Clitoral/Reconstruction/ Transposition after female genital mutilation/ Cutting: Differences in access,refunding,technique,care and outcomes (2018)
This study is a Descriptive research regarding All FGM/C with the following characteristics:
Author(s): Abdulcadir,J. & Petignat,P.
FGM/C Type(s): All
Health area of focus: Clitoral,Reconstruction,andTransposition.
Objective: The study aimed to review the evidence on access,care,surgical techniques,practices and outcomes of clitoral surgery,called reconstruction or transposition,after female genital mutilation/ cutting (FGM/C).
Study Population: Relied on the published/ grey literature and current practices.
Findings: Two systematic reviews on the risks and advantages of persistent pain/dyspareunia,sexual pleasure,and clitoral appearance determined that the evidence on the safety and effectiveness of clitoral surgery following FGM/C is ambiguous. The results of a systematic study of surgical and non-surgical treatments for pain following FGM/C were negative. Due to a lack of evidence,the Royal College of Obstetricians and Gynecologists and the World Health Organization did not include clitoral reconstruction/transposition in their guidelines for the management of complications of FGM/C. In three distinct specialties — urology (Foldès),gynecology (Ouedraogo),and plastic surgery (O’Dey and Chang et al.) — four distinct more or less invasive surgical procedures are outlined. A scoping analysis of therapies to address sexual function following FGM/C and four case series demonstrated that,when multidisciplinary care is available,only 16 to 20 percent of women who originally desire surgery actually undergo it. Non-surgical treatments,including knowledge on clitoral anatomy and function and psychosexual therapy,meet the needs of women. Current indications for clitoral reconstruction include enhancing sexual function,lowering dyspareunia or chronic discomfort,recovering an uncut genital look,and reclaiming female gender identity. In many countries with high and low incomes,clitorectal surgery following FGM/C is neither reimbursable nor accessible,and expertise in the technique is uncommon. In nations such as Belgium,clitoral surgery is only reimbursed in two national,multidisciplinary referral clinics where women receive both surgical and non-surgical treatments. In some countries,such as France and Switzerland,any trained surgeon may do clitoral surgery in both public and private clinics,with or without psychosexual treatment. Women who want clitoral repair or transposition should be informed of the paucity of data and the efficacy of non-surgical treatments in conjunction with or without surgery. Multidisciplinary care should precede and accompany surgical procedures. In order to improve the treatments and information provided to women,additional multicenter and interprofessional research on surgical and non-surgical care is required. It is recommended renaming the procedure clitoral re-exposition instead of reconstruction/transposition to make it clear to patients that the clitoris is present behind the scar of FGM/C and that the surgery uncovers it.
Geographical coverage
Region(s):Not specified
Country(ies):Not specified