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Repair of Genital mutilation, specialty of the Reed Centre

Between 100 and 140 million females worldwide live with the consequences of genital mutilation.   They are predominately in sub-Saharan Africa and the Arab States. But rates of FGM are increasing, a reflection of global population growth.

A key challenge is not only protecting girls who are currently at risk but also ensuring that those to be born in the future will be free from the dangers of the practice. This is especially important considering that FGM-concentrated countries are generally experiencing high population growth and have large youth populations. In 2010, for example, more than 45 per cent of the female populations in the Gambia, Mali, Somalia and  Uganda were under age 15.

FGM, or female circumcision, is the practice of removing parts of a girl’s genitals. The procedure varies in extremity—from removing a thin slice of flesh to removing the entire labia minora and/or the labia majora. In these cases, the “cutter” leaves nothing but a pinhole sized opening surrounded with scar tissue. The most common type of FGM involves the removal of the clitoris. Girls subjected to this practice often grow up to face severe health complications with menstruation, sexual intercourse, pregnancy, and childbirth.

According to estimates from World Health Organization, between 100 and 140 million females worldwide live with the consequences of FGM. At least 30 million girls under the age of 15 are at risk. But what’s most surprising is that, according to The Centers for Disease Control and Prevention, nearly a quarter of a million of those girls live in the United States. Brigham and Women’s Hospital puts the figure at 228,000 with 38,000 in California, 26,000 in New York, and 19,000 in New Jersey.

While independent organizations all over the world have been working to raise awareness about female genital mutilation and decrease the number of women at risk, those already subjected to the procedure tend to have no recourse. They simply have to live with the results of what was done to them.

Restoration of the clitoral hood is fairly easy and photos are shown on http://srsmiami.com/repair-of-female-genital-mutilation-fgm/  Surgical repair is fairly easy.  Amputation of the clirotal glans can be corrected by releasing the clitoral body and exterioizing it.

The World Health Organizaiton describes treatment of persons with female genital mutilation

This study describes surgical repair of the clitoris in 453 patients who requested the procedure in France between 1992 and 2005 [1].The process of “clitoral rehabilitation” involved resecting the skin covering the stump in order to identify the clitoris. The suspensor ligament was sectioned in order to mobilize the stump, the sclerous tissues were removed from the extremity and the neo glans was brought to a normal situation. Pre-operative pain and clitoral impairment were assessed within five categories. The same was done with anatomical and functional post-operative results after six months.

For all patients the stay in hospital was 24 hours and the procedure lasted no more than 30 minutes. Minor early complications were recorded in 58 patients (haematoma, rupture of the suture, pain). Four patients reported persistant pain at four months. A visible clitoral massif was restored in 87% of the cases and a notable improvement in clitoral function was obtained in 75% of the patients.

 

Harold M. Reed, M.D.
The Reed Centre for Genital Surgery – Miami
1-305-865-2000

 

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