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Scientific article
Review
Open access
English

Clitoral Reconstruction After Female Genital Mutilation/Cutting: A Review of Surgical Techniques and Ethical Debate

Published inThe journal of sexual medicine, vol. 17, no. 3, p. 531-542
Publication date2020-03
First online date2020-01-10
Abstract

Introduction: Clitoral reconstruction (CR) is a controversial surgical procedure performed for women who have undergone medically unnecessary, often ritualistic genital cutting involving the clitoris. Such cutting is known by several terms; we will use female genital mutilation/cutting (FGM/C). Treatments offered to women affected by complications of FGM/C include defibulation (releasing the scar of infibulation to allow penetrative intercourse, urinary flow, physiological delivery, and menstruation) and CR to decrease pain, improve sexual response, and create a pre-FGM/C genital appearance.

Aim: In this study, our aim is to summarize the medical literature regarding CR techniques and outcomes, and stimulate ethical discussion surrounding potential adverse impacts on women who undergo the procedure.

Methods: A broad literature review was carried out to search any previous peer-reviewed publications regarding the techniques and ethical considerations for CR.

Main outcome measure: The main outcome measure includes benefits, risks, and ethical analysis of CR.

Results: While we discuss the limited evidence regarding the risks and efficacy of CR, we did not find any peer-reviewed reports focused on ethical implications to date.

Clinical implications: CR can be indicated as a treatment for pain and potential improvement of associated sexual dysfunction when these have not responded to more conservative measures. Women must be appropriately informed about the risks of CR and the lack of strong evidence regarding potential benefits. They must be educated about their genital anatomy and disabused of any myths surrounding female sexual function as well as assessed and treated in accordance with the current scientific evidence and best clinical practices.

Strength & limitations: This is the first formal ethical discussion surrounding CR. This is not a systematic review, and the ethical discussion of CR has only just begun.

Conclusion: We present a preliminary ethical analysis of the procedure and its potential impact on women with FGM/C.

eng
Keywords
  • Clitoral Reconstruction
  • Clitoris
  • Cutting
  • Defibulation
  • Ethical Analysis
  • Excision
  • Female Genital Cutting
  • Female Genital Mutilation
  • Medical Synthesis
  • Adult
  • Circumcision, Female / adverse effects
  • Clitoris / physiopathology
  • Clitoris / surgery
  • Female
  • Humans
  • Pain / etiology
  • Reconstructive Surgical Procedures / methods
  • Sexual Dysfunction, Physiological / etiology
Citation (ISO format)
SHARIF MOHAMED, Fatima et al. Clitoral Reconstruction After Female Genital Mutilation/Cutting: A Review of Surgical Techniques and Ethical Debate. In: The journal of sexual medicine, 2020, vol. 17, n° 3, p. 531–542. doi: 10.1016/j.jsxm.2019.12.004
Main files (2)
Article (Accepted version)
Article (Published version)
Identifiers
ISSN of the journal1743-6095
216views
250downloads

Technical informations

Creation10/05/2021 7:49:00 AM
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