Pérez-López Faustino R, Ornat Lía, López-Baena María T, Pérez-Roncero Gonzalo R, Tajada-Duaso Mauricio C, Chedrau Peter
Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine, Zaragoza, Spain.
Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine, Zaragoza, Spain.
Eur J Obstet Gynecol Reprod Biol. 2020 Nov;254:236-244. doi: 10.1016/j.ejogrb.2020.09.031. Epub 2020 Sep 25.
To meta-analyze possible associations between female genital mutilation (FGM) and female sexual dysfunction, dyspareunia and pelvic pain.
A systematic literature search was performed in PubMed, EMBASE, Scopus, Web of Science, African Index Medicus and Cochrane Library. The PICO protocol included Population: Studies evaluating girls or women; Intervention/Exposure: participants with FGM; Comparison: participants without FGM; Outcomes: female sexual function, dyspareunia or pelvic pain using validated tests. Random effect models were used for meta-analyses, and standardized mean differences (SMDs) and their 95 % confidence intervals (CIs) for any of the measured continuous outcomes were calculated when possible. Risk of bias was assessed with the Newcastle-Ottawa Scale.
Fifteen studies (n = 6672 participants) reported on the outcomes of the 19-item Female Sexual Function Index (FSFI). The meta-analysis of the total FSFI score showed a SMD of -1.43 (95 % CI -2.17, -0.69) suggestive of female sexual dysfunction. In addition, scores for the six FSFI domains were significantly lower in women with FGM: SMDs for desire -0.62 (95 % CI -1.01, -0.22), arousal -0.88 (95 % CI -1.41, -0.35), lubrication -0.95 (95 % CI -1.45, -0.46), orgasm -1.07 (95 % CI -1.63, -0.50), satisfaction -0.96 (95 % CI -1.52, -0.41) and pain -0.48 (95 % CI -0.91, -0.05). Estimation of the prevalence of female sexual dysfunction with the FSFI was not possible since different cut-offs values were used in those studies that reported for this outcome. No other searched outcomes using other tools were reported.
FGM seriously alters female sexual function as assessed with the FSFI, globally and per domain.
对女性生殖器切割（FGM）与女性性功能障碍、性交疼痛和盆腔疼痛之间可能存在的关联进行荟萃分析。
在PubMed、EMBASE、Scopus、科学网、非洲医学索引和Cochrane图书馆进行了系统的文献检索。PICO方案包括：研究对象：评估女孩或妇女的研究；干预/暴露：接受女性生殖器切割的参与者；对照：未接受女性生殖器切割的参与者；结局：使用经过验证的测试评估女性性功能、性交疼痛或盆腔疼痛。荟萃分析采用随机效应模型，尽可能计算任何测量的连续结局的标准化均数差（SMD）及其95%置信区间（CI）。采用纽卡斯尔-渥太华量表评估偏倚风险。
15项研究（n = 6672名参与者）报告了19项女性性功能指数（FSFI）的结局。对FSFI总分的荟萃分析显示标准化均数差为-1.43（95%CI -2.17，-0.69），提示女性性功能障碍。此外，接受女性生殖器切割的女性在FSFI的六个领域的得分显著较低：性欲的标准化均数差为-0.62（95%CI -1.01，-0.22），性唤起为-0.88（95%CI -1.41，-0.35），润滑为-0.95（95%CI -1.45，-0.46），性高潮为-1.07（95%CI -1.63，-0.50），满意度为-0.96（95%CI -1.52，-0.41），疼痛为-0.48（95%CI -0.91，-0.05）。由于在报告该结局的研究中使用了不同的临界值，因此无法用FSFI估计女性性功能障碍的患病率。未报告使用其他工具进行的其他搜索结局。
根据FSFI评估，女性生殖器切割会严重改变全球及各领域的女性性功能。
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