Clitoral Neuroma After Female Genital Mutilation/Cutting: A Rare but Possible Event

Abstract

Introduction Female genital mutilation/cutting (FGM/C), in particular, type III, also called infibulation, can cause various long-term complications. However, posttraumatic neuroma of the clitoris is extremely rare; only one case was previously reported in the literature. Aim The aim of this study was to describe the case of a patient presenting a clitoral neuroma post-FGM/C in detail and her successful multidisciplinary treatment. Methods We report the case of a 24-year-old woman originating from Somalia presenting a type III a–b FGM/C who attended our outpatient clinic at the Geneva University Hospitals complaining of primary dysmenorrhea and a post-mutilation painful clitoral mass. The mass was clinically diagnosed as a cyst and surgically removed. Histopathological analysis revealed that it was a posttraumatic neuroma and a foreign body granuloma around the ancient surgical thread. Our patient was also offered a multidisciplinary counseling by a specialized gynecologist on FGM/C, a sexologist, and a reproductive and sexual health counselor. Results One month after surgical treatment, the vulvar pain was over. Conclusions This is the second case of clitoral neuroma after FGM/C reported and the first with complete clinical, as well as histopathological documentation and multidisciplinary care. Considering the high frequency of clitoral cysts in case of infibulation, clitoral neuroma should be considered in the differential diagnosis. In this case, if symptomatic, the treatment should be surgery, clinical follow-up, and counseling. If necessary, appropriate sexual therapy should be offered too.

Female genital mutilation/cutting in The Gambia: long-term health consequences and complications during delivery and for the newborn

“…Clitoral neuroma was observed in 8.1% of women with type I FGM/C and in 20.6% of women with type II FGM/C, indicating that clitoral neuroma may be a more frequent complication in women with FGM/C than previously thought 29,30…”

Reconstructive Surgery for Female Genital Mutilation Starts Sexual Functioning in Sudanese Woman: A Case Report

“…Defibulation of FGM type III, using either scissors or carbon dioxide laser, is described and recommended in three studies, from Italy, Switzerland, and the United States [8][9][10]. Abdulcadir and colleagues describe the procedure for excision of a clitoral cyst and defibulation in a rare case of clitoral neuroma after FGM [11]. Our case report from Sudan add to the literature on potential treatment options for women after FGM, and we recommend that health providers who encounter women with FGM counsel couples about the health and sexual benefits of reconstructive surgery.…”

Adult recall of childhood female genital cutting and perceptions of its effects: A pilot study for service improvement and research feasibility

“…Th e immediate health complications may include infection, severe pain and bleeding and potentially fatal haemorrhaging (Adam et al 2010). Th e longer-term eff ects could also be life-threatening, ranging from birth complications to clitoral neuroma (Abdulcadir et al 2012). Th e breadth and depth of social and psychological eff ects are more diffi cult to ascertain.…”