Reconstructive surgery may help women who have undergone female genital cutting (FGC – also called female genital mutilation), according to French researchers.
The surgery, which aims to restore clitoral anatomy and function, has reduced pain and increased sexual pleasure for many women.
Female genital cutting is a common practice in parts of Africa, Asia, and the Middle East. It involves cutting or removing parts of female genitalia for non-medical reasons. It usually occurs between infancy and age 15 and is considered a rite of passage for many cultures. Some believe that girls who have been cut are more desirable as marriage partners or that removing parts of the genitals will stunt a woman’s sex drive.
Dr. Pierre Foldès of Poissy Saint Germain Hospital in France developed the technique and performed the surgery on 2,938 women. He and his colleagues conducted a prospective study to learn more about the short- and long-term effects of the procedure.
The women were mainly from Mali, Senegal, and the Ivory Coast. 564 of them had undergone FGC in France.
When questioned about their expectations of surgery, 99% of the women said they wanted to recover their identities. 81% of the women hoped for a better sex life and 29% expected less pain.
About 5% of the women had complications from the surgery, including hematoma, suture failure, and moderate fever.
One year after the surgery, over 800 women participated in a follow-up assessment. Of this group, 821 out of 840 women said their pain had decreased or was no worse than before. 815 out of 834 women said they experienced clitoral pleasure.
In addition, a third of the women who had never had an orgasm before surgery could now have “restricted” (lower intensity) orgasms or regular orgasms. Half the women who had restricted orgasms before surgery could now have regular ones.
While the procedure shows promise, availability, cost, and insurance coverage are prominent barriers. “Cultural education and specific training of medical professionals are lacking in many countries. Therefore, women with genital mutilation are not usually informed about the possibility of specific health care to address the consequences of mutilation,” wrote Jasmine Abdulcadir, Michael Boulvain, and Patrick Petignat of University Hospitals of Geneva in a comment article published in The Lancet.
“In some countries, the health insurance or national healthcare systems do not recognize defibulation and clitoral reconstruction as therapeutic procedures, classing them as cosmetic surgery,” they added.
The study authors noted the psychological impact of FGC: “The complexity of the sexual dysfunctions that can be associated with female genital mutilation underlines, for us, the need to systematically offer sexual therapy to patients. Furthermore, these women might have experienced suffering and violence in many different forms, which could result in post-traumatic stress disorder – an aspect we are currently exploring.”
“Reconstructive surgery after female genital mutilation reduces pain, improves sexual pleasure, and could help thousands of women”
(Press release from The Lancet. June 11, 2012)
Dallas, Mary Elizabeth
“Procedure Might Ease Pain of Female Genital Mutilation”
(June 12, 2012)
International Society for Sexual Medicine
“Female Genital Cutting”
(Public policy statement. 2012)
“ISSM Issues Policy Statement on Female Genital Cutting”
Abdulcadir, Jasmine, et al.
“Reconstructive surgery for female genital mutilation”
(Full-text. Comment. Published online June 12, 2012)
Foldès, Pierre, MD, et al.
“Reconstructive surgery after female genital mutilation: a prospective cohort study”
(Full text. Published online: June 12, 2012)
“Surgery Restores Sexual Function In Women With Genital Mutilation”
(June 13, 2012)