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The Impact of Abdominal Contouring with Monsplasty on Sexual Function and Urogenital Distress in Women Following Massive Weight Loss
Michael R. Bykowski, M.D., J. Peter Rubin, M.D., Jeffrey A. Gusenoff, M.D..
University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Background: Monsplasty is a procedure that treats massive weight loss (MWL) patients with redundant tissues and fat in the mons region (see Figure). Monsplasty is not a routine component of abdominal contouring. We investigated changes in urinary dysfunction and sexual function in patients who undergo abdominal contouring with monsplasty versus no abdominal contouring.
Methods: A prospective study was performed to record factors such as age, body mass indices, parity, pannus weight, relationship and hormonal status, and weight loss method. Changes in urinary dysfunction and sexual function were assessed at two time periods using validated tools. The “non-surgical group” was evaluated at a baseline time and then three months later. The “surgical group” was evaluated before abdominal contouring with monsplasty and then three months later.
Results: Mean age in the surgical group (n=20) was 47 years (IQR, 38-55 yrs) vs. 41 years (IQR, 36-53.8 years) in the non-surgical group (n=20, p=0.43); mean body mass (p=0.93); mean parity was 2 (range: 0-3) vs. 2 (range: 0-3) (p=0.68). There was a statistically significant decrease in the Urogenital Distress Inventory Short Form score for the surgical group (Interquartile Range; IQR = -7.7 to 5.6) versus the non-surgical group (IQR: 0 to 11.1; p= 0.03). The change in Female Sexual Function Index was not different between the surgical and non-surgical groups (IQR: 1.2 – 1.6 vs 0.1 – 2.6; p=0.11).
Conclusion: Urinary dysfunction improved even at the early time point of three months following abdominal contouring procedures including monsplasty. The postoperative period of three months, however, was not long enough to see a significant change in female sexual function, although research suggests that there is an improvement to be realized. Thus, we recommend monsplasty in conjunction with abdominal contouring procedures in the MWL female patient.

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