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International Urogynecology Journal

, Volume 25, Issue 7, pp 985–986 | Cite as

Female genital mutilation reversal: a general approach

  • Mallika AnandEmail author
  • Todd J. Stanhope
  • John A. Occhino
IUJ Video

Abstract

Introduction and hypothesis

Female genital mutilation (FGM) is a violation of human rights; yet, more than 100 million females are estimated to have undergone the procedure worldwide. There is an increased need for physician education in treating FGM. Female pelvic surgeons have a unique opportunity to treat this population of patients. Here, we depict the classification of FGM and a general approach to FGM reversal. We specifically address the procedure of type III FGM reversal, or defibulation.

Methods

In this video, we first highlight the importance of the problem of FGM. Next, we present the classification of FGM using an original, simple, schematic diagram highlighting they key anatomic structures involved in the four types of FGM. We then present a simple case of reversal of type III FGM, a procedure also known as defibulation. After depicting the surgical procedure, we discuss clinical results and summarize key principles of the defibulation procedure.

Results

Our patient was a 25-year-old woman who had undergone type III FGM as a child in Somalia. She desired restoration of vaginal function. We performed a reversal, and her postoperative course was uncomplicated. By 6 weeks postoperatively, she was able to engage in sexual intercourse without dyspareunia.

Conclusion

FGM is a problem at the doorsteps of female pelvic medicine and reconstructive surgery. Our video demonstrates a basic surgical approach that can be applied to simple cases of type III FGM presenting to the female pelvic surgeon.

Keywords

Female genital mutilation Circumcision reversal Defibulation 

Notes

Acknowledgments

The authors thank Elaine Flom of Media Support Services, Mayo Clinic, for her video editing expertise. This video was presented at the American Urogynecologic Society 34th Annual Scientific Meeting on 19 October 2013, in Las Vegas, NV, USA

Consent

Written informed consent was obtained from the patient for publication of this video article and any accompanying images.

Conflicts of Interest

None.

Supplementary material

ESM 1

(MP4 91544 kb)

References

  1. 1.
    World Health Organization (2008) Eliminating Female Genital Mutilation: An Interagency StatementGoogle Scholar
  2. 2.
    Meniru GI, Hecht BR, Hopkins MP (2000) Female circumcision: at our doorsteps and beyond. Prim Care Update Ob Gyns 7(6):231–237PubMedCrossRefGoogle Scholar
  3. 3.
    Teufel K, Dörfler DM (2013) Female genital circumcision/mutilation: implications for female urogynaecological health. Int Urogynecol J. Jul 16. [Epub ahead of print]Google Scholar
  4. 4.
    Nour NM, Michels KB, Bryant AE (2006) Defibulation to treat female genital cutting: effect on symptoms and sexual function. Obstet Gynecol 108(1):55–60PubMedCrossRefGoogle Scholar
  5. 5.
    Standring S (ed) (2008) Gray’s Anatomy: the anatomical basis of clinical practice. Churchill Livingstone Elsevier, EdinburghGoogle Scholar

Copyright information

© The International Urogynecological Association 2014

Authors and Affiliations

  • Mallika Anand
    • 1
    Email author
  • Todd J. Stanhope
    • 1
  • John A. Occhino
    • 1
  1. 1.Division of Gynecologic Surgery, Department of Obstetrics and GynecologyMayo ClinicRochesterUSA

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