BACKGROUND Monsplasty treats massive weight loss (MWL) patients with redundant tissues in the mons region. Monsplasty, however, is not a routine component of abdominal contouring. OBJECTIVES The goal of this study was to evaluate the changes in urinary and sexual functioning in patients who undergo abdominal contouring with monsplasty vs non-operated controls. METHODS A prospective study was performed of patients who underwent abdominal contouring + monsplasty or no surgery. The Urogenital Distress Inventory Short Form (UDI-6) and the Female Sexual Function Index (FSFI) questionnaires were administered to both groups at baseline and then three months later. RESULTS The surgical (n = 20) and nonsurgical groups (n = 20) were similar related to patient demographics, body mass index after MWL, parity, relationship status, hormonal status, and baseline UDI-6/FSFI scores (all P values >0.05). After three months, there was a statistically significant decrease in the UDI-6 score for the surgical groups vs the nonsurgical group: median UDI-6 score = -0.01 (interquartile range [IQR], -7.65-5.55) vs 0 (IQR, 0-11.11) (P = .03). There was no change for the Female Sexual Function Index in the surgical vs nonsurgical groups: median FSFI = 0.20 (IQR, -1.20-1.58) vs 0.95 (IQR, 0.08-2.58) (P = .11). CONCLUSIONS Urinary dysfunction improved even at the early time point of three months following abdominal contouring procedures including monsplasty. At the early postoperative period of three months, however, there was no significant change in female sexual function. Monsplasty in conjunction with abdominal contouring is recommended in the MWL female patient. LEVEL OF EVIDENCE 2 Therapeutic.