PubMed · 15799258
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Pirjo Terho. 2005. [Confusing conclusion about circumcision].. https://pubmed.ncbi.nlm.nih.gov/15799258/
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The genital self-mutilation is not rare in women. Risk factors found in these cases are: mood disorders, food behavior anomalies and antecedents of sexual aggression. However, surgical repair is not done in emergency: we find no similar report to our clinical case describing an added up bilateral reduction nymphoplasty carried out in emergency after hemorrhagic genital self-mutilation. We discuss psychological risk factors, psychiatric diagnosis and optimal treatment, studied from medico-ethical point of view, for this surgical emergency.
The majority of women with extensive forms of genital cutting develop one or more chronic complications such as dysmenorrhea, dyspareunia, pain and cysts in the perineum, vaginal obstruction with haematocolpos, relative urine retention and recurrent urinary tract infections. Extensive forms of circumcision also influence childbirths. The severity of the cutting is associated with the probability of developing later complications. The women's clinics at the regional hospital in Norway have established outpatient clinics to receive women with complications after genital cutting. The aim was to develop an adequate health service to the affected. In order to improve the access to care and to ensure anonymity the women may refer themselves. During 2004, a total of 60 women were treated. The majority suffered from poor urinary flow, pain at micturition, dysmenorrhea and dyspareunia. Reconstruction of the vaginal orifice was performed to relieve some of the discomforts. The numbers of women who visit the clinics are increasing. The surgical procedure itself is not technically difficult, but the consultation before and after the surgery require cultural sensitivity. As health care personnel we can influence the affected to realise that genital cutting is an assault against a small girl. Norwegian health care workers need to learn more about how to communicate well about the medical as well as the cultural and mental aspects of genital cutting.
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