Reconstructive surgery for women with female genital mutilation: A scoping review

Almadori, Aurora; Palmieri, Stefania; Coho, Christie; Evans, Catrin; Elneil, Soheir; Albert, Juliet

Abstract

Background
Female genital mutilation (FGM) is a global public health concern. However, reconstructive surgery remains unavailable in many countries.

Objectives
This scoping review, guided by Joanna Briggs Institute (JBI) principles, explores indications, referral routes, eligibility, care pathways and clinical outcomes of reconstructive surgery for FGM.

Search strategy
Medical Subject Headings (MeSH) terms and subject headings were searched in EMBASE, MEDLINE, SCOPUS, Web of Science and publicly available trial registers.

Selection criteria
Any primary experimental and quasi-experimental study addressing reconstructive surgery for FGM, and its impact on women, published before June 2023.

Data collection and analysis
After removing duplicates from the search results, titles and abstracts were screened and data were extracted. Disagreements were resolved through panel discussion. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) flow diagram depicts the search results and inclusion process.

Main results
A total of 40 studies were included. Multidisciplinary teams were involved in 40% (16/40) of the studies, and psychosexual counselling was offered in 37.5% (15/40) of studies. Clitoral reconstruction using Foldes’ technique was predominant (95%, 38/40). A total of 7274 women underwent some form of reconstruction. Post-surgery improvement was reported in 94% of the cases (6858/7274). The complication rate was 3% (207/7722 women with reconstruction).

Conclusions
Further research and clinical trials are needed. Although the outcomes suggest improved sexual function and quality of life post-surgery, the evidence remains limited. Advocating surgical reconstruction for survivors of FGM is vital for addressing health disparities and potential cost-effectiveness.

Citation

Almadori, A., Palmieri, S., Coho, C., Evans, C., Elneil, S., & Albert, J. (2024). Reconstructive surgery for women with female genital mutilation: A scoping review. BJOG: An International Journal of Obstetrics and Gynaecology, https://doi.org/10.1111/1471-0528.17886

• Journal Article Type: Review
• Acceptance Date: Jun 3, 2024
• Online Publication Date: Jun 24, 2024
• Publication Date: Jun 24, 2024
• Deposit Date: Jun 13, 2024
• Publicly Available Date: Mar 25, 2025
• Journal: BJOG: An International Journal of Obstetrics and Gynaecology
• Print ISSN: 1470-0328
• Electronic ISSN: 1471-0528
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1111/1471-0528.17886
• Keywords: clitoral reconstruction; cutting; emotional support; female genital mutilation; labia reconstruction; model of care; outcome assessment; psychosexual counselling; psychosexual therapy; reconstructive surgery; referral pathway
• Public URL: https://nottingham-repository.worktribe.com/output/36011926
• Publisher URL: https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.17886