Peer-reviewed article
Postoperative pain after clitoral reconstruction in women with female genital mutilation: An evaluation of practices.
Bah M, Abdulcadir J, Tataru C, Caillet M, Hatem-Gantzer G et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study surveyed 32 surgeons across 14 countries about how they manage pain after clitoral reconstruction surgery for women with female genital mutilation. Researchers found that postoperative pain is very common (97% of patients at day 7) and often lasts at least a month. Most surgeons use only basic pain medications and rarely screen for or treat nerve-related pain, and many report feeling uncertain about how to help.
Key points
- 97% of patients experienced pain 7 days after clitoral reconstruction surgery
- Pain persisted for at least one month in 50% of cases
- 22% of surgeons reported feeling powerless in managing postoperative pain
- 61% of analgesic protocols used only step II and anti-inflammatory drugs
- Screening for neuropathic pain was rare (3%), and pudendal nerve block was used by only 8% of surgeons
Limitations
This study describes current practices through surgeon self-report rather than measuring actual patient outcomes or pain levels. The findings are based on responses from a relatively small sample of surgeons and may not represent all practitioners performing clitoral reconstruction.
Abstract
Introduction More than 200 million women and girls have undergone genital mutilation. Clitoral reconstruction (CR) can improve the quality of life of some of them, but is accompanied by significant postoperative pain. Objective Assess and describe the management of postoperative pain after CR, and the practices amongst specialists in different countries. Methods Between March and June 2020, 32 surgeons in 14 countries (Germany, Austria, Belgium, Burkina Faso, Canada, Ivory Coast, Egypt, Spain, United States of America, France, the Netherlands, Senegal, Switzerland, Sweden) responded to an online questionnaire on care and analgesic protocols for CR surgery. Results At day 7 post CR, 97% of the surgeons observed pain amongst their patients, which persisted up to 1 month for half of them. 22% of the participants reported feeling powerless in the management of such pain. The analgesic treatments offered are mainly step II and anti-inflammatory drugs (61%). Screening for neuropathic pain is rare (3%), as is the use of pudendal nerve block, used by 8% of the care providers and only for a small percentage of women. Conclusion Pain after CR is frequent, long-lasting, and potentially an obstacle for the women who are willing to undergo clitoral surgery and also their surgeons. Most surgeons from different countries follow analgesic protocols that do not use the full available therapeutic possibilities. Early treatment of neuropathic pain, optimisation of dosing of standard analgesics, addition of opioids, use of acupuncture, and routine intraoperative use of pudendal nerve block might improve the management of pain after CR.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Current postoperative pain management protocols following clitoral reconstruction surgery
- Population
- Women undergoing clitoral reconstruction after female genital mutilation, treated by 32 surgeons across 14 countries
Key finding
97% of surgeons observed pain in patients at day 7 post-reconstruction
M et al. · Europe PMC · 15 Sept 2021