Clitoral Reconstructive Surgery After Female Genital Mutilation/Cutting: Anatomy, Technical Innovations and Updates of the Initial Technique

Introduction: Female genital mutilation (FGM) includes all procedures that involve partial or total removal of the female external genitalia or any other injury of the female genitalia that is performed for nonmedical reasons. FGM is classified into 4 types. Surgical clitoral reconstruction was first described by Thabet and Thabet in Egypt and subsequently by Foldes in France. The technique was then modified by different authors.Aim: This article aims to provide a detailed description of clitoral surgical reconstruction and the modifications which have been made over time to improve the procedure while recalling current knowledge in the anatomy of the clitoris.Methods: We performed a broad systematic search in PubMed/Medline and EMBASE bibliographic databases for studies that report the surgical technique of clitoral reconstruction. From the anatomical point of view, we examined available evidence (from 1950 until 2020) related to clitoral anatomy, the clitoral role in sexual functioning, female genital mutilation/cutting, and surgical implications for the clitoris.Main Outcomes: A review of the surgical techniques for clitoral reconstruction after female genital mutilation/cuttingResults: We described the current anatomical knowledge about the clitoris, and the procedures based on the surgical technique by Pierre Foldes, We included the technical modifications and contributions described in articles published subsequently.Conclusion: Surgical repair of the clitoris for FGM offers anatomical and functional results although they still have to be evaluated. However, it should not be the only therapeutic solution offered to women with FGM. Copyright (C) 2021 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.