Abdulcadir Jasmine, Tille Jean-Christophe, Petignat Patrick
Department of Obstetrics and Gynecology, Geneva University Hospitals, 30 Bld de la Cluse, 30 Bld de la Cluse, 1211, Geneva, Switzerland.
Faculty of Medicine, University of Geneva, Rue Michel Servet 1, 1205, Geneva, Switzerland.
Reprod Health. 2017 Feb 8;14(1):22. doi: 10.1186/s12978-017-0288-3.
Traumatic neuromas are the result of regenerative disorganized proliferation of the proximal portion of lesioned nerves. They can exist in any anatomical site and are responsible for neuropathic pain. Post-traumatic neuromas of the clitoris have been described as an uncommon consequence of female genital mutilation/cutting (FGM/C). FGM/C involves partial or total removal of the female genital organs for non-therapeutic reasons. It can involve cutting of the clitoris and can cause psychological, sexual, and physical complications. We aimed to evaluate the symptoms and management of women presenting with a clitoral neuroma after female genital mutilation/cutting (FGM/C).
We identified women who attended our specialized clinic for women with FGM/C who were diagnosed with a traumatic neuroma of the clitoris between April 1, 2010 and June 30, 2016. We reviewed their medical files and collected socio-demographic, clinical, surgical, and histopathological information.
Seven women were diagnosed with clitoral neuroma. Six attended our clinic to undergo clitoral reconstruction, and three of these suffered from clitoral pain. The peri-clitoral fibrosis was removed during clitoral reconstruction, which revealed neuroma of the clitoris in all six subjects. Pain was ameliorated after surgery. The seventh woman presented with a visible and palpable painful clitoral mass diagnosed as a neuroma. Excision of the mass ameliorated the pain. Sexual function improved in five women. One was not sexually active, and one had not yet resumed sex.
Post-traumatic clitoral neuroma can be a consequence of FGM/C. It can cause clitoral pain or be asymptomatic. In the case of pain symptoms, effective treatment is neuroma surgical excision, which can be performed during clitoral reconstruction. Surgery should be considered as part of multidisciplinary care. The efficacy of neuroma excision alone or during clitoral reconstruction to treat clitoral pain should be further assessed among symptomatic women.
创伤性神经瘤是受损神经近端再生性无序增殖的结果。它们可存在于任何解剖部位，并导致神经性疼痛。阴蒂创伤性神经瘤被描述为女性生殖器切割（FGM/C）的一种罕见后果。FGM/C涉及出于非治疗目的部分或全部切除女性生殖器官。它可能包括阴蒂切割，并可导致心理、性和身体并发症。我们旨在评估女性生殖器切割（FGM/C）后出现阴蒂神经瘤的女性的症状及治疗情况。
我们确定了在2010年4月1日至2016年6月30日期间到我们的女性生殖器切割专科诊所就诊且被诊断为阴蒂创伤性神经瘤的女性。我们查阅了她们的病历，并收集了社会人口统计学、临床、手术和组织病理学信息。
7名女性被诊断为阴蒂神经瘤。其中6名到我们诊所接受阴蒂重建，其中3名患有阴蒂疼痛。在阴蒂重建过程中切除了阴蒂周围的纤维化组织，这6名受试者均发现有阴蒂神经瘤。术后疼痛得到缓解。第7名女性出现一个可见且可触及的疼痛性阴蒂肿物，诊断为神经瘤。肿物切除后疼痛缓解。5名女性的性功能得到改善。1名无性活动，1名尚未恢复性生活。
创伤性阴蒂神经瘤可能是女性生殖器切割的后果。它可导致阴蒂疼痛或无症状。对于有疼痛症状的情况，有效的治疗方法是神经瘤手术切除，可在阴蒂重建时进行。手术应被视为多学科护理的一部分。对于有症状的女性，应进一步评估单独切除神经瘤或在阴蒂重建时切除神经瘤治疗阴蒂疼痛的疗效。
