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Beausang J, Mama ST. A Summary of Female Genital Mutilation/Cutting for the Pediatric and Adolescent Care Provider. J Pediatr Adolesc Gynecol 2023; 36:97-102. [PMID: 36402442 DOI: 10.1016/j.jpag.2022.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 09/25/2022] [Accepted: 11/04/2022] [Indexed: 11/19/2022]
Abstract
The World Health Organization defines female genital mutilation/cutting as any medically unnecessary procedure involving partial or total removal of the external female genitalia or other injury to the female genital organs. It is a violation of human rights and associated with serious complications and lifelong impact on health. This review article summarizes for the pediatric and adolescent care provider the incidence worldwide, the impact of cultural practices, appropriate screening and diagnosis, interventions, and treatment, along with legal and ethical issues.
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Affiliation(s)
- Jasjit Beausang
- Cooper Medical School of Rowan University Cooper University Health Care, Camden, New Jersey
| | - Saifuddin T Mama
- Cooper Medical School of Rowan University Cooper University Health Care, Camden, New Jersey.
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2
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Applebaum SA, Placik OJ. Genital Self-Image and Esthetic Genital Surgery. Clin Plast Surg 2022; 49:509-516. [PMID: 36162946 DOI: 10.1016/j.cps.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Genital self-image describes the perception of one's genital appearance as being "normal" or "abnormal," and a disharmonious image leads to an increasing number of women seeking esthetic genital surgery each year. The concept of what constitutes "normal" is strongly influenced by the media, cultural norms, and sexual relations. In reality, the extent of normalcy is highly variable and overall patient education regarding extremes of size and shape should be provided to all patients considering surgery. When performed with appropriate training, expertise, and attention to detail in a properly selected patient, esthetic genital surgery is associated with minimal complications or sequelae.
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Affiliation(s)
- Sarah A Applebaum
- Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, 880 West Central Road, Street 6100, Arlington Heights, IL 60005, USA; Department of Surgery, University of Maryland Medical Center, 22 South Greene Street, S8B02, Baltimore, MD 21201, USA.
| | - Otto J Placik
- Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, 880 West Central Road, Street 6100, Arlington Heights, IL 60005, USA.
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Pham B, Langlais T, Kayem G, Amidouche A. [Pubic osteitis after clitoral reconstruction surgery for genital mutilation: A case report]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2022; 50:419-421. [PMID: 34990882 DOI: 10.1016/j.gofs.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Affiliation(s)
- B Pham
- Department of Obstetrics and Gynecology, Trousseau Hospital, AP-HP, Paris, France.
| | - T Langlais
- Department of Orthopedics surgery, Trousseau Hospital, AP-HP, Paris, France
| | - G Kayem
- Department of Obstetrics and Gynecology, Trousseau Hospital, AP-HP, Paris, France
| | - A Amidouche
- Department of Obstetrics and Gynecology, Trousseau Hospital, AP-HP, Paris, France
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Bah M, Abdulcadir J, Tataru C, Caillet M, Hatem-Gantzer G, Maraux B. Postoperative pain after clitoral reconstruction in women with female genital mutilation: An evaluation of practices. J Gynecol Obstet Hum Reprod 2021; 50:102230. [PMID: 34536588 DOI: 10.1016/j.jogoh.2021.102230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 09/14/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION More than 200 million women and girls have undergone genital mutilation. Clitoral reconstruction (CR) can improve the quality of life of some of them, but is accompanied by significant postoperative pain. OBJECTIVE Assess and describe the management of postoperative pain after CR, and the practices amongst specialists in different countries. METHODS Between March and June 2020, 32 surgeons in 14 countries (Germany, Austria, Belgium, Burkina Faso, Canada, Ivory Coast, Egypt, Spain, United States of America, France, the Netherlands, Senegal, Switzerland, Sweden) responded to an online questionnaire on care and analgesic protocols for CR surgery. RESULTS At day 7 post CR, 97% of the surgeons observed pain amongst their patients, which persisted up to 1 month for half of them. 22% of the participants reported feeling powerless in the management of such pain. The analgesic treatments offered are mainly step II and anti-inflammatory drugs (61%). Screening for neuropathic pain is rare (3%), as is the use of pudendal nerve block, used by 8% of the care providers and only for a small percentage of women. CONCLUSION Pain after CR is frequent, long-lasting, and potentially an obstacle for the women who are willing to undergo clitoral surgery and also their surgeons. Most surgeons from different countries follow analgesic protocols that do not use the full available therapeutic possibilities. Early treatment of neuropathic pain, optimisation of dosing of standard analgesics, addition of opioids, use of acupuncture, and routine intraoperative use of pudendal nerve block might improve the management of pain after CR.
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Affiliation(s)
- Marly Bah
- Service de Gynécologie-Obstétrique, Hôpital Lariboisière, 2 Rue Ambroise Paré, 75010 Paris, France; La Maison des Femmes, Hôpital Delafontaine, Saint Denis, 1 Chemin du Moulin Basset, 93200 Saint-Denis, France.
| | - Jasmine Abdulcadir
- The Obstetrics-Gynaecology Emergency Unit FGM/C Outpatient clinic, Department of Woman, Child and Adolescent, Faculty of Medicine. UNIGE, Rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland
| | - Consuela Tataru
- Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Centre Hospitalier Intercommunal de Créteil, Université́ Paris-Est Val de Marne, 40 avenue de Verdun, 94000 Créteil, France
| | - Martin Caillet
- Département de Gynécologie-Obstétrique, CHU Saint Pierre, Rue Haute, 322, 1000 Bruxelles, Belgique
| | - Ghada Hatem-Gantzer
- La Maison des Femmes, Hôpital Delafontaine, Saint Denis, 1 Chemin du Moulin Basset, 93200 Saint-Denis, France
| | - Barbara Maraux
- Service de Gynécologie-Obstétrique, Hôpital Lariboisière, 2 Rue Ambroise Paré, 75010 Paris, France
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Shahawy S, Nour NM. Female Genital Cutting: An Evidence-based Review for the OBGYN of Long-term Sequelae and Management Options. Clin Obstet Gynecol 2021; 64:519-527. [PMID: 34323231 DOI: 10.1097/grf.0000000000000644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Female genital cutting (FGC) is a persisting global practice that increases patients' risk for experiencing long-term health sequelae. Existing meta-analysis evidence strongly supports an association between FGC and the development of long-term dyspareunia, urinary tract infections, and sexual dysfunction as well as increased risk obstetrically of prolonged labor, cesarean section, perineal lacerations, and episiotomy. Surgical defibulation is recommended in patients with type III FGC to decrease obstetric and gynecologic morbidity. Existing evidence does not seem to definitively support clitoral reconstructive surgery. More research is needed to study conservative treatment and management approaches to long-term sequelae of FGC.
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Affiliation(s)
- Sarrah Shahawy
- Division of Global OB/GYN, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Van de Velde SM, Van Eekert N. Seeking a Deeper Understanding of the Underlying Causes of Sexual Pain in Women Who Have Undergone Female Genital Cutting. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1897-1901. [PMID: 31559521 DOI: 10.1007/s10508-019-01555-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/13/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Sarah M Van de Velde
- Department of Sociology, Centre for Population, Family and Health, University of Antwerp, Sint-Jacobstraat 2-4, 2000, Antwerp, Belgium.
| | - Nina Van Eekert
- Department of Sociology, Centre for Population, Family and Health, University of Antwerp, Sint-Jacobstraat 2-4, 2000, Antwerp, Belgium
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
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Auricchio V, Garzon S, Pomini P, Laganà AS, Casarin J, Cromi A, Ghezzi F, Vigato E, Franchi M. Clitoral reconstructive surgery after female genital mutilation: A systematic review. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 29:100619. [PMID: 33845447 DOI: 10.1016/j.srhc.2021.100619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 03/01/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To summarize available evidence on clitoral reconstruction after Female genital mutilations/cut (FGM/C). STUDY DESIGN Systematic review of the literature to identify studies on clitoral reconstruction after previous FGM/C with at least 6 months of follow-up. The literature search was performed in the following databases: PubMed, EMBASE, Web of Science, and the Cochrane Library. The period considered was from the database inception to June 30th, 2020. MAIN OUTCOME MEASURES Post-operative vulvar pain or dyspareunia, changes in sexual activity or orgasm, and the impact on self-image. RESULTS We identified 8 studies; four used the same "Foldès technique", and four adopted similar techniques based on the downward mobilization of the clitoral stump, with different reconstructions of glans and prepuce. The postoperative complication rate was reported at 5.3%. Sexual function is the only outcome investigated by all studies, which consistently suggest that clitoral reconstruction appear effective to improve clitoral pleasure/orgasm. Almost all studies assessed self-image, which appears improved. Only 2 studies provided data about pain and/or dyspareunia, which were improved by clitoral reconstruction. However, the risk of bias is high. Most patients were lost at follow-up, and validated instruments to assess outcomes were used only in a minority of studies. CONCLUSIONS Although clitoral reconstructive surgery for FGM/C appears safe and effective, caution is required to interpret available evidence due to significant limitations. Further studies are required to compare the proposed techniques and to confirm the effectiveness in terms of vulvar pain and/or dyspareunia, sexual activity and/or orgasm, and self-image improvement.
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Affiliation(s)
- Valeria Auricchio
- Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, Verona, VR, Italy
| | - Simone Garzon
- Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, Verona, VR, Italy.
| | - Paola Pomini
- Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, Verona, VR, Italy
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynaecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, VR, Italy
| | - Jvan Casarin
- Department of Obstetrics and Gynaecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, VR, Italy
| | - Antonella Cromi
- Department of Obstetrics and Gynaecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, VR, Italy
| | - Fabio Ghezzi
- Department of Obstetrics and Gynaecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, VR, Italy
| | - Enrico Vigato
- Department of Plastic and Reconstructive Surgery, AOUI Verona, University of Verona, Verona, VR, Italy
| | - Massimo Franchi
- Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, Verona, VR, Italy
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Jordal M, Levin L, Påfs J, Griffin G, Wahlberg A. Swedish Gynecologists' Positioning in Relation to Clitoral Reconstruction After Female Genital Cutting. A Qualitative Interview Study. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2020; 33:76-87. [PMID: 38596474 PMCID: PMC10807807 DOI: 10.1080/19317611.2020.1853301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/09/2020] [Accepted: 11/13/2020] [Indexed: 04/11/2024]
Abstract
Background: Clitoral reconstruction (CR) is surgical reparation of the clitoris cut as part of the practice of female genital cutting (FGC) available in a handful of countries, including Sweden. The surgery aims at restoring the clitoris esthetically and functionally, thus has implications for sexual health. Gynaecological examinations can be an opportunity for dialogue regarding women's sexual health. Gynecologist play a role in referring patients experiencing FGC-related problems, including sexual, to specialist services such as CR. Aim: The aim of this study was to explore how gynecologists position themselves in relation to CR. Method: Eight gynecologists were interviewed using semi-structured interviews. The interviews were tape-recorded, transcribed and analyzed using thematic analysis. Results: The gynecologists positioned themselves in three different ways in relation CR; outright negative, uncertain or positive toward the surgery. Those positioning themselves as negative thought CR was a harmful fraud and denied any possible benefits, at least sufficient for referral for CR. Those positioning themselves as uncertain did not deny possible benefits, but were skeptical toward CR improving cut women's sexual health and function. Those positioning themselves positive considered the potential physical, psychological/emotional, esthetic, or symbolic aspects of CR as important for general well-being and sexual health. Conclusion: There was a great variety in how the gynecologists positioned themselves toward CR, and many were skeptical toward the functional benefits in relation to sexual health. This is likely to diverge cut women's access to CR surgery.
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Affiliation(s)
- Malin Jordal
- Centre for Gender Research, Uppsala University, Uppsala, Sweden
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden
| | - Linn Levin
- Centre for Gender Research, Uppsala University, Uppsala, Sweden
| | - Jessica Påfs
- Department of Social Work, University of Gothenburg, Gothenburg, Sweden
| | | | - Anna Wahlberg
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
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Effects of clitoral reconstruction for female genital mutilation on perinatal outcomes: A retrospective case-control study. J Gynecol Obstet Hum Reprod 2020; 50:101954. [PMID: 33080401 DOI: 10.1016/j.jogoh.2020.101954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To investigate the perinatal outcomes of women with a history of female genital mutilation (FGM) who underwent clitoral reconstruction (CR) compared with women with FGM who did not undergo CR. MATERIAL AND METHODS Retrospective case-control study at Angers University Hospital, between 2005 and 2017. INCLUSION CRITERIA pregnant women >18 years who underwent CR after FGM. Only the first subsequent delivery after CR was included. Each woman with CR was matched for age, ethnicity, FGM type, parity, and gestational age at the time of delivery with two women with FGM who did not undergo CR during the same period of time. At birth, the main outcomes were the need for episiotomy and having an intact perineum after delivery. RESULTS 84 women were included (28 in the CR group; 56 in the control group). In the CR group, patients required significantly fewer episiotomies (5/17[29.4 %]) compared to the control group (28/44[63.6 %], p = 0.02), even after excluding operative vaginal deliveries (2/13[15.4 %] vs 21/36[58.3], p < 0.01). CR reduces the risk of episiotomy (aOR = 0.15, 95 %CI [0.04-0.56]; p < 0.01) after adjusting on the infant weight and the need for instrumental delivery. In the CR group, 47 % of the patients had an intact perineum after delivery, compared to 20.4 % in the control group (p = 0.04). CR increases the odds of having an intact perineum at birth by 3.46 times (CI95 %[1.04-11.49]; p = 0.04). CONCLUSION CR after FGM increases the chances of having an intact perineum after delivery by 3.46 times and reduces the risk of episiotomy by 0.15 times compared to women with FGM who did not underwent CR.
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Sigurjonsson H, Jordal M. Addressing Female Genital Mutilation/Cutting (FGM/C) in the Era of Clitoral Reconstruction: Plastic Surgery. CURRENT SEXUAL HEALTH REPORTS 2018; 10:50-56. [PMID: 29755298 PMCID: PMC5937872 DOI: 10.1007/s11930-018-0147-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
PURPOSE OF THE REVIEW The aim of this review is to give an overview of the recent evidence on clitoral reconstruction and other relevant reconstructive plastic surgery measures after female genital mutilation/cutting (FGM/C). RECENT FINDINGS Recent publications present refinements and modifications of the surgical technique of clitoral reconstruction along with reconstruction of the labia majora and clitoral hood. Novel approaches with reposition of the clitoral nerve, anchoring of the labia majora, fat grafting, and full thickness mucosa grafts have been introduced. The current evidence on outcomes of clitoral reconstruction shows potential benefits. However, there is a risk of postoperative complications and a negative outcome. Experts in the field advocate for a multidisciplinary approach including psychosexual counseling and health education with or without subsequent clitoral reconstructive surgery. SUMMARY The evolution of reconstructive treatment for women with FGM/C is expanding, however at a slow rate. The scarcity of evidence on clitoral reconstruction halters availability of clinical guidelines and consensus regarding best practice. Clitoral reconstruction should be provided by multidisciplinary referral centers in a research setting with long-term follow-up on outcomes of postoperative morbidity and possible benefits.
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Affiliation(s)
- Hannes Sigurjonsson
- Department of Plastic and Reconstructive Surgery, Karolinska University Hospital, 171 76 Stockholm, Sweden
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Malin Jordal
- Center for Gender Research, Uppsala University, Uppsala, Sweden
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Caillet M, O’Neill S, Minsart AF, Richard F. Addressing FGM with Multidisciplinary Care. The Experience of the Belgian Reference Center CeMAViE. CURRENT SEXUAL HEALTH REPORTS 2018. [DOI: 10.1007/s11930-018-0145-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Berg RC, Taraldsen S, Said MA, Sørbye IK, Vangen S. The effectiveness of surgical interventions for women with FGM/C: a systematic review. BJOG 2017; 125:278-287. [DOI: 10.1111/1471-0528.14839] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2017] [Indexed: 10/19/2022]
Affiliation(s)
- RC Berg
- Norwegian Institute of Public Health; Oslo Norway
- Department of Community Medicine; University of Tromso; Tromso Norway
| | - S Taraldsen
- Norwegian National Advisory Unit on Women's Health; Division of Gynaecology and Obstetrics; Oslo University Hospital HF Rikshospitalet; Oslo Norway
| | - MA Said
- Oslo University Hospital - Ullevål Hospital; Oslo Norway
| | - IK Sørbye
- Norwegian National Advisory Unit on Women's Health; Division of Gynaecology and Obstetrics; Oslo University Hospital HF Rikshospitalet; Oslo Norway
| | - S Vangen
- Norwegian National Advisory Unit on Women's Health; Division of Gynaecology and Obstetrics; Oslo University Hospital HF Rikshospitalet; Oslo Norway
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
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Berg RC, Taraldsen S, Said MA, Sørbye IK, Vangen S. Reasons for and Experiences With Surgical Interventions for Female Genital Mutilation/Cutting (FGM/C): A Systematic Review. J Sex Med 2017; 14:977-990. [PMID: 28666656 DOI: 10.1016/j.jsxm.2017.05.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 05/19/2017] [Accepted: 05/31/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Because female genital mutilation/cutting (FGM/C) leads to changes in normal genital anatomy and functionality, women are increasingly seeking surgical interventions for their FGM/C-related concerns. AIM To conduct a systematic review of empirical quantitative and qualitative research on interventions for women with FGM/C-related complications. METHODS We conducted systematic searches up to May 2016 in 16 databases to obtain references from different disciplines. We accepted all study designs consisting of girls and women who had been subjected to FGM/C and that examined a reparative intervention for a FGM/C-related concern. We screened the titles, abstracts, and full texts of retrieved records for relevance. Then, we assessed the methodologic quality of the included studies and extracted and synthesized the study data. OUTCOMES All outcomes were included. RESULTS Of 3,726 retrieved references, 71 studies including 7,291 women were eligible for inclusion. We identified three different types of surgical intervention: defibulation or surgical separation of fused labia, excision of a cyst with or without some form of reconstruction, and clitoral or clitoral-labial reconstruction. Reasons for seeking surgical interventions consisted of functional complaints, sexual aspirations, esthetic aspirations, and identity recovery. The most common reasons for defibulation were a desire for improved sexual pleasure, vaginal appearance, and functioning. For cyst excision, cystic swelling was the main reason for seeking excision; for reconstruction, the main reason was to recover identity. Data on women's experiences with a surgical intervention are sparse, but we found that women reported easier births after defibulation. Our findings also suggested that most women were satisfied with defibulation (overall satisfaction = 50-100%), typically because of improvements in their sexual lives. Conversely, the results suggested that defibulation had low social acceptance and that the procedure created distress in some women who disliked the new appearance of their genitalia. Most women were satisfied with clitoral reconstruction, but approximately one third were dissatisfied with or perceived a worsening in the esthetic look. CLINICAL TRANSLATION The information health care professionals give to women who seek surgical interventions for FGM/C should detail the intervention options available and what women can realistically expect from such interventions. STRENGTHS AND LIMITATIONS The systematic review was conducted in accordance with guidelines, but there is a slight possibility that studies were missed. CONCLUSION There are some data on women's motivations for surgery for FGM/C-related concerns, but little is known about whether women are satisfied with the surgery, and experiences appear mixed. Berg RC, Taraldsen S, Said MA, et al. Reasons for and Experiences With Surgical Interventions for Female Genital Mutilation/Cutting (FGM/C): A Systematic Review. J Sex Med 2017;14:977-990.
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Affiliation(s)
- Rigmor C Berg
- Norwegian Institute of Public Health, Oslo, Norway; University of Tromso, Tromso, Norway.
| | - Sølvi Taraldsen
- Norwegian National Advisory Unit on Women's Health, Division of Gynecology and Obstetrics, Oslo University Hospital HF Rikshospitalet, Oslo, Norway
| | - Maryan A Said
- Norwegian National Advisory Unit on Women's Health, Division of Gynecology and Obstetrics, Oslo University Hospital HF Rikshospitalet, Oslo, Norway; Oslo University Hospital Ullevål Hospital, Oslo, Norway
| | - Ingvil Krarup Sørbye
- Norwegian National Advisory Unit on Women's Health, Division of Gynecology and Obstetrics, Oslo University Hospital HF Rikshospitalet, Oslo, Norway
| | - Siri Vangen
- Norwegian National Advisory Unit on Women's Health, Division of Gynecology and Obstetrics, Oslo University Hospital HF Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Odukogbe ATA, Afolabi BB, Bello OO, Adeyanju AS. Female genital mutilation/cutting in Africa. Transl Androl Urol 2017; 6:138-148. [PMID: 28540220 PMCID: PMC5422681 DOI: 10.21037/tau.2016.12.01] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Female genital mutilation/cutting (FGM/C) is a traditional practice in which the external female genitalia is partially or totally incised or excised for a non-therapeutic reason, usually without the consent of the individual. FGM/C is common in Africa with varying prevalence in different countries, though the incidence is reducing because it is considered a human rights issue with tremendous advocacy for its elimination by mainly nongovernmental organizations. It is mainly underreported in many countries in Africa especially where it has been declared illegal. FGM/C is often performed by a nonmedical practitioner with the aim of fulfilling religious or cultural rites and sometimes for economic benefits with the resultant acute, intermediate and late complications. It is sometimes performed by medical practitioners when it is speciously believed that its medicalization reduces the complications associated with the practice. The sensitivity of FGM/C is amplified when compared to male circumcision and voluntary alterations of the female external genitalia like piercing and tattooing as similar practices. The magnitude of the physical and psychosocial consequences of FGM/C outweighs the presumed benefits of the procedures highlighting the need for improvement of the multiple preventive measures by all the stakeholders and in all the sectors.
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Affiliation(s)
- Akin-Tunde A Odukogbe
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Bosede B Afolabi
- Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Lagos, Nigeria
| | - Oluwasomidoyin O Bello
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Ayodeji S Adeyanju
- Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria
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