cohort who had vaginal delivery after labiaplasty. METHODS: A retrospective chart review of the senior author's database was conducted. All patients undergoing in-office labiaplasty from 2007-2018 were surveyed. The resulting cohort was stratified into patients who had delivered children prior to labiaplasty, and those that delivered after labiaplasty. RESULTS: 204 patients responded to a phone survey. 70 patients had children prior to undergoing labiaplasty, while 33 had children after labiaplasty. The rate of vaginal delivery was lower in the women who had children before labiaplasty (82.6% vs. 91.8%, p = 0.015). The tear/episiotomy rate for vaginal deliveries was lower in women who had children prior to labiaplasty compared to after labiaplasty (3.1% vs. 17.8%, p < 0.001). Among the women who had children only after labiaplasty, the reported tear/episiotomy rate was 7/39 vaginal deliveries (17.9%). CONCLUSION: Patients in our cohort had over 90% success with vaginal deliveries after labiaplasty. For nulliparous patients contemplating the procedure, the data we present suggest the risk of episiotomy or vaginal tear risk with vaginal birth after labiaplasty is comparable to or lower than the general population, further supporting the safety of this procedure. For patients with prior delivery, the data are more limited but suggest no increased risk in this small cohort.