Département d'obstétrique et de gynécologie, Hôpital Louis Mourier (Assistance Publique Hôpitaux de Paris), Colombes, 92700, France.
Département d'obstétrique et de gynécologie, Hôpital Maison Blanche (Centre hospitalier universitaire de Reims), Reims, 51092, France.
J Sex Med. 2023 Dec 22;21(1):59-66. doi: 10.1093/jsxmed/qdad150.
Complications of surgical clitoral reconstruction for female genital mutilation/cutting (FGM/C) are a rare occurrence, but there has been reports of patients experiencing chronic pain or clitoral burial.
This study aims to assess which factors are predictive of the occurrence of surgical complications in women who had surgical reconstruction for FGM/C (type 1, 2, or 3).
This monocentric retrospective study was conducted among patients who underwent clitoral reconstruction after FGM/C from January 2016 to March 2020. Demographic and clinical data were abstracted from the medical records.
The primary outcome was the occurrence of chronic pain (defined as occurrence or persistence of any clitoral pain >3 months after surgery), and the secondary outcome was the occurrence of clitoral burial.
A total of 87 women were included in the analysis. Univariate analysis indicated significantly higher rates of a history of physical abuse in the group of women who experienced chronic pain after surgery (4 [100%] vs 2 [37.1%], P = .049). Patients with clitoral burial were significantly younger than the rest of the sample in univariate analysis (median [IQR], 29.6 years [24.6-30.2] vs 33.8 [28.2-37.9]; P = .049).
Surgical treatment of women who underwent FGM/C should include the entire history of the patient and especially a record of experiencing physical abuse.
The study stands out for its originality, the extensive sample size gathered over nearly 4 years, the surgical clitoral reconstructions conducted by an experienced surgeon, and the minimal amount of missing data. However, because the occurrence of these complications was rare, the number of patients in the subgroups was extremely low, preventing a valid multivariate analysis to be conducted.
The study suggests that women with a history of physical abuse could be at greater risk for chronic pain after surgery and that younger women tend to experience more clitoral burial.
女性生殖器切割（FGM/C）手术矫正术后的并发症较为罕见，但有报道称患者会出现慢性疼痛或阴蒂埋藏。
本研究旨在评估接受 FGM/C（1 型、2 型或 3 型）手术矫正的女性中，哪些因素与手术并发症的发生相关。
这是一项单中心回顾性研究，纳入了 2016 年 1 月至 2020 年 3 月间接受 FGM/C 术后阴蒂重建的患者。从病历中提取人口统计学和临床数据。
主要结局是慢性疼痛的发生（定义为术后 3 个月以上仍存在任何阴蒂疼痛），次要结局是阴蒂埋藏的发生。
共有 87 名女性纳入分析。单因素分析表明，术后出现慢性疼痛的女性组中，有身体虐待史的比例明显更高（4 [100%] 例比 2 [37.1%] 例，P = .049）。单因素分析中，发生阴蒂埋藏的患者比样本中其余患者明显更年轻（中位数 [IQR]，29.6 岁 [24.6-30.2] 比 33.8 岁 [28.2-37.9]；P = .049）。
对接受 FGM/C 的女性进行手术治疗时，应包括患者的整个病史，尤其是身体虐待的病史。
该研究的新颖性、近 4 年来收集的大量样本量、由经验丰富的外科医生进行的手术阴蒂重建以及数据缺失极少等方面均较为突出。然而，由于这些并发症的发生率较低，亚组中的患者数量极低，无法进行有效的多变量分析。
本研究表明，有身体虐待史的女性在术后更有可能出现慢性疼痛，而年轻女性更有可能出现阴蒂埋藏。
