Addressing Female Genital Mutilation/Cutting (FGM/C) in the Era of Clitoral Reconstruction: Plastic Surgery

Abstract

Purpose of the ReviewThe aim of this review is to give an overview of the recent evidence on clitoral reconstruction and other relevant reconstructive plastic surgery measures after female genital mutilation/cutting (FGM/C).Recent FindingsRecent publications present refinements and modifications of the surgical technique of clitoral reconstruction along with reconstruction of the labia majora and clitoral hood. Novel approaches with reposition of the clitoral nerve, anchoring of the labia majora, fat grafting, and full thickness mucosa grafts have been introduced. The current evidence on outcomes of clitoral reconstruction shows potential benefits. However, there is a risk of postoperative complications and a negative outcome. Experts in the field advocate for a multidisciplinary approach including psychosexual counseling and health education with or without subsequent clitoral reconstructive surgery.SummaryThe evolution of reconstructive treatment for women with FGM/C is expanding, however at a slow rate. The scarcity of evidence on clitoral reconstruction halters availability of clinical guidelines and consensus regarding best practice. Clitoral reconstruction should be provided by multidisciplinary referral centers in a research setting with long-term follow-up on outcomes of postoperative morbidity and possible benefits.

Psychosexual Consequences of Female Genital Mutilation and the Impact of Reconstructive Surgery: A Narrative Review

“…Clitoral reconstruction represents the principal but not the only reconstructive option for women with FGM/C; other possibilities include reconstruction of the clitoris and labia, defibulation, removal of cysts, neuromas, and scar tissue. 62 In addition, these approaches can be combined with novel reconstructive techniques. Chang et al 63 performed on three consecutive women with grade II FGM/C a new clitoral reconstruction technique based on the concept of anchoring the labia majora to the pubic bone to reduce the risk of labial fusion.…”

The benefits and disappointments following clitoral reconstruction after female genital cutting: A qualitative interview study from Sweden

“…Concomitant reconstructive surgery (e.g. defibulation, removal of cysts) is done if necessary [26]. Since 2014, over 40 women have undergone surgery at the Karolinska University Hospital in Sweden.…”

Genital restorative surgery after female genital cutting

“…These complications improved over a 6-12 month time period and PRP injections. 3,8,9 Better results were found in young adult women with bettereducation and higher socio-economic status, with type I and type II FGM/C; which are probably attributed to the psychological benefits of the procedure, which far exceed the physical benefits. 3…”