Academic cosmetic gynecology and energy-based therapies: ambiguities, explorations, and FDA advisories

Excerpt

What is preprolapse? Similar to prediabetes describing impaired glucose tolerance not yet severe enough to warrant a pathologic diagnosis, preprolapse is a mild defect in pelvic organ support. A concept that is easily conveyed to patients, this term is not yet standardized or widely accepted among urogynecologists. What about vaginal laxity? Here, at least, we have a working precedent of the complaint of excessive vaginal looseness [1]; however, without an objective measure such as the Pelvic Organ Prolapse Quantification System (POP-Q), this also will vary between patients and providers. Energy-based and surgical treatment for these nebulous conditions, along with others too numerous to describe here, have fallen under the umbrella of the mutually ambiguous yet ubiquitous term vaginal rejuvenation. And now, with Pandora’s box completely opened, this July, the US Food and Drug Administration (FDA) issued an official warning against energy-based therapy [2]. …