Ozan DOĞAN, Murat YASSA, Aşkı Ellibeş KAYA, Eray ÇALIŞKAN, Pınar KADIROĞULLARI, Erhan Hüseyin CÖMERT, Cavide ALİ, Ebru ALPER, Kübra BAĞCI, Melih BESTEL, Pınar Birol İLTER, Sinem BOSTAN, Sezen Bozkurt KÖSEOĞLU, Yasin CEYLAN, Telal DOĞRUEL, Murat EMANETOĞLU, Süleyman ESERDAĞ, Gökçe GÖKKAYA, Sevtap Hamdemir KILIÇ, Ümran Karabulut DOĞAN, Ozan KARADENİZ, Cihan KAYA, Özgür LEYLEK, Ali MUTLU, Nurullah PEKER, Hanifi ŞAHİN, Mehmet Baki ŞENTÜRK, Akın SIVASLIOĞLU, İnci SÜLEYMANOVA, Özgüç TAKMAZ, Elif UÇAR
Anatolian Journal of Obstetrics and Gynecology Research - 2026;3(2):62-78
Purpose: Aesthetic vaginoplasty, defined as surgical vaginal tightening performed for cosmetic, sexual, and/or functional reasons without a primary medical indication, has become increasingly common in gynecological practice. Despite growing demand, no validated clinical guidelines exist to govern patient selection, surgical technique, perioperative management, or outcome assessment for these procedures. The Pelvic Floor and Cosmetic Gynecology (PETKOZ) Association of Turkey initiated this project to develop the first, expert-based consensus statement on aesthetic vaginoplasty. Methods: A modified Delphi methodology was used across three successive rounds, with a 100% response rate in each round. Twenty-six nationally recognized experts in gynecology, urogynecology, pelvic floor surgery, and related disciplines participated. A steering committee developed an initial statement pool across 14 clinical domains: contraindications; preoperative assessment; indications; surgical principles and goals; technical selection; intraoperative management; revision surgery; complications; perioperative management; postoperative care; outcomes; guidelines and future directions; advanced technical topics; and ethics and psychosexual evaluation. Consensus was defined as >=70% agreement. All rounds were conducted anonymously via Google Forms. Results: A total of 211 statements were evaluated across 14 domains. Consensus was reached on 198 statements (93.8%); 13 statements (6.2%) across six domains did not meet the threshold. Agreement rates ranged from 70% to 100%, with majority of statements reaching 88% or above. Strong consensus was obtained on comprehensive preoperative assessment, individualized technique selection, the importance of functional alongside aesthetic outcomes, standardized perioperative protocols, and the need for formal training programs. Statements that did not reach consensus included whether subjective vaginal laxity alone is a sufficient surgical indication, the role of partner expectations in decision-making, the use of local anesthesia, and suitability of same-day discharge. Conclusion: This consensus statement, developed by PETKOZ through structured expert consultation, provides a practical guidance framework for the safe implementation of aesthetic vaginoplasty in clinical practice. Given the limitations of the current evidence base, this document is intended as a reference for clinicians until data from well-designed prospective studies become available.
