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女性生殖器切割后慢性外阴疼痛:一项回顾性研究

Chronic Vulvar Pain After Female Genital Mutilation/Cutting: A Retrospective Study.

作者信息

Bazzoun Yara, Aerts Leen, Abdulcadir Jasmine

机构信息

Faculty of Medicine, University of Geneva, Geneva, Switzerland.

Division of Gynaecology, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.

出版信息

Sex Med. 2021 Oct;9(5):100425. doi: 10.1016/j.esxm.2021.100425. Epub 2021 Sep 11.

Abstract

INTRODUCTION

Chronic vulvar pain is a condition that affects many women during their lifetime, including women with Female Genital Mutilation/Cutting (FGM/C).

AIM

To study the prevalence and possible etiologies of chronic vulvar pain among women living with FGM/C.

METHODS

We conducted a retrospective review of consecutive medical files of 506 women who consulted our specialized clinic for women with FGM/C between April 1, 2010 and December 31, 2017. We collected sociodemographic and clinical data including information on the type of FGM/C and its complications. We focused on studying the prevalence, etiologies and characteristics of chronic vulvar pain.

MAIN OUTCOME MEASURES

Prevalence and etiologies of vulvar pain in women with FGM/C.

RESULTS

Chronic vulvar pain was present in 14 women (2.8%). Pain was unprovoked in one case (7.1%) and provoked in the 13 other cases (92.9%). In most of the cases, women presented vulvar pain related to scar complications such as clitoral or peri-clitoral adhesions or scar tissue (n = 3, 21.4%), bridle scars (n = 1, 7.1%), post-traumatic neuromas (n = 2, 14.3%) and vulvar cysts (n = 6, 42.9%), the latter being found more frequently in women with FGM/C type III. In 2 cases (14.3%) of chronic vulvar pain, no lesions other than FGM/C were visible at clinical examination. Among these 14 women, 12 suffered from superficial dyspareunia as well. The remaining ones had not had any sexual contact for several years. Dyspareunia was present in 126 women (24.9%), among which 75 patients (14.8%) suffered from superficial dyspareunia and 25 patients (4.9%) complained of deep dyspareunia. Fourteen women (2.8%) reported both superficial and deep dyspareunia. Twelve women (2.3%) reported dyspareunia with no specified localization documented in the medical charts. Dyspareunia was significantly more frequent among infibulated women compared to women with FGM/C different from type III (P = .014).

CONCLUSION

Chronic vulvar pain after FGM/C is probably associated with scar complications and FGM/C type III (infibulation). Dyspareunia is more frequent in women with FGM/C type III. Bazzoun Y, Aerts L, Abdulcadir J. Chronic Vulvar Pain After Female Genital Mutilation/Cutting: A Retrospective Study. Sex Med 2021;9:100425.

摘要

引言

慢性外阴疼痛是一种在许多女性一生中都会出现的病症,包括接受过女性生殖器切割(FGM/C)的女性。

目的

研究FGM/C女性中慢性外阴疼痛的患病率及其可能的病因。

方法

我们对2010年4月1日至2017年12月31日期间在我们专门的FGM/C女性诊所就诊的506名女性的连续医疗档案进行了回顾性研究。我们收集了社会人口学和临床数据,包括FGM/C的类型及其并发症的信息。我们重点研究慢性外阴疼痛的患病率、病因和特征。

主要观察指标

FGM/C女性外阴疼痛的患病率和病因。

结果

14名女性(2.8%)存在慢性外阴疼痛。1例(7.1%)疼痛为自发性,其他13例(92.9%)为诱发性。在大多数病例中,女性出现的外阴疼痛与瘢痕并发症有关,如阴蒂或阴蒂周围粘连或瘢痕组织(n = 3,21.4%)、系带瘢痕(n = 1,7.1%)、创伤后神经瘤(n = 2,14.3%)和外阴囊肿(n = 6,42.9%),后者在III型FGM/C女性中更常见。在2例(14.3%)慢性外阴疼痛病例中,临床检查除FGM/C外未见其他病变。在这14名女性中,12名也患有浅表性交困难。其余女性已数年没有任何性接触。126名女性(24.9%)存在性交困难,其中75名患者(14.8%)患有浅表性交困难,25名患者(4.9%)主诉深部性交困难。14名女性(2.8%)报告同时存在浅表和深部性交困难。12名女性(2.3%)报告性交困难,但病历中未记录具体部位。与非III型FGM/C女性相比,闭锁型女性性交困难的发生率明显更高(P = 0.014)。

结论

FGM/C后的慢性外阴疼痛可能与瘢痕并发症和III型FGM/C(闭锁)有关。III型FGM/C女性性交困难更为常见。巴祖恩Y、阿尔茨L、阿卜杜勒卡迪尔J。女性生殖器切割后慢性外阴疼痛:一项回顾性研究。性医学2021;9:100425。

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