Tag Archives: Case reports

Clinical presentations that may be followed by evaluative studies that eventually lead to a diagnosis.

I knew how it feels but couldn’t save my daughter; testimony of an Ethiopian mother on female genital mutilation/cutting.

FREEReprod Health. 2017 Dec 1;14(1):162. doi: 10.1186/s12978-017-0434-y.

I knew how it feels but couldn’t save my daughter; testimony of an Ethiopian mother on female genital mutilation/cutting.

Adinew YM, Mekete BT

ABSTRACT

BACKGROUND: World Health Organization defines female genital mutilation/cutting as all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. The practice is common in Ethiopia, especially among Somali (99%) ethnic groups. Even though FGM/C is labeled illegal practice according to the revised 2005 Penal Code of the country, the practice is still responsible for misery of many girls in Ethiopia. METHODS: This personal testimony is presented using woman’s own words. Data were collected through in-depth interview with a woman at Gursum health center, Somali regional state, eastern Ethiopia on June 19/2016. The interview was conducted in a private environment and original names were changed to overcome ethical concerns. Informed written consent was obtained from the participant prior to data collection. The interview was audio-taped using a digital voice recorder, later transcribed and translated verbatim from the local language, Amharic to English. RESULTS: The study participant described a range of experiences she had during her own and her daughter’s circumcision. Three themes emerged from the woman’s description: womanhood, social pressure and stigmatization of uncircumcised women and uncertain future. CONCLUSION: Even though the national prevalence may show a decline, FGM/C is still practiced underground. Thus, anti-FGM/C interventions shall take in to account elders influence and incorporate a human rights approach rather than relying merely on the dire health consequences. Further exploration of the determinants of FGM/C on a wider scale is recommended.

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Acquired Clitoromegaly: A Gynaecological Problem or an Obstetric Complication?

FREEJ Clin Diagn Res. 2016 Dec;10(12):QD10-QD11. doi: 10.7860/JCDR/2016/23212.9072. Epub 2016 Dec 1.

Acquired Clitoromegaly: A Gynaecological Problem or an Obstetric Complication?

Gupta M, Saini V, Poddar A, Kumari S, Maitra A.

ABSTRACT

Acquired non-hormonal clitoromegaly is a rare condition and is due to benign or malignant tumours and sometimes idiopathic. Few cases of clitoral abscesses have been reported after female circumcision. We hereby report a case of clitoral abscess causing acquired clitoromegaly following an obstetrical surgery.

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Labial fusion: A rare cause of urinary retention in reproductive age woman and review of literature.

FREETurk J Urol. 2017 Mar;43(1):98-101. doi: 10.5152/tud.2017.58897. Epub 2017 Mar 1.

Labial fusion: A rare cause of urinary retention in reproductive age woman and review of literature.

Erdoğdu E, Demirel C, Tahaoğlu AE, Özdemir A.

ABSTRACT

Labial fusion usually affects prepubertal girls and postmenopausal women, it may  rarely occurs in reproductive years in the absence of predisposing factors such as vulvar infections, dermatitis, trauma, female circumcision and lichen sclerosis. Should be considered in differential diagnosis in the differential diagnosis of urinary retention even if the patient doesn’t have history of sexual intercourse.

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Clitoral keloids after female genital mutilation/cutting.

FREETurk J Obstet Gynecol. 2016 Sep;13(3):154-157. doi: 10.4274/tjod.32067. Epub 2016 Sep 15.

Clitoral keloids after female genital mutilation/cutting.

Birge Ö, Akbaş M, Özbey EG, Adıyeke M.

ABSTRACT

We aimed to describe the presentation of long-term complications of female genital mutilation/cutting and the surgical management of clitoral keloids secondary to female genital mutilation/cutting. Twenty-seven women who underwent surgery because of clitoral keloid between May 2014 and September 2015 in Sudan Nyala Turkish Hospital were evaluated in this retrospective descriptive case series study. The prevalence of type 1, type 2, and type 3 female genital mutilation/cutting were 3.7%, 22.2%, and 74.1%, respectively (type 1: 1/27, type 2: 6/27, and type 3: 20/27). All patients had long-term health problems (dysuria, chronic pelvic pain, vaginal discharge, and chronic pruritus) and sexual dysfunction. Keloids were removed by surgical excision. There were no postoperative complications in any patient. Although clitoral keloid lesions can be seen after any type of female genital mutilation/cutting, they usually develop after type 3 female genital mutilation/cutting. Most of these keloids were noticed after menarche. Keloids can be removed by surgical excision and this procedure can alleviate some long-term morbidities of female genital mutilation/cutting.

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Clitoral stones are a rare complication of female genital mutilation.

Int J Gynaecol Obstet. 2016 Jul 31.doi: 10.1016/j.ijgo.2016.06.011. [Epub ahead of print]

Clitoral stones are a rare complication of female genital mutilation

Al-Hussaini TK

ABSTRACT

Female genital mutilation (FGM) is practiced widely in Egypt and is a deeply rooted tradition; although the government has banned the practice, FGM in Egypt dates back to the Pharaonic period, with adherence to the custom remaining widespread. FGM has been described as a direct assault on the clitoris and an indirect assault on female sexuality [1]. FGM is known to be widespread in Egypt, with 91% of all women aged 15–49 years having undergone some form of FGM [2]; in Upper Egypt, the prevalence is thought to be higher stil.

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Vulvar Epidermoid Cyst and Type 2 Radical Genital Mutilation

FREECase Rep Obstet Gynecol. 2015;2015:520190. doi: 10.1155/2015/520190. Epub 2015 Nov 22.

Vulvar Epidermoid Cyst and Type 2 Radical Genital Mutilation

Birge O, Ozbey EG, Arslan D, Erkan MM, Demir F, Akgor U

ABSTRACT

About 100 million women are estimated to be circumcised globally. Various rates of complications have been encountered, especially after circumcision, such as bleeding, infection, shock, menstrual irregularity, difficulty in urination or common urinary tract infections, inguinal pain, difficulty in sexual intercourse, and genital circumcision scar especially at the vulvar region, and cystic or solid character mass in short and long term. Furthermore, the maternal-fetal morbidity and mortality increase due to bleeding and fistula, which develop after prolonged labor, travail, and difficult labors. Our aim in this paper was to discuss a 42-year-old multiparous female case who had undergone type 2 radical genital mutilation (circumcision) when she was 7 years of age, along with the literature, which has been evaluated for the gradually growing mass at the left inguinal canal region in the last 10 years and diagnosed as epidermoid inclusion cyst developing secondary to postcircumcision surgical ground trauma, since there was no other case found in the literature search that had been circumcised at such an early age and developing after circumcision at such advanced age, and, therefore, this is suggested to be the first case on this subject.

This article can be accessed in this LINK

Traumatic Vulvar Epithelial Inclusion Cysts Following Female Genital Mutilation (FGM)

Geburtshilfe Frauenheilkd. 2015 Sep;75(9):945-948.FREE

Traumatic Vulvar Epithelial Inclusion Cysts Following Female Genital Mutilation (FGM)

Mack-Detlefsen B, Banaschak S, Boemers TM

ABSTRACT

Background: Female genital mutilation (FGM) occurs mainly in Africa, parts of the Arabian Peninsula and parts of Asia. It is commonly associated with acute complications as well as diverse late/delayed complications. One of the most common of these late complications is progressively enlarging painless cysts of the vulva.

Case Report: An 8-year-old girl from Eritrea presented to our paediatric emergency department with a progressively enlarging mass of the vulva. She had undergone a clitoridectomy and partial removal of the labia minora as an infant in Eritrea. We performed surgical excision of the cyst and reconstruction of the labia. Histology showed a traumatic squamous epithelial inclusion cyst of the vulva.

Conclusion: Epithelial or dermoid cysts of the vulva following FGM are extremely rare. Symptoms often require surgical intervention. Through increasing migration, more girls and female youths with FGM are likely to present to practices and hospitals in Germany. Thus increased knowledge and awareness of the medical complications of FGM and their treatment will be necessary in years to come.

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Female genital mutilation in children presenting to a London safeguarding clinic: a case series

Arch Dis Child. 2015 Jul 27. pii: archdischild-2015-308243. doi: 10.1136/archdischild-2015-308243. [Epub ahead of print]

Female genital mutilation in children presenting to a London safeguarding clinic: a case series.

Hodes D, Armitage A, Robinson K, Creighton SM

BACKGROUND

OBJECTIVE: To describe the presentation and management of children referred with suspected female genital mutilation (FGM) to a UK safeguarding clinic.

DESIGN AND SETTING: Case series of all children under 18 years of age referred with suspected FGM between June 2006 and May 2014.

MAIN OUTCOME MEASURES: These include indication for referral, demographic data, circumstances of FGM, medical symptoms, type of FGM, investigations and short-term outcome.

RESULTS: Of the 47 girls referred, 27 (57%) had confirmed FGM. According to the WHO classification of genital findings, FGM type 1 was found in 2 girls, type 2 in 8 girls and type 4 in 11 girls. No type 3 FGM was seen. The circumstances of FGM were known in 17 cases, of which 12 (71%) were performed by a health professional or in a medical setting (medicalisation). Ten cases were potentially illegal, yet despite police involvement there have been no prosecutions.

CONCLUSIONS: This study is an important snapshot of FGM within the UK paediatric population. The most frequent genital finding was type 4 FGM with no tissue damage or minimal scarring. FGM was performed at a young age, with 15% reported under the age of 1 year. The study also demonstrated significant medicalisation of FGM, which matches recent trends in international data. Type 4 FGM performed in infancy is easily missed on examination and so vigilance in assessing children with suspected FGM is essential.

This article can be accessed in this LINK

Female genital mutilation in infants and young girls: report of sixty cases observed at the general hospital of abobo (abidjan, cote d’ivoire, west Africa).

Int J Pediatr. 2014;2014:837471. doi: 10.1155/2014/837471. Epub 2014 Mar 4.FREE

Female genital mutilation in infants and young girls: report of sixty cases observed at the general hospital of abobo (abidjan, cote d’ivoire, west Africa).

Plo K, Asse K, Seï D, Yenan J.

ABSTRACT

The practice of female genital mutilations continues to be recurrent in African communities despite the campaigns, fights, and laws to ban it. A survey was carried out in infants and young girls at the General Hospital of Abobo in Cote D’Ivoire. The purpose of the study was to describe the epidemiological aspects and clinical findings related to FGM in young patients. Four hundred nine (409) females aged from 1 to 12 years and their mothers entered the study after their consent. The results were that 60/409 patients (15%) were cut. The majority of the young females came from Muslim families (97%); the earlier age at FGM procedure in patients is less than 5 years: 87%. Amongst 409 mothers, 250 women underwent FGM which had other daughters cut. Women were mainly involved in the FGM and their motivations were virginity, chastity, body cleanliness, and fear of clitoris similar to penis. Only WHO types I and II were met. If there were no incidental events occurred at the time of the procedure, the obstetrical future of these young females would be compromised. With FGM being a harmful practice, health professionals and NGOs must unite their efforts in people education to abandon the procedure.

This paper can be accessed in this LINK

Missed opportunities for diagnosis of female genital mutilation.

Int J Gynaecol Obstet. 2014 Mar 5. pii: S0020-7292(14)00114-3. doi: 10.1016/j.ijgo.2013.11.016. [Epub ahead of print]

Missed opportunities for diagnosis of female genital mutilation.

Abdulcadir J, Dugerdil A, Boulvain M, Yaron M, Margairaz C, Irion O, Petignat P.

ABSTRACT

OBJECTIVE: To investigate missed opportunities for diagnosing female genital mutilation (FGM) at an obstetrics and gynecology (OB/GYN) department in Switzerland.

METHODS: In a retrospective study, we included 129 consecutive women with FGM who attended the FGM outpatient clinic at the Department of Gynecology and Obstetrics at the University Hospitals of Geneva between 2010 and 2012. The medical files of all women who had undergone at least 1 previous gynecologic exam performed by an OB/GYN doctor or a midwife at the study institution were reviewed. The type of FGM reported in the files was considered correct if it corresponded to that reported by the specialized gynecologist at the FGM clinic, according to WHO classification.

RESULTS: In 48 (37.2%) cases, FGM was not mentioned in the medical file. In 34 (26.4%) women, the diagnosis was correct. FGM was identified but erroneously classified in 28 (21.7%) cases. There were no factors (women’s characteristics or FGM type) associated with missed diagnosis.

CONCLUSION: Opportunities to identify FGM are frequently missed. Measures should be taken to improve FGM diagnosis and care.

This article can be accessed in this LINK.