Reconstructive surgery after female genital mutilation beneficial
MedWire News: Reconstructive surgery after female genital mutilation reduces local pain and restores clitoral pleasure, according to a study of women in France.
However, study co-author Béatrice Cuzin (Edouard Herriot University Hospital, Lyon) and colleagues note that the new technique needs to be "made more readily available in developed countries, where the needs are greatest, by training surgeons."
Between 130 and 140 million women worldwide have undergone female genital mutilation in the past 10 years, including 92 million girls in Africa.
Efforts to end the procedure started decades ago, but require major social changes. With this in mind repairing the mutilation should be considered "an interim solution," Cuzin and colleagues note in TheLancet.
In recent decades the team developed new surgical techniques in Burkina Faso, a landlocked country in West Africa.
Their procedure involves resection of the scar covering the clitoral stump, sectioning the suspensory ligament, removing the fibrosis surrounding the mobilised stump, and repositioning it as a neoglans.
In the current study, the team performed the surgery on 2938 women aged 18 years and older who had consulted an urologist at Poissy-St Germain Hospital between 1998 and 2008.
Women were aged an average of 29 years and had undergone mutilation at an average age of 6 years, mostly in Mali, Senegal, and Ivory Coast, although 564 patients had undergone mutilation in France.
All patients answered a questionnaire at entry about their characteristics, expectations, and preoperative clitoris pleasure and pain, measured on a 5-point scale.
Of the 866 (29%) women who attended the 1-year follow-up visit, 363 (42%) had a hoodless glans, 239 (28%) had a normal clitoris, 210 (24%) had a visible projection, 51 (6%) had a palpable projection, and three (0.4%) had no change.
Most patients reported an improvement, or at least no worsening, in pain (821 of 840 patients) and clitoral pleasure (815 of 834 patients). At 1 year, 430 (51%) of 841 women experienced orgasms.
Immediate complications after surgery (hematoma, suture failure, moderate fever) were noted in 155 (5%) of the 2938 patients, and 108 (4%) were briefly re-admitted to hospital.
In conclusion, Cuzin et al comment: "Although clitoral reconstruction is extremely important, we believe that women should be offered a multidisciplinary care package, including sexual therapy, if this is acceptable to them."
By Andrew Czyzewski