Genital reconstruction after FGM

Reconstruction is possible after the circumcision or female genital mutilation (FGM) of girls. This has been a speciality of Dr. Karim since 2010. To do this, he uses existing techniques in genital surgery. In this operation, the external female genitalia which were mutilated during circumcision are recreated.

Female genital mutilation (FGM) can cause all kinds of problems.

The risk of medical complications is high, immediately after circumcision and even years later. Research has shown that FGM can also lead to:

– Psychological problems, such as stress, depression, and anxiety.
– Social problems, such as anger or loneliness.
– Primary related effects: Some women have difficulty entering into a relationship, or are afraid that their partner will not take their sexual limitations into account.

Some women feel ashamed to go to the doctor and/or are afraid of a doctor examining their genitals.

STEP-BY-STEP PLAN

Appointment
Make an appointment for a preliminary visit with Dr. Karim. During this visit we will discuss your wishes. When you make an appointment you can nearly always count on being received by Dr. Karim within 2 weeks. A medical assistant is always present during any genital visit or treatment.

Follow-up appointment
Dr. Karim will also consider the causes of your problem. If you wish, we can hold a follow-up meeting a few weeks after the first visit. Sometimes the problem turns out to be gynaecological or psychological. In that case, Dr. Karim would let you know.

Operation
The procedure can usually be performed within two weeks of the interview.

Rest
After the procedure, you should take a two-week break. Avoid pressure-increasing moments, such as bending and heavy lifting.
It takes about six to twelve weeks before the operation wound is completely recovered.

Checkups
You will return regularly for a checkup: one, two and six weeks after the operation. Also after three and twelve months.
During the checkups there will always be a female assistant accompanying Dr. Karim.

Before the operation

Travel
Because you cannot drive home after an operation (no car or bicycle), it is important to make travel arrangements.

Drugs
Do you use blood-thinning drugs? Please let us know if you do. Ask the doctor from whom you get the prescription and find out if you can temporarily stop treatment. Your doctor will tell you how many days before the operation you should or can stop taking the blood-thinning drug. Dr. Karim wants to ensure this is possible in order to avoid unnecessary risks.

Disease
Fever or flu the day before the operation? Contact Dr. Karim to decide if the operation can be performed or should be postponed.

Cosmetics and personal care products
We understand that you always want to look your best, but on the day of surgery you cannot use skin care products or makeup.

Alcohol
You may feel nervous about the operation, but you can’t drink alcohol the day before (or on the day itself, of course!)! Drinking alcohol increases the chances of subsequent bleeding of the wound.

During the operation

Anaesthesia

Reconstruction of the clitoris
For this, part of the base of the clitoris which is located inside your body is used.

Stitching

FGM

After the operation

Application of cold
We will cool the treated area and take you to a recovery room for recovery.

Discharge
You can go home the same day.

Showering
You can wet your wounds in the shower once the drains are removed.

Pain
The first two weeks you may feel pain when urinating and walking.

Drugs
To reduce the first effects of the pain, we will prescribe an analgesic gel and a hormonal ointment:

– Vaseline with lidocaine: apply a thin layer of the product to the wound three times a day for three days.
– Synapause E3 Cream: Apply a thin layer of the product around the wound once a day for three weeks, starting on the second day.

In addition, you can take two 500 mg paracetamol tablets four times a day if necessary.

Soluble stitches
After a genital reconstruction surgery, the wound is closed with soluble stitches.

Risks

Safe operation
A genital reconstruction is a safe procedure.

Risks inherent to any operation
Subsequent bleeding, infection, fluid retention, thromboembolism, slow healing and/or unsightly scarring.

Specific risks
Temporary feeling of change in the clitoris.

Results

More than seventy percent of women who have had their clitoris reconstructed can have normal sexual intercourse one and a half years after the operation.

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