Arrhythmias are common following elective large bowel resection. They occur in older patients and are associated with the development of other complications.

Penile augmentation is increasingly sought by men who are dissatisfied with the size and/or appearance of their penis. However, augmentation procedures are still considered to be highly controversial with no standardized recommendations reported in the medical literature and limited outcome data. Nevertheless, these procedures continue to be performed in increasing numbers in private settings. Therefore, there is a need for safe, effective, and minimally invasive procedures to be developed, evaluated, and reported in the research literature. In this article, we focus particularly on girth enhancement procedures rather than lengthening procedures as penile girth appears to be particularly important for sexual satisfaction. We discuss the advantages and disadvantages of the common techniques to date, with a focus on the minimally invasive injectable girth augmentation techniques. Based on considerable operative experience, we offer our own suggestions for patient screening, technique selection, and perioperative care.

Background An increasing number of men, dissatisfied with their penises, are seeking cosmetic procedures to enhance their penis size. However, little is known about the social and cultural factors that influence men to consider these procedures. Objectives The aim of this study was to investigate the sociocultural factors affecting men’s attitudes toward their penis size as well as their decisions to undergo penile augmentation. Methods One-on-one semistructured interviews were conducted with 6 adult men who had previously undergone a penile augmentation. The men were asked about the sociocultural factors that they thought contributed to dissatisfaction with their penis size, and their motivations for having penile augmentation. All interviews were audio recorded and then transcribed verbatim. Interview transcripts were analyzed through the use of thematic analysis. Results Three main themes emerged from the interviews, namely “influence of pornography,” “comparison with peers,” and “indirect appearance-related teasing.” The men noted that the large penises of male actors in pornography had skewed their perception of normal penis size. All men had compared their penises with those of their peers, usually in the locker room, and often felt their own penis was smaller as a result. None of the participants had received direct negative comments about their penis size, but were aware that having a small penis was a source of mockery from exposure to jokes on mainstream media sources. Conclusions These new insights into the sociocultural factors, namely media and peers, that influence men’s desire for penile augmentation may assist clinicians in enhancing their communication with prospective patients.

Background In the subspecialty of female genital cosmetic procedures, patient satisfaction and quality of life are key outcome measures. As such, valid and reliable patient-reported outcome measures (PROMs) examining these outcomes are essential. Objectives The authors sought to identify and scrutinize all PROMs developed for female patients undergoing genital cosmetic procedures. Methods The authors performed a systematic literature review utilizing MEDLINE, PreMEDLINE, Ebase, Embase, OVID, CINAHL, Cochrane Library, PsycINFO, PubMed, and Google Scholar to identify PROMs developed and validated for utilization in female genital cosmetic procedure patients. Instruments identified were assessed according to international guidelines for health outcome measures development and validation. Results The authors identified 50 outcome questionnaires employed in the female genital cosmetic procedure literature. Of these, 26 were ad hoc instruments (ie, had not been formally developed and tested) and 22 were generic instruments (ie, intended for use in broad groups of people, not only specific patient groups). Only 2 instruments have been validated in a female genital cosmetic procedure patient population. These were the Genital Appearance Satisfaction scale and the Cosmetic Procedure Screening Scale–Labiaplasty. Although both these scales had undergone fairly rigorous psychometric development and validation, both had content limitations. Conclusions There is a lack of specific, valid, and reliable satisfaction and quality-of-life PROMs in the field of female genital cosmetic procedures. Future research should involve the development of such measures to more accurately assess the outcomes and benefits of these procedures.

Background The popularity of genital cosmetic procedures in women is increasing. These procedures are often assumed and promoted as having a positive effect on women’s psychological well-being, particularly their self-esteem. Empirical support for these claims is lacking. Objectives The aim of this study was to conduct a systematic review and meta-analysis of the impact of genital cosmetic procedures on self-esteem in women. Methods The authors performed a systematic literature review of MEDLINE, PreMEDLINE, Ebase, EMBASE, OVID, CINAHL, Cochrane, PsycINFO, and PubMed to identify articles that measured self-esteem in women after a genital cosmetic procedure. A meta-analysis was conducted to assess the pooled effect of these procedures on self-esteem. Results The authors identified 5 eligible studies for the meta-analysis, comprising 2 prospective and 3 retrospective studies. Labia minora reduction was the most commonly studied procedure. All 5 studies used different measures of self-esteem, with only 1 study employing a validated psychometric measure at both preoperative and postoperative time points. The meta-analysis results showed a pooled logit rate estimate of 1.230, indicating a positive effect of surgery on self-esteem. However, there was substantial heterogeneity across studies. Conclusions Female genital cosmetic procedures, particularly labiaplasty, appear to have a positive effect on women’s self-esteem. However, inconsistencies in study measures and methods limit our conclusions. Future research should involve the development of standardized outcome measures to more accurately assess the impact of these procedures on self-esteem, and on psychological well-being more generally. Level of Evidence: 3