Table 1

Chosen criteria for analysis of websites

CriteriaWhat was analysed
1. Types of procedure offeredProcedures classified into general types of procedure (if possible)
2. Description of procedureInformation given on surgical technique and other information for example, use of laser
3. Use of medical rhetoricSuggestions that treatment is for a medical condition. Specific use of the term ‘labial hypertrophy’ as an indication for labiaplasty.
4. Symptoms that surgery treatsPhysical discomfort or appearance concerns
5. Benefits of surgery stated or impliedImprove discomfort or appearance. Mention of any other benefits such as hygiene
6. Success ratesWhat percentage of women achieve the benefits listed in 5.
7. Specific reference to social and psychological advantagesNon medical benefits such as confidence leading to other advantages.
8. Specific reference to enhancement of sexual experienceAny mention that sex will be improved for the patient or partner.
9. Risks of surgeryInfection and bleeding should be documented as a potential risk of any surgical procedure. Other recognised risks include scarring and dissatisfaction with outcome.
10. Absence or presence of a caution sectionAre consumers advised to think carefully before proceeding to FGCS?
11. AftercareBasic wound hygiene should be given following any genital surgical procedure
12. Immediate outcomesThese would include beneficial outcomes and short-term risks as listed in 9.
13. Long-term outcomesThese would include beneficial outcomes such as those listed in 5,7 and 8 as well as potential risks listed in 9.
14. Absence or presence of positive testimonialsUsually in the form of personal stories about how surgery impacted upon an individual
15. Absence or presence of ‘before’ and ‘after’ imagesPhotographs ‘before’ and ‘after’ were analysed. Some sites contained videos which we did not analyse
16. Lowest age limit for surgeryAny mention that 16 years is the age of legal consent for surgery