Facteurs psychologiques d'automutilation génitale et intérêt médico-éthique d'une reconstruction vulvaire en urgence

Genital self-mutilation in an attempt of suicide by a patient with a borderline personality

“…[16] Fayed et al ., reported a 17-year-old girl who was admitted in the gynecological emergency department for an acute hemorrhage resulting from a GSM using an electric knife. The self-destructive act was accomplished during an episode of dissociation of a borderline personality.…”

“…Three years earlier, this young girl was a victim of sexual abuse without penetration by three people; and she kept the incident secrete. [16] The investigation of the risk factors of the self-mutilation behavior in borderline patients found factors counting loss of physical integrity, confusion, the feeling of guiltiness, self-underestimation, the dependence or the abusive consumption of a substance. [3171819202122] The presence of maltreatment during childhood including physical or effective negligence, sexual abuse is mostly mentioned as a predictive factor of the self-mutilation in borderline personality patients.…”

“…[18] This approach would involve either a serotoninergic dysfunction yielding impulsive and aggressive aspects or a low limit of excitability in the secondary limbic structure with repeated emotional trauma during a fast evolution. [8] Conacher[4816] considered that GSM is a model of suicidal act. Indeed our clinical case illustrates the issue that is often raised in the literature such: what is the suicidal component in the self -mutilation behaviors?…”