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Sensitivity after Clitoral Reconstruction in Patients with Female Genital Mutilation
Uwe von Fritschen1,2, Cornelia Strunz3, Roland Scherer3
1From the Department of Plastic and Aesthetic Surgery, Hand Surgery, HELIOS Hospital Emil von Behring, Berlin, Germany.
Plastic and Reconstructive Surgery. Global Open
|June 17, 2024
Summary
Female genital mutilation reconstruction significantly improves clitoral sensitivity. Clitoral reconstruction (CR) in 73 patients restored sensitivity to levels comparable to unharmed women, with no decrease in sensitivity post-surgery.
Area of Science:
- Urology
- Gynecology
- Sexual Health
Background:
- Reconstructive surgery after female genital mutilation (FGM) has evolved beyond basic procedures.
- Current trends include clitoral and prepuce reconstruction, and nerve dissection, raising concerns about functional outcomes and iatrogenic injury due to limited evidence.
- Female genital mutilation (FGM) encompasses a range of procedures that can affect clitoral anatomy and sensitivity.
Purpose of the Study:
- To evaluate the functional outcomes of clitoral reconstruction (CR) in patients who have undergone female genital mutilation (FGM).
- To assess changes in clitoral sensitivity following reconstructive surgery using objective testing.
- To determine if clitoral reconstruction improves sexual and aesthetic aspects without nerve dissection.
Main Methods:
- A cohort of 128 patients undergoing reconstructive surgery post-female genital mutilation (FGM) was studied.
- Clitoral sensitivity was objectively measured using the Semmes-Weinstein monofilament test before and after clitoral reconstruction (CR).
- A control group of patients with a visually intact clitoris was included for comparison.
Main Results:
- Preoperatively, patients with a visually intact clitoris had significantly better sensitivity than those with mutilated clitoris or infibulation (P < 0.0001).
- Following clitoral reconstruction (CR), 70 of 73 patients (95.9%) achieved sensitivity comparable to the control group, perceiving 2.83 monofilaments.
- A significant improvement in clitoral sensitivity was observed in the subgroup of patients with a mutilated clitoris who underwent CR (P = 0.0020), with no patient experiencing decreased sensitivity.
Conclusions:
- Clitoral reconstruction (CR) significantly improves objective clitoral sensitivity in patients following female genital mutilation (FGM).
- The majority of patients undergoing CR achieved sensitivity levels similar to unharmed women.
- CR provides substantial functional improvement in clitoral sensitivity without the need for additional clitoral nerve dissection.
