Genito Pelvic Vaginal Laxity: Classification, Etiology, Symptomatology, and Treatment Considerations

Purpose of Review: Genitopelvic laxity remains a heterogenous medical condition that is treated by a variety of health care professionals including obstetricians, gynecologists, urologists, dermatologists, and plastic surgeons. There remains much confusion regarding definitions of esthetic and functional pelvic laxity as well as which therapeutic intervention may be best suited to treat this condition. There are currently no commonly accepted vernacular, definitions, medical etiology, and predisposing risk factors to this medical and esthetic condition. There is no accepted standardization for assessment and treatment paradigms. Recent Findings: There is limited consistency with nosology, etiology, and treatment paradigm for genitopelvic laxity. The published literature on non-invasive office-based technological interventions for both laser and radiofrequency devices includes primarily prospective descriptive studies, and randomized sham-controlled research is sparse. There are knowledge gaps for both health care professionals and patients. We provide a comprehensive review of the condition and propose new terminology so that clinicians worldwide may be using the same terms to discuss the same condition. A proposed comprehensive treatment paradigm is presented that outlines conservative to more aggressive interventions for this condition. This will facilitate sharing of medical information and further advance the field of study. Summary: Common terminology, nosology, and a better understanding of the mechanism of action of each therapeutic device are warranted. An awareness of the medical etiology of genitopelvic laxity, coupled with a better familiarity of disease impact, will allow better treatment paradigms to be developed and implemented. There is a need for high-quality sham-controlled longitudinal studies as it pertains to new emerging technologies such as laser and radiofrequency.