Female genital mutilation and other harmful practices
Treatment of persons with female genital mutilation
Defibulation to reverse infibulation, type III FGM
This study, which is described in an article that uses the term “female genital cutting” to describe female genital mutilation [1], examines the possibility of using defibulation as a means of reversing type III FGM. Defibulation (i.e. surgical opening of the labia) is reconstructive surgery of the scar tissue caused when the labia are joined together by infibulation. The researchers propose that defibulation can alleviate some of the complications that result from FGM. The researchers studied physical and sexual outcomes following defibulation and evaluated the level of satisfaction of both the defibulated woman and her husband.
The study involved reviewing the medical records of 40 consecutive women with a history of type III FGM who underwent defibulation at two Boston (USA) hospitals between 1995 and 2003. Data collected included demographics, indications for the FGM procedure, type of closure of the labia, and intraoperative and postoperative complications. All of the women either had symptoms or had requested defibulation. Telephone surveys were conducted between six months and two years after the procedure to evaluate the long-term outcomes in terms of health and sexual satisfaction.
Of 40 women identified as having undergone defibulation, 95% were Somali, 65% were married, and 73% were between the ages of 19 and 30. The main indications for defibulation were being pregnant (30%), dysmenorrhea (30%), apareunia (20%) and dyspareunia (15%). Secondary indications were apareunia (20%), difficult urination (12.5%), dyspareunia (10%) and engagement to be married (7%). Sixty-five per cent of the women had a subcuticular repair; 48% had an intact clitoris buried beneath the scar. None of the women had intraoperative or postoperative complications. Of the 32 patients reached by telephone, 94% stated that they would highly recommend defibulation to others. All of the patients (and their husbands) were satisfied with the results of the defibulation, they felt their appearance had improved, and they were sexually satisfied.
The researchers conclude by recommending defibulation for all infibulated women who suffer long-term complications as a result. The complication rates of defibulation are reported to be minimal, while satisfaction rates among patients and their husbands are high.
References
1. Nour NM, Michels KB, Bryant AE. Defibulation to treat female genital cutting: effect on symptoms and sexual function. Obstetrics & Gynaecology 2006; 108(1):55-60 (doi: 10.1097/01.AOG.0000224613.72892.77).