外阴,特别是阴蒂疼痛会影响女性生殖器切割/切割(FGM/C)的女性。迄今为止,关于FGM/C后外阴疼痛的不同可用治疗方法没有全面的研究。
研究患有FGM/C的女性外阴和/或阴蒂疼痛的手术治疗结果
对2010年4月1日至2017年12月31日期间在女性外阴残割患者专科门诊咨询的所有506名女性的连续医疗档案进行回顾性回顾。
手术治疗后慢性外阴疼痛的主观变化。
总共,36.1%的女性(n=183)经历过慢性疼痛,包括所有类型,其中2.8%(n=14)经历了引起或无端的慢性外阴疼痛。在14名患有或无缘无故慢性外阴疼痛的女性中,10例(71.4%)接受了手术治疗:7例接受了外阴瘢痕并发症切除术(囊肿,bridles,粘连)伴有(n=4)或不伴有(n=3)伴发脱音,3例进行了阴蒂重建,1例进行了阴唇重建,并消除了阴蒂周围的粘连。十分之九(90%)的患者在手术后疼痛缓解,其余妇女(10%)失去随访。
存在安全有效的手术治疗,女性生殖器切割/C后慢性外阴疼痛患者应转诊给专家,他们会考虑适当的手术适应症,并支持知情的决策和治疗。
这项研究的优势在于,来自不同文化和宗教背景的女性的样本量很大,以及手术前和手术后图像材料和组织学的可用性。局限性包括疼痛的主观报告,而没有经过验证的问卷。
FGM/C后引起或非引起的慢性外阴疼痛的有效手术治疗是阴蒂重建,解密者,膀胱切除术,和马笼头拆除。手术治疗应与文化敏感的多学科护理和随访相结合。BazzounY.,AertsL.,AbdulcadirJ.女性生殖器切割/切割后慢性外阴疼痛的手术治疗。JSexMed2022;19:290-301。
Vulvar and in particular clitoral pain can affect women with Female Genital Mutilation/Cutting (FGM/C). To date, there is no comprehensive study on the different available treatments for vulvar pain after FGM/C.
To study the outcome of surgical treatments of vulvar and/or clitoral pain among women living with FGM/C.
Retrospective review of the consecutive medical files of all 506 women who consulted at a specialized outpatient clinic for women with FGM/C between April 1, 2010 and December 31, 2017.
Subjective change in chronic vulvar pain after surgical treatment.
In total, 36.1% of women (n = 183) experienced chronic pain, all types included, among which 2.8% (n = 14) experienced provoked or unprovoked chronic vulvar pain. Among the 14 women with provoked or unprovoked chronic vulvar pain, ten (71.4%) underwent surgical treatment: 7 underwent resection of vulvar scar complications (cysts, bridles, adhesions) with (n = 4) or without (n = 3) concomitant defibulation, 3 had clitoral reconstruction and one had labium reconstruction with removal of peri-clitoral adhesion. Nine out of ten (90%) experienced resolution of pain after surgery and the remaining woman (10%) was lost to follow-up.
Safe and effective surgical treatments exist and patients with chronic vulvar pain post-FGM/C should be referred to specialists who would consider appropriate indications for surgery and support informed decision-making and treatment.
The strengths of this research are the big sample size of women from diverse cultural and religious backgrounds, as well as the availability of pre- and postsurgery iconographic material and histology. Limitations include a subjective reporting of pain without validated questionnaires.
Effective surgical treatments for provoked or unprovoked chronic vulvar pain post-FGM/C are clitoral reconstruction, defibulation, cystectomy, and bridle removal. Surgical treatments should be combined with a culturally sensitive multidisciplinary care and follow-up. Bazzoun Y., Aerts L., Abdulcadir J. Surgical Treatments of Chronic Vulvar Pain After Female Genital Mutilation/Cutting. J Sex Med 2022;19:290-301.