Postoperative Course of Reconstructive Procedures in FGM Type III-Proposal for a Modified Classification of Type III...

Area of Science:

• Medical Science
• Surgical Reconstruction
• Public Health

Background:

• Female genital mutilation (FGM) reconstruction has evolved beyond treating complications to encompass body image and sexual function.
• Limited evidence directly links FGM to sexual dysfunction.
• The current WHO classification for FGM is imprecise, hindering comparative studies.

Purpose of the Study:

• To develop a novel grading system for Type III FGM reconstruction.
• To evaluate operative time and postoperative outcomes in relation to clitoral glans integrity.
• To address limitations of the existing WHO classification.

Main Methods:

• Retrospective analysis of 85 patients with FGM-Type III at the Desert Flower Center.
• Evaluation of clitoral involvement, operative time for prepuce reconstruction, and postoperative complications.
• Comparison of outcomes based on the degree of clitoral glans damage.

Main Results:

• A partly resected clitoral glans was observed in 42% of patients post-deinfibulation.
• Significantly longer operative times were noted in patients with completely or partly resected clitoral glans (p < 0.0001).
• Higher complication rates were observed in patients with a mutilated clitoral glans, though not statistically significant.

Conclusions:

• A resected clitoral glans in Type III FGM is associated with increased operative time and potential complications.
• The current WHO classification does not adequately address clitoral glans status.
• A new, more precise classification system is proposed to aid research and clinical practice.