Reconstructive surgery after female genital mutilation: a prospective cohort study

Area of Science:

• Urology
• Gynecology
• Public Health

Background:

• Female genital mutilation (FGM) is a harmful practice with long-term health consequences.
• Reconstructive surgery offers a potential solution for women affected by FGM, but access remains limited.
• This study evaluates the outcomes of reconstructive surgery for FGM.

Purpose of the Study:

• To assess the immediate and long-term outcomes of reconstructive surgery for women with FGM.
• To evaluate improvements in pain, clitoral pleasure, and sexual function post-surgery.

Main Methods:

• Prospective study of 2938 women aged 18+ with FGM (WHO types II or III) between 1998-2009.
• Surgical technique involved clitoral de-epithelialization, suspensory ligament sectioning, and scar tissue removal.
• Patients completed questionnaires on pre-operative and 1-year post-operative pain, pleasure, and function.

Main Results:

• Of 866 patients (29% follow-up), 42% achieved a hoodless glans, and 28% had a normal clitoris at 1 year.
• Significant improvements reported in pain (821/840) and clitoral pleasure (815/834).
• 51% of women experienced orgasms at 1-year follow-up; immediate complications occurred in 5%.

Conclusions:

• Reconstructive surgery for FGM is associated with reduced pain and restored clitoral pleasure.
• The procedure can improve sexual function and contribute to identity recovery.
• Increased availability through surgeon training in developed countries is recommended.