A rare cause of infertility: A late complication of female genital mutilation (2016)

This study is a Descriptive research regarding II FGM/C with the following characteristics:

Author(s): Ferjaoui Mohamed Aimen, François Monneins, Gharrad Majed, Belaiba Amine
FGM/C Type(s): II
Health area of focus: Gynaecological,sexual.

Objective: To report a case of a rare long-term complications of FGM and how to manage it
Study Population: A 36-year-old Malian women
Findings: A 36-year-old Malian women,gravida 1 para 1,presented a two-year-secondary infertility. Her medical history was marked by a genital excision at the age of 5 years,she had no memory about this incident and she avoided to talk about. She had a vaginal delivery 2 years ago without complications. Since two years,the patient felt embarrassed to do sexual intercourse because of a vulvar tumor which increased in size gradually. She had no pelvic pain neither dyspareunia but she described recently a hypoactive sexual desire. The clinical examination showed a vulvar tumor covered by a regular skin depending on the clitoral area measuring 7 cm. This tumor had a soft consistence without adhesion to the deep planes. The urinary meatus was individualized and uncompressed. All vulva elements appeared normal (labia majora,labia minora,vestibule and vaginal orifice) except clitoral area marked by the vulvar tumor located in the scar of the mutilation. Patient recognized psychological discomfort specially during sexual intercourse. An ultrasound imaging was performed,it showed a multi-locular cystic tumor measuring 4 cm × 7 cm with heterogeneously dense contained. The decision was to perform a cystectomy and a vulvar plastic procedure under spinal anesthesia. Through a vertical incision dissection of the cyst was done. Cystectomy was performed after ligation of the cyst pedicle. The root of the glans clitoris was individualized. Finally a clitoral reconstruction and vulvoplasty were performed. The histologic examination showed an epidermic cyst containing abundant laminated keratin.

Geographical coverage
Region(s):Western Europe
Country(ies):France

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