The effectiveness of surgical interventions for women with <scp>FGM</scp>/C: a systematic review

Berg, Rigmor C.; Taraldsen, Sølvi; Said, Maryan; Sørbye, Ingvil Krarup; Vangen, Siri

doi:10.1111/1471-0528.14839

Cited by 63 publications

(73 citation statements)

References 32 publications

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“…A recent systematic review 61 evaluated the effects of reconstructive surgery. The results indicate that about three women out of four regain a visible clitoris; self-reported ameliorations in pain during sex, clitoral function/pleasure, orgasm, and desire are in the 43–63% range, but up to 22% reported a worsening in sexual outcomes.…”

Section: Reconstructive Surgerymentioning

confidence: 99%

Psychosexual Consequences of Female Genital Mutilation and the Impact of Reconstructive Surgery: A Narrative Review

et al. 2019

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Purpose: We aim to provide a comprehensive overview of the health consequences of female genital mutilation/cutting (FGM/C), with a particular focus on the psychosexual implications of this practice and the overall impact of reconstructive plastic surgery.Methods: A MEDLINE search through PubMed was performed to identify the best quality evidence published studies in English language on long-term health consequences of FGM/C.Results: Women with FGM/C are more likely to develop psychological disorders, such as post-traumatic stress disorder, anxiety, somatization, phobia, and low self-esteem, than those without FGM/C. Most studies showed impaired sexual function in women with FGM/C. In particular, women with FGM/C may be physiologically less capable of becoming sexually stimulated than uncut women. Reconstructive surgery could be beneficial, in terms of both enhanced sexual function and body image. However, prospective studies on the impact of reconstructive surgery are limited, and safety issues should be addressed.Conclusion: Although it is clear that FGM/C can cause devastating immediate and long-term health consequences for girls and women, high-quality data on these issues are limited. Psychosexual complications need to be further analyzed to provide evidence-based guidelines and to improve the health care of women and girls with FGM/C. The best treatment approach involves a multidisciplinary team to deal with the multifaceted FGM/C repercussions.

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Section: Reconstructive Surgerymentioning

confidence: 99%

Psychosexual Consequences of Female Genital Mutilation and the Impact of Reconstructive Surgery: A Narrative Review

et al. 2019

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“…Therefore, the authors concluded that FSFI is a suitable psychometric tool for conducting a standardized assessment of sexual function in women with FGM/C. A recent systematic review, which has included 62 studies (5829 women), has reported that up to 22% of women with FGM/C showed worsening of sexual function after CR [51].…”

Section: Discussionmentioning

confidence: 99%

Clinical Features Associated with Female Genital Mutilation/Cutting: A Pilot Longitudinal Study

Paslakis

Farré

Tolosa-Sola

et al. 2020

JCM

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(1) Background: Female genital mutilation/cutting (FGM/C) is associated with physical and psychological complications. However, there is scarce literature on how women with FGM/C respond to treatment interventions. (2) Methods: In the present pilot longitudinal study, we assessed changes in general psychopathology (Symptom Check List-90-R), sexual functioning and distress (Female Sexual Function Index, Female Sexual Distress Scale-Revised, and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) female sexual dysfunction criteria), body image (Body Shape Questionnaire), and sexual body image (Female Genital Self-Image Scale) in a sample of n = 15 women with FGM/C before and after reconstructive surgery. (3) Results: Sexual distress was significantly improved following surgery. We also observed an improvement in general psychopathology and genital self-image. However, sexual function was not improved. (4) Conclusions: These results provide evidence for the benefits of reconstructive surgery on sexual distress in women with FGM/C. The impact of surgery on sexual function cannot be conclusively evaluated.

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“…The one woman who underwent elective antenatal de‐infibulation received thorough consultant‐led counselling. A meta‐analysis of the scarce evidence for surgical intervention for FGM showed that de‐infibulation is associated with a significantly lower risk of CS (relative risk 0.33) and severe perineal trauma however, women who are de‐infibulated during delivery may experience higher blood loss…”

Section: Discussionmentioning

confidence: 99%

Female genital mutilation: Obstetric outcomes in metropolitan Sydney

Davis

Jellins

2019

Aust NZ J Obst Gynaeco

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Background: Female genital mutilation (FGM) and its impact on women's health are becoming relevant in Australia due to increases in numbers of refugees and migrants from affected countries. Notwithstanding the psychological trauma from FGM, there is a broad range of sequelae relevant to obstetrics and gynaecology, particularly related to maternal morbidity from labour and delivery. Aims:To assess the prevalence of FGM in our unit and document its effect on maternal and neonatal outcomes. Methods:Retrospective cohort study of women affected by FGM who delivered at a metropolitan hospital in Sydney over a five-year period. The primary outcome was mode of delivery and secondary outcomes addressed maternal morbidity and neonatal nursery admission compared with women unaffected by FGM. Results:A full data set was available for 141/142 women affected by FGM. The overall prevalence of FGM was 1.64%. The majority of women affected by FGM were documented to have FGM 3 (41.1%). There was no difference in caesarean section rate. Women with FGM were less likely to be delivered by vacuum or forceps (11.1% vs 2.8%; P = 0.0009). There was no difference in perineal trauma, postpartum haemorrhage and neonatal nursery admission. Women with FGM 3 were more likely to have an episiotomy (4.8% vs 25.9%; P = 0.0007) without an increase in anal sphincter injury (P = 0.7). Documentation complying with local policy and guidelines was poor.Conclusions: FGM is increasingly common in Australia. This study adds to the Australian literature quantifying the effects on obstetric outcomes in these high-risk women.

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The effectiveness of surgical interventions for women with FGM/C: a systematic review

Abstract: Systematic review shows defibulation after FGM/C has obstetric benefits; effect of reconstruction is uncertain.

Cited by 63 publications

References 32 publications

Psychosexual Consequences of Female Genital Mutilation and the Impact of Reconstructive Surgery: A Narrative Review

Psychosexual Consequences of Female Genital Mutilation and the Impact of Reconstructive Surgery: A Narrative Review

Clinical Features Associated with Female Genital Mutilation/Cutting: A Pilot Longitudinal Study

Female genital mutilation: Obstetric outcomes in metropolitan Sydney

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