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Almadori A, Palmieri S, Coho C, Evans C, Elneil S, Albert J. Reconstructive surgery for women with female genital mutilation: A scoping review. BJOG 2024. [PMID: 38923662 DOI: 10.1111/1471-0528.17886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 05/24/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Female genital mutilation (FGM) is a global public health concern. However, reconstructive surgery remains unavailable in many countries. OBJECTIVES This scoping review, guided by Joanna Briggs Institute (JBI) principles, explores indications, referral routes, eligibility, care pathways and clinical outcomes of reconstructive surgery for FGM. SEARCH STRATEGY Medical Subject Headings (MeSH) terms and subject headings were searched in EMBASE, MEDLINE, SCOPUS, Web of Science and publicly available trial registers. SELECTION CRITERIA Any primary experimental and quasi-experimental study addressing reconstructive surgery for FGM, and its impact on women, published before June 2023. DATA COLLECTION AND ANALYSIS After removing duplicates from the search results, titles and abstracts were screened and data were extracted. Disagreements were resolved through panel discussion. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) flow diagram depicts the search results and inclusion process. MAIN RESULTS A total of 40 studies were included. Multidisciplinary teams were involved in 40% (16/40) of the studies, and psychosexual counselling was offered in 37.5% (15/40) of studies. Clitoral reconstruction using Foldes' technique was predominant (95%, 38/40). A total of 7274 women underwent some form of reconstruction. Post-surgery improvement was reported in 94% of the cases (6858/7274). The complication rate was 3% (207/7722 women with reconstruction). CONCLUSIONS Further research and clinical trials are needed. Although the outcomes suggest improved sexual function and quality of life post-surgery, the evidence remains limited. Advocating surgical reconstruction for survivors of FGM is vital for addressing health disparities and potential cost-effectiveness.
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Affiliation(s)
- Aurora Almadori
- Division of Surgery and Interventional Science, University College of London, London, UK
- Department of Plastic Surgery, NHS Royal Free Hospital London Trust, London, UK
| | - Stefania Palmieri
- University College London, Hospitals NHS Foundation Trust, London, UK
| | | | - Catrin Evans
- The Nottingham Centre for Evidence Based Healthcare, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Soheir Elneil
- Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, UK
| | - Juliet Albert
- University of Nottingham, Nottingham, UK
- Division of Womens, Children and Clinical Support, Imperial College Healthcare NHS Trust (ICHNT), London, UK
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Tognazzo E, Berndt S, Abdulcadir J. Autologous Platelet-Rich Plasma in Clitoral Reconstructive Surgery After Female Genital Mutilation/Cutting: A Pilot Case Study. Aesthet Surg J 2023; 43:340-350. [PMID: 36251970 DOI: 10.1093/asj/sjac265] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/07/2022] [Accepted: 10/07/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Postoperative healing after clitoral reconstruction (CR) for female genital mutilation/cutting can be long and painful due to prolonged clitoral re-epithelialization time (up to 3 months). Autologous platelet-rich plasma (A-PRP) might reduce postoperative clitoral epithelialization time and pain. OBJECTIVES The authors assessed postoperative clitoral re-epithelialization time and pain after intraoperative clitoral administration of A-PRP. METHODS Five consecutive women underwent CR (Foldès technique) followed by the administration of A-PRP Regen Lab SA (Le Mont-sur-Lausanne, Switzerland) plasma and glue, injected inside and applied above the re-exposed clitoris, respectively. We recorded surgical complications, postoperative clitoral pain (visual analogue scale), painkiller intake, time to complete re-epithelialization, and the experienced subjective changes in sexual response and perception of their own body image referred by women. RESULTS Sexual distress/dysfunction as well as the desire to be physically and symbolically "repaired" were the reasons behind women's requests for surgery. None of the women suffered from chronic vulvar or non-vulvar pain. All women achieved complete clitoral epithelialization by day 80, 3 women between day 54 and 70, and only 1 woman was still taking 1 g of paracetamol twice a day at 2 months postoperative. She had stopped it before the 3-month control. There were no short- or long-term complications. All women described easier access and stimulation of their clitoris as well as improved sexual arousal, lubrication, and pleasure and claimed to be satisfied with their restored body image. CONCLUSIONS A-PRP could expedite postoperative clitoral epithelialization and reduce postoperative pain after CR after female genital mutilation/cutting. LEVEL OF EVIDENCE: 4
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Christopher AN, Othman S, Morris MP, Broach RB, Percec I. Clinical and Patient-Reported Outcomes of 19 Patients Undergoing Clitoral and Labial Reconstruction After Female Genital Mutilation/Cutting. Aesthetic Plast Surg 2022; 46:468-477. [PMID: 34729638 DOI: 10.1007/s00266-021-02648-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/24/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Female genital mutilation/cutting (FGM/C) is the intentional alteration, removal, or injury of female genitalia for non-medical reasons. Approximately 200 million females have been victims of FGM/C, and genital reconstructive procedures are increasing in demand. OBJECTIVES The objectives of this study were to assess clinical and patient-reported outcomes after FGM/C reconstruction to help guide treatment practices. METHODS Adult patients undergoing anatomic reconstruction after FGM/C were retrospectively identified. Outcomes included clitoral, labial, and donor site surgical site occurrences (SSO) and the need for revision operations. Patient-reported outcomes were assessed using an adapted version of the Female Sexual Function Index (FSFI), a validated outcomes instrument that assesses sexual function through 6 domains, with each domain having a maximum score of 6. RESULTS Nineteen patients were identified in our review. Patients presented for reconstruction due to dyspareunia, inability to orgasm, chronic infections, to normalize appearance, and/or to "feel normal." There were no SSOs and two revision operations for adhesions. 74% of patients completed the FSFI postoperatively. Despite most patients seeking repair for inability to orgasm and/or dyspareunia, the median scores for these domains were 4.6 and 5.2. Patients' desire to engage in sexual activity scored lowest (3.9), and patients reported concerns over the appearance of their genitalia (50%) that affected self-confidence (85.7%). CONCLUSION FGM/C reconstruction is safe and contributes to improvements in physical sexual health. Psychological trauma may contribute to lessened sexual desire and self-confidence even after reconstruction. Multidisciplinary treatment is important to address the long-term psychological effects of this practice. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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O'Neill S, Richard F, Vanderhoven C, Caillet M. Pleasure, womanhood and the desire for reconstructive surgery after female genital cutting in Belgium. Anthropol Med 2021; 29:237-254. [PMID: 34842011 DOI: 10.1080/13648470.2021.1994332] [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: 10/19/2022]
Abstract
Growing numbers of women are showing interest in clitoral reconstructive surgery after 'Female Genital Mutilation'. The safety and success of reconstructive surgery, however, has not clearly been established and due to lack of evidence the World Health Organization does not recommend it. Based on anthropological research among patients who requested surgery at the Brussels specialist clinic between 2017 and 2020, this paper looks at two cases of women who actually enjoy sex and experience pleasure but request the procedure to become 'whole again' after stigmatising experiences with health-care professionals, sexual partners or gossip among African migrant communities. An ethnographic approach was used including indepth interviews and participant observation during reception appointments, gynecological consultations, sexology and psychotherapy sessions. Despite limited evidence on the safety of the surgical intervention, surgery is often perceived as the ultimate remedy for the 'missing' clitoris. Such beliefs are nourished by predominant discourses of cut women as 'sexually mutilated'. Following Butler, this article elicits how discursive practices on the physiological sex of a woman can shape her gender identity as a complete or incomplete person. We also examine what it was that changed the patients' mind about the surgery in the process of re-building their confidence through sexology therapy and psychotherapy.
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Affiliation(s)
- Sarah O'Neill
- LAMC, Université libre de Bruxelles - Campus du Solbosch, Bruxelles, Belgium
| | - Fabienne Richard
- Ecole de Santé Publique, Université Libre de Bruxelles - Campus Erasme, Bruxelles, Belgium.,CeMaViE, CHU Saint-Pierre, Bruxelles, Belgium
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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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Blayney F, Camuzard O, Klein A, Perchenet AS, Bertrand B, Philandrianos C, Massin V, Abellan-Lopez M, Casanova D. Anatomical study of the clitoris and its implications on female genital mutilation and surgical repair. J Plast Reconstr Aesthet Surg 2021; 74:3394-3403. [PMID: 34253487 DOI: 10.1016/j.bjps.2021.05.034] [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: 11/14/2020] [Revised: 03/29/2021] [Accepted: 05/27/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Worldwide, 200 million girls and women have been subjected to female genital mutilation. To restore the clitoral function and vulvar anatomy, clitoral repair has been performed since the 2000s. Nevertheless, there is a lack of precise and comprehensive data on the clitoral anatomy during surgical repair. This study aimed to precisely describe the terminal anatomies of the dorsal nerve and artery of the clitoris, and the clitoral neurovascular flap advancement for reconstruction in patients with female genital mutilation. METHODS This study was performed on seven fresh female cadavers. The site of origin, diameter, length, and trajectory of each nerve and artery were recorded. The clitoral neurovascular flap advancement was measured after a midline transection of the suspensory ligament was performed and after extensive liberation of the dorsal bundles at their emergence from the pubic rami. RESULTS At the distal point of the clitoral body, the width of the dorsal nerve and artery was 1.9 ± 0.3 mm and 0.9 ± 0.2 mm, respectively. The total length of the dorsal bundles was 6.6 cm (± 0.4). The midpart of the suspensory ligament was sectioned, which allowed a mean anteroposterior mobility of 2.7 cm (± 0.2). Extensive dissection of the neurovascular bundles up to their point of emergence from the suspensory ligament allowed a mean mobility of 3.4 ± 0.2 cm. CONCLUSION We described the anatomical characteristics of the dorsal nerve and artery of the clitoris and the mobility of the clitoral neurovascular flap for reconstruction post clitoridectomy. This was done to restore the anatomic position of the glans clitoris while preserving and potentially restoring clitoral function in patients with female genital mutilation.
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Affiliation(s)
- Fanny Blayney
- Conception Hospital/assistance publique hôpitaux de Marseille Plastic, esthetic and Reconstructive surgery department Pr. Casanova PhD, 147, Boulevard Baille, 13005, Marseille, France.
| | - Olivier Camuzard
- Pasteur universitary hospital, Plastic surgery department and Hand Reconstruction, 30 voie Romaine, 06001 Nice Cedex 1, France
| | - Arthur Klein
- Conception Hospital/assistance publique hôpitaux de Marseille Plastic, esthetic and Reconstructive surgery department Pr. Casanova PhD, 147, Boulevard Baille, 13005, Marseille, France
| | | | - Baptiste Bertrand
- Conception Hospital/assistance publique hôpitaux de Marseille Plastic, esthetic and Reconstructive surgery department Pr. Casanova PhD, 147, Boulevard Baille, 13005, Marseille, France
| | - Cécile Philandrianos
- Conception Hospital/assistance publique hôpitaux de Marseille Plastic, esthetic and Reconstructive surgery department Pr. Casanova PhD, 147, Boulevard Baille, 13005, Marseille, France
| | - Valentin Massin
- Conception Hospital/assistance publique hôpitaux de Marseille Plastic, esthetic and Reconstructive surgery department Pr. Casanova PhD, 147, Boulevard Baille, 13005, Marseille, France
| | - Maxime Abellan-Lopez
- Conception Hospital/assistance publique hôpitaux de Marseille Plastic, esthetic and Reconstructive surgery department Pr. Casanova PhD, 147, Boulevard Baille, 13005, Marseille, France
| | - Dominique Casanova
- Conception Hospital/assistance publique hôpitaux de Marseille Plastic, esthetic and Reconstructive surgery department Pr. Casanova PhD, 147, Boulevard Baille, 13005, Marseille, France
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Botter C, Sawan D, SidAhmed-Mezi M, Spanopoulou S, Luchian S, Meningaud JP, Hersant B. Clitoral Reconstructive Surgery After Female Genital Mutilation/Cutting: Anatomy, Technical Innovations and Updates of the Initial Technique. J Sex Med 2021; 18:996-1008. [PMID: 33931348 DOI: 10.1016/j.jsxm.2021.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 02/01/2021] [Accepted: 02/16/2021] [Indexed: 09/30/2022]
Abstract
INTRODUCTION Female genital mutilation (FGM) includes all procedures that involve partial or total removal of the female external genitalia or any other injury of the female genitalia that is performed for nonmedical reasons. FGM is classified into 4 types. Surgical clitoral reconstruction was first described by Thabet and Thabet in Egypt and subsequently by Foldès in France. The technique was then modified by different authors. AIM This article aims to provide a detailed description of clitoral surgical reconstruction and the modifications which have been made over time to improve the procedure while recalling current knowledge in the anatomy of the clitoris. METHODS We performed a broad systematic search in PubMed/Medline and EMBASE bibliographic databases for studies that report the surgical technique of clitoral reconstruction. From the anatomical point of view, we examined available evidence (from 1950 until 2020) related to clitoral anatomy, the clitoral role in sexual functioning, female genital mutilation/cutting, and surgical implications for the clitoris. MAIN OUTCOMES A review of the surgical techniques for clitoral reconstruction after female genital mutilation/cutting RESULTS: We described the current anatomical knowledge about the clitoris, and the procedures based on the surgical technique by Pierre Foldès, We included the technical modifications and contributions described in articles published subsequently. CONCLUSION Surgical repair of the clitoris for FGM offers anatomical and functional results although they still have to be evaluated. However, it should not be the only therapeutic solution offered to women with FGM. Botter C, Sawan D, SidAhmed-Mezi M, et al. Clitoral Reconstructive Surgery After Female Genital Mutilation/Cutting: Anatomy, Technical Innovations and Updates of the Initial Technique. J Sex Med 2021;18:996-1008.
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Affiliation(s)
- Charles Botter
- Department of Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery, Henri Mondor Hospital, Créteil, France.
| | - Dana Sawan
- Department of Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery, Henri Mondor Hospital, Créteil, France
| | - Mounia SidAhmed-Mezi
- Department of Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery, Henri Mondor Hospital, Créteil, France
| | - Sofia Spanopoulou
- Department of Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery, Henri Mondor Hospital, Créteil, France
| | - Stefan Luchian
- Department of Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery, Henri Mondor Hospital, Créteil, France
| | - Jean-Paul Meningaud
- Department of Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery, Henri Mondor Hospital, Créteil, France
| | - Barbara Hersant
- Department of Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery, Henri Mondor Hospital, Créteil, France
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Sharif Mohamed F, Wild V, Earp BD, Johnson-Agbakwu C, Abdulcadir J. Clitoral Reconstruction After Female Genital Mutilation/Cutting: A Review of Surgical Techniques and Ethical Debate. J Sex Med 2020; 17:531-542. [PMID: 31932257 DOI: 10.1016/j.jsxm.2019.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 11/14/2019] [Accepted: 12/04/2019] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Clitoral reconstruction (CR) is a controversial surgical procedure performed for women who have undergone medically unnecessary, often ritualistic genital cutting involving the clitoris. Such cutting is known by several terms; we will use female genital mutilation/cutting (FGM/C). Treatments offered to women affected by complications of FGM/C include defibulation (releasing the scar of infibulation to allow penetrative intercourse, urinary flow, physiological delivery, and menstruation) and CR to decrease pain, improve sexual response, and create a pre-FGM/C genital appearance. AIM In this study, our aim is to summarize the medical literature regarding CR techniques and outcomes, and stimulate ethical discussion surrounding potential adverse impacts on women who undergo the procedure. METHODS A broad literature review was carried out to search any previous peer-reviewed publications regarding the techniques and ethical considerations for CR. MAIN OUTCOME MEASURE The main outcome measure includes benefits, risks, and ethical analysis of CR. RESULTS While we discuss the limited evidence regarding the risks and efficacy of CR, we did not find any peer-reviewed reports focused on ethical implications to date. CLINICAL IMPLICATIONS CR can be indicated as a treatment for pain and potential improvement of associated sexual dysfunction when these have not responded to more conservative measures. Women must be appropriately informed about the risks of CR and the lack of strong evidence regarding potential benefits. They must be educated about their genital anatomy and disabused of any myths surrounding female sexual function as well as assessed and treated in accordance with the current scientific evidence and best clinical practices. STRENGTH & LIMITATIONS This is the first formal ethical discussion surrounding CR. This is not a systematic review, and the ethical discussion of CR has only just begun. CONCLUSION We present a preliminary ethical analysis of the procedure and its potential impact on women with FGM/C. Sharif Mohamed F, Wild V, Earp BD, et al. Clitoral Reconstruction After Female Genital Mutilation/Cutting: A Review of Surgical Techniques and Ethical Debate. J Sex Med 2020;17:531-542.
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Affiliation(s)
- Fatima Sharif Mohamed
- Department of Obstetrics and Gynecology, Maricopa Integrated Health System, Phoenix, AZ, USA
| | - Verina Wild
- Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Brian D Earp
- Yale-Hastings Program in Ethics and Health Policy, Yale University and The Hastings Center, New Haven, CT, USA
| | - Crista Johnson-Agbakwu
- Department of Obstetrics and Gynecology, Maricopa Integrated Health System, Phoenix, AZ, USA; Office of Refugee Health, Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ, USA
| | - Jasmine Abdulcadir
- Department of Woman, Child and Adolescent, Division of Gynecology, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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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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Abdulcadir J, Abdulcadir O, Caillet M, Catania L, Cuzin B, Essén B, Foldès P, Johnsdotter S, Johnson-Agbakwu C, Nour N, Ouedraogo C, Warren N, Wylomanski S. Clitoral Surgery After Female Genital Mutilation/Cutting. Aesthet Surg J 2017; 37:NP113-NP115. [PMID: 29025234 DOI: 10.1093/asj/sjx095] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jasmine Abdulcadir
- Outpatient Clinic for Women with FGM/C, Department of Obstetric and Gynecology, Geneva University Hospitals
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Omar Abdulcadir
- Referral Centre for Preventing and Curing Female Genital Mutilation, Department of Maternal and Child Health, Careggi University Hospital, Florence, Italy
| | - Martin Caillet
- Outpatient Clinic for Women with FGM/C, Department of Obstetric and Gynecology, Geneva University Hospitals
- CeMAViE; Department of Gynecology and Obstetrics, University Saint Pierre Hospital, Brussels, Belgium
| | - Lucrezia Catania
- Referral Centre for Preventing and Curing Female Genital Mutilation, Department of Maternal and Child Health, Careggi University Hospital, Florence, Italy
| | - Béatrice Cuzin
- Division of Urology and Transplantation, Edouard Herriot Hospital, Lyon, France
| | - Birgitta Essén
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Pierre Foldès
- Institute of Reproductive Health, Saint Germain en Laye, Paris, France
| | | | - Crista Johnson-Agbakwu
- Refugee Women's Health Clinic, Obstetrics & Gynecology, Maricopa Integrated Health System
- Obstetrics and Gynecology, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Nawal Nour
- Global Ob/Gyn and African Women's Health Center, Ambulatory Obstetrics, Office for Multicultural Careers, Division of Global Obstetrics and Gynecology, Brigham and Women's Hospital
| | | | - Nicole Warren
- Department of Community Public Health Nursing, John Hopkins School of Nursing, Baltimore, MD, USA
| | - Sophie Wylomanski
- Department of Gynecology and Obstetrics, Nantes University Hospital, Nantes, France
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