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Sample records for female genital system

  1. Female Genital Mutilation

    Science.gov (United States)

    ... problems (depression, anxiety, post-traumatic stress disorder, low self-esteem, etc.). Health complications of female genital mutilation Who ... female genital mutilation You are here: Media centre Fact sheets Quick Links Sitemap Home Health topics Data ...

  2. Female genital cosmetic surgery.

    Science.gov (United States)

    Shaw, Dorothy; Lefebvre, Guylaine; Bouchard, Celine; Shapiro, Jodi; Blake, Jennifer; Allen, Lisa; Cassell, Krista

    2013-12-01

    To provide Canadian gynaecologists with evidence-based direction for female genital cosmetic surgery in response to increasing requests for, and availability of, vaginal and vulvar surgeries that fall well outside the traditional realm of medically-indicated reconstructions. Published literature was retrieved through searches of PubMed or MEDLINE, CINAHL, and The Cochrane Library in 2011 and 2012 using appropriate controlled vocabulary and key words (female genital cosmetic surgery). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to May 2012. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table). Recommendations 1. The obstetrician and gynaecologist should play an important role in helping women to understand their anatomy and to respect individual variations. (III-A) 2. For women who present with requests for vaginal cosmetic procedures, a complete medical, sexual, and gynaecologic history should be obtained and the absence of any major sexual or psychological dysfunction should be ascertained. Any possibility of coercion or exploitation should be ruled out. (III-B) 3. Counselling should be a priority for women requesting female genital cosmetic surgery. Topics should include normal variation and physiological changes over the lifespan, as well as the possibility of unintended consequences of cosmetic surgery to the genital area. The lack of evidence regarding outcomes and the lack of data on the

  3. Genital tuberculosis in females

    Directory of Open Access Journals (Sweden)

    G Angeline Grace

    2017-01-01

    Full Text Available The morbidity and mortality due to tuberculosis (TB is high worldwide, and the burden of disease among women is significant, especially in developing countries. Mycobacterium tuberculosis bacilli reach the genital tract primarily by haematogenous spread and dissemination from foci outside the genitalia with lungs as the common primary focus. Genital TB in females is a chronic disease with low-grade symptoms. The fallopian tubes are affected in almost all cases of genital TB, and along with endometrial involvement, it causes infertility in patients. Many women present with atypical symptoms which mimic other gynaecological conditions. A combination of investigations is needed to establish the diagnosis of female genital TB (FGTB. Multidrug anti-TB treatment is the mainstay of management and surgery may be required in advanced cases. Conception rates are low among infertile women with genital TB even after multidrug therapy for TB, and the risk of complications such as ectopic pregnancy and miscarriage is high. More research is needed on the changing trends in the prevalence and on the appropriate methods for diagnosis of FGTB.

  4. Female cosmetic genital surgery.

    Science.gov (United States)

    Goodman, Michael P

    2009-01-01

    Genital plastic surgery for women has come under scrutiny and has been the topic of discussion in the news media, online, and in medical editorials. In the absence of measurable standards of care, lack of evidence-based outcome norms, and little standardization either in nomenclature or training requirements, concern has been raised by both ethicists and specialty organizations.Some women request alteration of their vulvas and vaginas for reasons of cosmesis, increasing self-esteem, and improving sexual function. Patients must be assured their surgeon is properly trained and should understand that few validated long-term safety or outcome data are presently available in this relatively new field. Women also should be made aware that, although they may wish to cosmetically or physically alter their external genitalia, this does not mean that they are developmentally or structurally "abnormal." It is important that training guidelines for practitioners be established and that long-term outcome, psychosexual, and safety data be published. The genital plastic surgeon must have sufficient training in sexual medicine to withhold these procedures from women with sexual dysfunction, mental impairment, or body dysmorphic disorder. In an atmosphere in which trademarked marketing terms are becoming part of the lexicon, a more descriptive terminology is suggested, incorporating the terms "labiaplasty," "reduction of clitoral hood," "perineoplasty," "hymenoplasty," and "vaginoplasty." The term "female cosmetic genital surgery" is presented as a descriptive umbrella encompassing these genital plastic procedures.

  5. Anatomy and arterial vascularization of female genital system of margay (Leopardus weidii

    Directory of Open Access Journals (Sweden)

    Andrezza Braga Soares Silva

    2016-02-01

    Full Text Available The margay (Leopardus wiedii belongs to Carnivora order and present’s nocturnal habits. There are few studies using this specie, whereas it is between feline species vulnerable to extinction. Thus, we propose a descriptive study about female genital system and behavior of the arteries responsible for the blood supply to these organs in margay. It used one exemplary victim of poaching that to death. The animal was stored in freezer. Subsequent to defrost at room temperature, it proceeded with the solution injection Leoprene Latex ‘650’ colored in red for better identification of vessels before the adjacent strutures. The specimen was fixed using an aqueous 10% formaldehyde with subsequent immersion in the same fixative solution. The genital system were dissected and the organs and arterial branches were identified and photodocumented. The female genital system of margay consists of a pair of ovaries, uterus with a pair of uterine horns, vagina and vulva. The arterial distribution of female system have a common vessel to iliac artery which branches and leads to internal pudendal artery sends a branch along the pudendal nerve pathway, urogenital artery. This, we performed divided into two branches, cranial and caudal. The cranial branch irrigates laterally cervix and uterine horns and caudal branch, vagina and vulva. The ovarian arteries, peers, originate from abdominal aorta only vascularization the ovaries. The female genital system and vascularization of the genitals organs of margay resembles of domestic carnivores including cats and some wild felines like the ocelot and find differences with the same description held in other domestic and wild species.

  6. Female Genital Mutilation in Sudan

    Directory of Open Access Journals (Sweden)

    Adel Hussein Elduma

    2018-02-01

    CONCLUSION: The practice of female genital mutilation is spread all over the country. Poor women with low level of education are at high risk for this phenomenon. More efforts have to be provided to end this dangerous practice.

  7. Female genital mutilation in Djibouti.

    Science.gov (United States)

    Martinelli, M; Ollé-Goig, J E

    2012-12-01

    The practice of female genital mutilation (we will use the latest definition adopted by WHO/UNFP: female genital mutilation/cutting or FGM/C) is still widespread in 28 African countries. The World Health Organisation (WHO) estimates that more than two million females undergo some form of genital mutilation every year. Its negative health impact and its ethical and human rights aspects have been discussed and attempts to eliminate it have been the objectives of several meetings promoted by national and international organisations thanks to an increased awareness related to FGM/C in those countries practicing it and also, maybe due to the number of Africans migrating to industrialized countries. We review the present situation in Djibouti, a small country in the Horn of Africa, where 98 % of the female population has suffered different forms of FGM/C.

  8. Pattern Recognition via the Toll-Like Receptor System in the Human Female Genital Tract

    Directory of Open Access Journals (Sweden)

    Kaei Nasu

    2010-01-01

    Full Text Available The mucosal surface of the female genital tract is a complex biosystem, which provides a barrier against the outside world and participates in both innate and acquired immune defense systems. This mucosal compartment has adapted to a dynamic, non-sterile environment challenged by a variety of antigenic/inflammatory stimuli associated with sexual intercourse and endogenous vaginal microbiota. Rapid innate immune defenses against microbial infection usually involve the recognition of invading pathogens by specific pattern-recognition receptors recently attributed to the family of Toll-like receptors (TLRs. TLRs recognize conserved pathogen-associated molecular patterns (PAMPs synthesized by microorganisms including bacteria, fungi, parasites, and viruses as well as endogenous ligands associated with cell damage. Members of the TLR family, which includes 10 human TLRs identified to date, recognize distinct PAMPs produced by various bacterial, fungal, and viral pathogens. The available literature regarding the innate immune system of the female genital tract during human reproductive processes was reviewed in order to identify studies specifically related to the expression and function of TLRs under normal as well as pathological conditions. Increased understanding of these molecules may provide insight into site-specific immunoregulatory mechanisms in the female reproductive tract.

  9. A review of the human vs. porcine female genital tract and associated immune system in the perspective of using minipigs as a model of human genital Chlamydia infection.

    Science.gov (United States)

    Lorenzen, Emma; Follmann, Frank; Jungersen, Gregers; Agerholm, Jørgen S

    2015-09-28

    Sexually transmitted diseases constitute major health issues and their prevention and treatment continue to challenge the health care systems worldwide. Animal models are essential for a deeper understanding of the diseases and the development of safe and protective vaccines. Currently a good predictive non-rodent model is needed for the study of genital chlamydia in women. The pig has become an increasingly popular model for human diseases due to its close similarities to humans. The aim of this review is to compare the porcine and human female genital tract and associated immune system in the perspective of genital Chlamydia infection. The comparison of women and sows has shown that despite some gross anatomical differences, the structures and proportion of layers undergoing cyclic alterations are very similar. Reproductive hormonal cycles are closely related, only showing a slight difference in cycle length and source of luteolysing hormone. The epithelium and functional layers of the endometrium show similar cyclic changes. The immune system in pigs is very similar to that of humans, even though pigs have a higher percentage of CD4(+)/CD8(+) double positive T cells. The genital immune system is also very similar in terms of the cyclic fluctuations in the mucosal antibody levels, but differs slightly regarding immune cell infiltration in the genital mucosa - predominantly due to the influx of neutrophils in the porcine endometrium during estrus. The vaginal flora in Göttingen Minipigs is not dominated by lactobacilli as in humans. The vaginal pH is around 7 in Göttingen Minipigs, compared to the more acidic vaginal pH around 3.5-5 in women. This review reveals important similarities between the human and porcine female reproductive tracts and proposes the pig as an advantageous supplementary model of human genital Chlamydia infection.

  10. Female genital mutilation in Nigeria.

    Science.gov (United States)

    Mandara, M U

    2004-03-01

    To determine the prevalence and distribution of female genital mutilation (FGM) procedures in a Nigerian population. Five hundred consecutive women were evaluated for evidence of FGM. The WHO classification system was utilized. Demographic and sociocultural information was collected. Thirty-four percent of women were found to have some type of FGM. Type I and Type II procedures were the most common. Fifty-five percent of women were unaware they had FGM and 62% with FGM did not know the reason. Twenty-one percent of women said they were going to have FGM on their daughters. FGM is still broadly practiced among ethnic and religious groups in Nigeria. Educational efforts need to be directed at eliminating this practice.

  11. Confronting female genital mutilation

    International Development Research Centre (IDRC) Digital Library (Canada)

    The issue of FGM has always been considered 'sensitive' (meaning dangerous), which has deeply affected the way it has been approached and addressed. .... cutting18), even if it means hiding the apparent intention of the practice (to honour)? The most recent theory, popularised by Tostan, is that female circumcision is ...

  12. FEMALE GENITAL MUTILATION

    African Journals Online (AJOL)

    immigrants and refugees into Western cultures has made it important for health care practitioners to understand some of the customs, beliefs and traditions surrounding female circumcision. This is especially the case in South Africa with its 8 million illegal immigrants. .... A poster used in the campaign against FGM in France.

  13. Female Genital Mutilation in Egypt

    Directory of Open Access Journals (Sweden)

    Nissrin Hoffmann

    2013-07-01

    Full Text Available Female Genital Mutilation is widely practiced in Egypt as well as in big sections of the African continent. The tradition of mutilation of the female genital areas has been practiced over the course of many years in the country and has been attributed to being promoted by the Islamic religion in Egypt. The Islamic religion is the most widely practiced religion within Egypt and therefore is linked to being the main reason why the country possesses one of the highest prevalence rates of the practice within Africa, according to many surveys performed by many leading agencies and nongovernmental organizations that advocate for the abolition of the practice within the country. FGM as a social health concern has been realized as not possessing any health benefits for the women and young girls who are taken through the practice.

  14. Female Genital Mutilation in Egypt

    Directory of Open Access Journals (Sweden)

    Nissrin Hoffmann

    2013-01-01

    Full Text Available Female Genital Mutilation is widely practiced in Egypt as well as in big sections of the African continent. The tradition of mutilation of the female genital areas has been practiced over the course of many years in the country and has been attributed to being promoted by the Islamic religion in Egypt. The Islamic religion is the most widely practiced religion within Egypt and therefore is linked to being the main reason why the country possesses one of the highest prevalence rates of the practice within Africa, according to many surveys performed by many leading agencies and nongovernmental organizations that advocate for the abolition of the practice within the country. FGM as a social health concern has been realized as not possessing any health benefits for the women and young girls who are taken through the practice.

  15. Educating about female genital mutilation.

    Science.gov (United States)

    Holmes, Victoria; Farrington, Rebecca; Mulongo, Peggy

    2017-01-01

    Female genital mutilation (FGM) is illegal in the UK but nevertheless practised in some immigrant communities. Effective educational approaches are required to inform policy and to direct resources, often in the voluntary sector. The opinions in this article arise from discussions with professionals and members of FGM-practising communities. We highlight the importance of sharing experiences and expertise across health and social care professionals as well as working in partnership with culturally sensitive Non-Governmental Organisations. Enlisting the support of men and religious leaders is crucial to breaking down barriers in male-dominated communities and dispelling myths about FGM being a 'requirement' of faith.

  16. Localized neurofibromatosis of the female genital system: a case report and review of the literature.

    Science.gov (United States)

    Gómez-Laencina, Ana M; Martínez Díaz, Francisco; Izquierdo Sanjuanes, Blanca; Vicente Sánchez, Elena M; Fernandez Salmerón, Rosario; Meseguer Peña, Francisco

    2012-06-01

    Neurofibromatosis within the female genital tract is uncommon. The vulva is the most frequent genital location, but it has rarely been reported in the context of the vagina, uterine cervix or ovaries. In spite of its rarity, neurofibroma is a neoplasm that should be considered in the differential diagnosis of pelvic masses, especially in patients with neurofibromatosis. In this paper we describe the case of a 71-year-old patient with pelvic pain and a uterine mass who underwent a hysterectomy after having been diagnosed with an 11-cm neurofibroma occupying the myometrium of the entire uterine corpus. There were no neurofibromas in the endometrium, serosa, fallopian tubes or ovaries. The patient had an unknown von Recklinghausen's disease. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

  17. Female sexual dysfunction in female genital mutilation.

    Science.gov (United States)

    Elneil, Sohier

    2016-01-01

    Female genital mutilation (FGM), otherwise known as female genital cutting (FGC), is currently very topical and has become a significant global political issue. The impact of FGM on the lives of women and girls is enormous, as it often affects both their psychology and physical being. Among the complications that are often under-reported and not always acknowledged is female sexual dysfunction (FSD). FSD presents with a complex of symptoms including lack of libido, arousability and orgasm. This often occurs in tandem with chronic urogenital pain and anatomical disruption due to perineal scarring.To treat FSD in FGM each woman needs specifically directed holistic care, geared to her individual case. This may include psychological support, physiotherapy and, on occasion, reconstructive surgery. In many cases the situation is complicated by symptoms of chronic pelvic pain, which can make treatment increasingly difficult as this issue needs a defined multidisciplinary approach for its effective management in its own right. The problems suffered by women with FGM are wholly preventable, as the practice need not happen. The current global momentum to address the social, cultural, economic and medical issues of FGM is being supported by communities, governments, non-governmental agencies (NGOs) and healthcare providers. It is only by working together that the practice can be abolished and women and girls may be free from this practice and its associated consequences. © The Author(s) 2016.

  18. Female Genital Cutting in Contemporary Eritrea: Determinants ...

    African Journals Online (AJOL)

    Abstract. The observation that about 90% of Eritrean women were circumcised in 2002 increased interest to understand the trends, determinants, and consequences of female genital cutting (FGC). The study used data from the 2002 EDHS and the 2003 Female Genital Mutilation Survey to consider factors that influence the ...

  19. Effect of female genital mutilation on female sexual function ...

    African Journals Online (AJOL)

    Background: The global prevalence of female genital mutilation (FGM) ranges from 0.6% up to 98%. It has many health psychological impacts including abnormalities of female sexual function. Objectives: To study female genital mutilation and its effect on female sexual function, Alexandria, Egypt 2013. Methods: A ...

  20. International efforts on abandoning female genital mutilation

    OpenAIRE

    E. Edouard; O. Olatunbosun; L. Edouard

    2013-01-01

    Female genital mutilation (FGM), sometimes referred to as female circumcision or female genital cutting, is a harmful cultural practice without any known health benefit. Its short-term and long-term health risks have led to numerous initiatives toward its eradication at international and local levels, over the last two decades. While major challenges remain and millions of girls and women are still at risk of being subjected to FGM, there is growing evidence that interventions that take into ...

  1. Genital chlamydia trachomatis infection among female ...

    African Journals Online (AJOL)

    Background: Genital Chlamydia trachomatis infection is a common bacterial sexually transmitted infection worldwide. There is little information about this infection in Nigeria. This study determined the prevalence of genital Chlamydia trachomatis infection among female undergraduates of University of Port Harcourt and ...

  2. The medicalisation of female genital mutilation

    Directory of Open Access Journals (Sweden)

    Pierre Foldes

    2015-05-01

    Full Text Available The ‘medicalisation’ of female genital mutilation should be denounced on two counts.Firstly, it is usually anatomically more damaging and, secondly, it goes against the ethical basis of the medical profession.

  3. International efforts on abandoning female genital mutilation

    Directory of Open Access Journals (Sweden)

    E. Edouard

    2013-09-01

    Full Text Available Female genital mutilation (FGM, sometimes referred to as female circumcision or female genital cutting, is a harmful cultural practice without any known health benefit. Its short-term and long-term health risks have led to numerous initiatives toward its eradication at international and local levels, over the last two decades. While major challenges remain and millions of girls and women are still at risk of being subjected to FGM, there is growing evidence that interventions that take into account the social dynamics that perpetuate FGM are yielding positive results toward its reduction. Well-recognized as a human rights violation in international treaties, the elimination of female genital mutilation requires ongoing interventions through cross-sectoral approaches that address attitudinal, cultural and behavioral change.

  4. Attitudes towards female genital mutilation: an integrative review.

    Science.gov (United States)

    Reig Alcaraz, M; Siles González, J; Solano Ruiz, C

    2014-03-01

    Immigration and globalization processes have contributed to the international dissemination of practices such as female genital mutilation. Between 100 and 400 million girls and women have been genitally mutilated, and every year 3 million girls are at risk of being subjected to female genital mutilation. The objective of this study was to describe the attitudes towards the practice of female genital mutilation in relation to different health systems and the factors that favour its discontinuation. An integrative review was performed of publications from the period 2006 to 2013 included in the MedLine, PubMed, LILACS, SciELO, CINAHL and CUIDEN databases. We selected 16 studies focusing on diverse contexts that assessed the attitudes of both men and women regarding the perpetuation of this practice. Ten corresponded to studies conducted in countries of residence. Several areas of investigation were explored (factors contributing to the continuation of female genital mutilation, factors contributing to its discontinuation, feelings about the health system). It is possible that the relevant studies may not have been included given the limitations of the literature review and the invisibility of the phenomenon studied. This review demonstrates the strong social pressure to which women are subjected as regards the practice of female genital mutilation. However, many other factors can contribute to eroding beliefs and arguments in favour of this practice, such as the globalization, culture and social environment of countries in the West. Nurses occupy an essential position in detecting and combating these practices. © 2013 International Council of Nurses.

  5. Female genital mutilation : Conditions of decline

    NARCIS (Netherlands)

    Caldwell, JC; Orubuloye, IO; Caldwell, P

    Female genital mutilation (or female circumcision) has been experienced by over 100 million women in sub-Saharan Africa and the Nile valley Efforts to suppress the practice were made in the earlier decades of the present century, especially by missionaries in Kenya in the 1920s and early 1930s.

  6. Female genital mutilation: psychological and reproductive health ...

    African Journals Online (AJOL)

    The study examined the reproductive health and psychological effects of female genital mutilation, in one traditional area in the Upper East region (i.e. Kayoro Traditional Area) of Ghana. The results of the study revealed that, the practice of FGM actually affects the physical (deforming the female genitalia), psychological (the ...

  7. FEMALE_GENITAL. NEW.CDR

    African Journals Online (AJOL)

    Department of Community Health and Primary Health Care, Olabisi Onabanjo University Teaching Hospital,. Sagamu. KEY WORDS: Female genital. Cutting ... need to improve female education among this population, intensify anti-FGC campaigns and more ..... it as a health problem and a human rights abuse issue that.

  8. Efeitos da melatonina no sistema genital feminino: breve revisão Melatonin effects on the female genital system: a brief review

    Directory of Open Access Journals (Sweden)

    Carla C. Maganhin

    2008-06-01

    Full Text Available A melatonina é um hormônio produzido pela glândula pineal, cuja secreção está diretamente relacionada ao ciclo claro-escuro. É um poderoso antioxidante e tem papel fundamental na regulação do estado sono/vigília, do ritmo de vários processos fisiológicos, participando do controle do relógio biológico, inclusive nos seres humanos. Ressalta-se que há evidências da sua ação no sistema genital feminino, influenciando a função ovariana e a fertilidade. De fato, este hormônio interage com esteróides sexuais, como o estrogênio, modificando a sinalização celular e a resposta no tecido alvo. Estudos clínicos sugerem que o tratamento com a melatonina interviria com a evolução de neoplasia-dependente do estrogênio. O objetivo dessa revisão é analisar as principais ações da melatonina no sistema neuroendócrino, no ciclo sono-vigília, no sistema imunológico, no sistema cardiovascular, bem como no sistema reprodutor.Melatonin is secreted by the pineal gland and this is linked to the day/night cycle. It is an antioxidant and plays a fundamental role in the regulation of the jet-lag stage, in several physiological reactions and in control of the biologic rhythm. Human melatonin has an important influence on the female genital system. In fact, melatonin may influence production and action of steroids, modifying cellular signalization on the target tissue. There are many evidences that the melatonin therapy may be interfering with neoplasia development, mainly of the estrogen-dependent tumor. This paper aims to analyze the actions of melatonin on the neuroendocrine, immunological and cardiovascular systems, as well as on the reproductive function.

  9. Genital evolution: why are females still understudied?

    Directory of Open Access Journals (Sweden)

    Malin Ah-King

    2014-05-01

    Full Text Available The diversity, variability, and apparent rapid evolution of animal genitalia are a vivid focus of research in evolutionary biology, and studies exploring genitalia have dramatically increased over the past decade. These studies, however, exhibit a strong male bias, which has worsened since 2000, despite the fact that this bias has been explicitly pointed out in the past. Early critics argued that previous investigators too often considered only males and their genitalia, while overlooking female genitalia or physiology. Our analysis of the literature shows that overall this male bias has worsened with time. The degree of bias is not consistent between subdisciplines: studies of the lock-and-key hypothesis have been the most male focused, while studies of cryptic female choice usually consider both sexes. The degree of bias also differed across taxonomic groups, but did not associate with the ease of study of male and female genital characteristics. We argue that the persisting male bias in this field cannot solely be explained by anatomical sex differences influencing accessibility. Rather the bias reflects enduring assumptions about the dominant role of males in sex, and invariant female genitalia. New research highlights how rapidly female genital traits can evolve, and how complex coevolutionary dynamics between males and females can shape genital structures. We argue that understanding genital evolution is hampered by an outdated single-sex bias.

  10. Female Genital Mutilation - the Importance of Recognition and Management

    OpenAIRE

    Campos, AC

    2010-01-01

    Female genital mutilation, also named female genital cutting or female circumcision, refers to all practices involving total or partial removal of female external genitalia, or causing other lesions without an established health benefit. The World Health Organization estimates that 130 million women have been submitted to genital mutilation and 3 million are annually exposed to such risk in Africa. It has classified the practice of female genital mutation in four types. Portugal is considered...

  11. Mothers' Perceptions of Female Genital Mutilation

    Science.gov (United States)

    Ahanonu, E. L.; Victor, O.

    2014-01-01

    The practice of female genital mutilation (FGM) is widespread in Nigeria. This study was conducted to assess the perceptions of FGM among mothers at a primary healthcare centre in Lagos, Nigeria. A convenience sample of 95 mothers completed the pre-tested, semi-structured questionnaires. Data analysis was carried out using descriptive statistics…

  12. Large inclusion cyst complicating female genital mutilation

    Directory of Open Access Journals (Sweden)

    Abdel Aziem AbdAllah Ali

    2011-12-01

    Full Text Available We report a case of an inclusion cyst, resulting from female genital mutilation (FGM, which enlarged to such a degree that it restricted the patient’s movement. This report aims to raise the awareness of the medical community to the dangers that arise from a common remote complication of FGM.

  13. Female genital mutilation: Tradition versus human rights

    African Journals Online (AJOL)

    A.E. Groeneveld

    www.sciencedirect.com. Opinion article. Female genital mutilation: Tradition versus human rights. A.E. Groeneveld. Department of Urology, Mbabane Clinic, Swaziland. Received 22 November 2012; received in revised form 1st December 2012; accepted 1st December 2012. 'All procedures that involve partial or complete ...

  14. Female genital mutilation - from tradition to femicide

    Directory of Open Access Journals (Sweden)

    Rakić Jelena

    2017-01-01

    Full Text Available Female genital mutilation has been drawing international attention for the last couple of decades, but this phenomenon is almost unknown in Serbia. In this work we will point to its basic forms and its presence in the world as well as to the variety of consequences, especially those which are the most common causes of death. With this purpose in mind, the work represents the a review of theoretical debates and empirical studies, based on which relevant data may be gathered, related to the previously mentioned subject of the work. Female genital mutilation is a phenomenon mostly in Africa, but due to migrations has become a problem thoughout the whole world. Traditional and cultural norms of strict patriarchal societies along with deeply rooted inequality of genders have contributed to the maintenance of this custom up till today. This custom includes a sequence of different procedures which are used to injure female genitals even though there are no medical reasons for such acts. They are conducted by older women in insanitary conditions and by means such as scissors, razors or glass which bring numerous consequences which can result in death. Females subdued to infibulation are at greater risk of death, although each of the forms of mutilation may have this consequence. Female genital mutilation represents violence against women due to its inevitable physical consequences and its harmful effect on health. Girls and women are subdued to the procedure which in some cases results in death, for the purpose of the community acceptance, most of all the acceptance of the future husband. Namely, women are elligible for marriage only if they are virgins, which is achieved by genital mutilation, according to the opinion of the community in which this tradition is preserved. Beside that, marriage is of high importance for the economic stability of a woman, considering the fact that all the economic power is held by men. Genital mutilation has the purpose

  15. Female genital mutilation in Djibouti | Martinelli | African Health ...

    African Journals Online (AJOL)

    The practice of female genital mutilation (we will use the latest definition adopted by WHO/UNFP: female genital mutilation/cutting or FGM/C) is still widespread in 28 African countries. The World Health Organisation (WHO) estimates that more than two million females undergo some form of genital mutilation every year.

  16. Female genital mutilation and reporting duties for all clinical personnel.

    Science.gov (United States)

    Cropp, Gabrielle; Armstrong, Jane

    2016-07-01

    Female genital mutilation is illegal. It is now mandatory for health-care professionals to report female genital mutilation to the police. Professionals caring for women and girls of all ages must understand how female genital mutilation presents, and what action to take.

  17. Development of rat female genital cortex and control of female puberty by sexual touch.

    Science.gov (United States)

    Lenschow, Constanze; Sigl-Glöckner, Johanna; Brecht, Michael

    2017-09-01

    Rat somatosensory cortex contains a large sexually monomorphic genital representation. Genital cortex undergoes an unusual 2-fold expansion during puberty. Here, we investigate genital cortex development and female rat sexual maturation. Ovariectomies and estradiol injections suggested sex hormones cause the pubertal genital cortex expansion but not its maintenance at adult size. Genital cortex expanded by thalamic afferents invading surrounding dysgranular cortex. Genital touch was a dominant factor driving female sexual maturation. Raising female rats in contact with adult males promoted genital cortex expansion, whereas contact to adult females or nontactile (audio-visual-olfactory) male cues did not. Genital touch imposed by human experimenters powerfully advanced female genital cortex development and sexual maturation. Long-term blocking of genital cortex by tetrodotoxin in pubescent females housed with males prevented genital cortex expansion and decelerated vaginal opening. Sex hormones, sexual experience, and neural activity shape genital cortex, which contributes to the puberty promoting effects of sexual touch.

  18. Development of rat female genital cortex and control of female puberty by sexual touch.

    Directory of Open Access Journals (Sweden)

    Constanze Lenschow

    2017-09-01

    Full Text Available Rat somatosensory cortex contains a large sexually monomorphic genital representation. Genital cortex undergoes an unusual 2-fold expansion during puberty. Here, we investigate genital cortex development and female rat sexual maturation. Ovariectomies and estradiol injections suggested sex hormones cause the pubertal genital cortex expansion but not its maintenance at adult size. Genital cortex expanded by thalamic afferents invading surrounding dysgranular cortex. Genital touch was a dominant factor driving female sexual maturation. Raising female rats in contact with adult males promoted genital cortex expansion, whereas contact to adult females or nontactile (audio-visual-olfactory male cues did not. Genital touch imposed by human experimenters powerfully advanced female genital cortex development and sexual maturation. Long-term blocking of genital cortex by tetrodotoxin in pubescent females housed with males prevented genital cortex expansion and decelerated vaginal opening. Sex hormones, sexual experience, and neural activity shape genital cortex, which contributes to the puberty promoting effects of sexual touch.

  19. FEMALE GENITAL MUTILATION: ARE WE WINNING?

    Science.gov (United States)

    Makinde, O N; Elusiyan, J B E; Adeyemi, A B; Taiwo, O T

    2012-06-01

    For more than 25 years, efforts have been geared towards curtailing the practice of female genital mutilation (FGM) in countries like Nigeria. This study was designed to see if all these efforts have made any impact in reducing the prevalence of FGM appreciably in the south-West of Nigeria. To determine the prevalence of female genital mutilation and profiling the trends of FGM affected patients. A prospective study based on direct observation of the external genitalia by health-care workers . Five hundred and sixty five females less than 15 years of age. The children emergency and gynaecological wards of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria from 1st of January to December 31s 2007. Forty one point nine percent of the patients examined had female genital mutilation, 93.2% of these had the procedure before attaining the age of one year. Type 2 FGM predominated (58.22%). The procedure was performed predominantly (64.6%) by traditional birth attendants. The decision to have the procedure done was influenced in 78% of cases by mothers and grandmothers. In 35.4% of cases, there were immediate and short term complications. Demands of tradition predominated (59.1%) as the most important reason for the practice of female genital mutilation. The practice of FGM appears to be still highly prevalent and resistant to change probably due to deep rooted socio-cultural factors. Strategies such as public education campaigns highlighting its negative impact on health and disregard for human rights should be evolved.

  20. Female genital mutilation: a urology focus.

    Science.gov (United States)

    Clarke, Elinor

    2016-10-13

    Female genital mutilation (FGM) is a collective term for the deliberate alteration, removal and cutting of the female genitalia. It has no known health benefits and can have negative physical and psychological consequences. The number of women and girls in the UK that are affected by FGM is unknown. Recent NHS data suggested that FGM has been evident (declared or observed) in women who have accessed health care; however, there are gaps in knowledge and a limited evidence base on the health consequences of FGM. This article explores the urological complications experienced by women who have undergone this practice, and the effects this can have on their health and wellbeing.

  1. Diagnostic imaging and cataloguing of female genital malformations

    Directory of Open Access Journals (Sweden)

    Pedro Acién

    2016-08-01

    Full Text Available Abstract To help physicians and radiologists in the diagnosis of female genito-urinary malformations, especially of complex cases, the embryology of the female genital tract, the basis for Müllerian development anomalies, the current classifications for such anomalies and the comparison for inclusion and cataloguing of female genital malformations are briefly reviewed. The use of the embryological system to catalogue female genito-urinary malformations may ultimately be more useful in correlations with clinical presentations and in helping with the appropriate diagnosis and treatment. Diagnostic imaging of the different genito-urinary anomalies are exposed, placing particular emphasis on the anomalies within group II of the embryological and clinical classification (distal mesonephric anomalies, all of them associated with unilateral renal agenesis or dysplasia. Similarly, emphasis is placed on cases of cervico-vaginal agenesis, cavitated noncommunicated uterine horns, and cloacal and urogenital sinus anomalies and malformative combinations, all of them complex malformations. Diagnostic imaging for all these anomalies is essential. The best imaging tools and when to evaluate for other anomalies are also analysed in this review. Teaching points • The appropriate cataloguing of female genital malformations is controversial. • An embryological classification system suggests the best diagnosis and appropriate management. • The anomalies most frequently diagnosed incorrectly are the distal mesonephric anomalies (DMAs. • DMAs are associated with unilateral renal agenesis or renal dysplasia with ectopic ureter. • We analyse other complex malformations. Diagnostic imaging for these anomalies is essential.

  2. Female genital mutilation/cutting: an update.

    Science.gov (United States)

    Rouzi, A A; Alturki, F

    2015-01-01

    Female genital mutilation/cutting (FGM/C) is a cultural practice involving several types of external female genitalia cutting. FGM/C is known to occur in all parts of the world but is most prevalent in 28 countries in Africa and the Middle East and among immigrant communities in Europe, Australia, New Zealand, Canada, and the United States. Studies of FGM/C suffer from many methodological problems including inadequate analysis and an unclear reporting of results. The evidence to link FGM/C to infertility is weak. The management of epidermal clitoral inclusion cysts includes expensive investigations like comprehensive endocrinology tests and MRI resulting in unnecessary anxiety due to delay in surgical treatment. Similarly, unnecessary cesarean sections or rupture of the infibulation scar continue to occur because of the inadequate use of intrapartum defibulation. A significant amount of efforts is required to improve and correct the inadequate care of FGM/C women and girls.

  3. Correlates of female genital mutilation (FGM) among patients of a ...

    African Journals Online (AJOL)

    The efforts to combat female genital mutilation (FGM) may not avail much if the factors promoting it are not well understood. An observer rated instrument consisting of socio-demographic variables and items concerning female genital mutilation drawn from Demographic and Health Survey and Multiple Indicator Cluster ...

  4. Perception and practice of female genital cutting in a rural ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    A cross sectional study was carried out among Ayadehe women in Itu, LGA Akwa Ibom State, Nigeria using a semi-structured interviewer ... Keywords: Perception, practice, female education, female genital cutting, traditional birth attendants. Introduction ... girls and women are genitally mutilated while 2 million are at risk ...

  5. Female genital tract cancers in Sagamu, southwest, Nigeria ...

    African Journals Online (AJOL)

    Objective: To describe pattern of female genital tract cancers seen at Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Nigeria. Design: This is a retrospective review of all cases of female genital tract cancers managed at the Gynaecology department of OOUTH, Sagamu, Nigeria. Setting: OOUTH is a ...

  6. Female genital mutilation and pregnancy: associated risks.

    Science.gov (United States)

    Gayle, Claudine; Rymer, Janice

    2016-09-22

    Female genital mutilation (FGM) is a traditional practice that has no medical benefit and severe health consequences for girls and women. This article discusses the risks to patients who are pregnant and have had FGM. It will describe urinary tract infections caused by FGM, and how this condition increases the risk of preterm labour and delivery. It will also address the difficulty in vaginal examinations that can be caused by FGM and instances when this can delay diagnosis and treatment. In addition, it will explore a number of intrapartum risks caused by FGM and the role of deinfibulation in pregnancy. Finally, it will look at the link between maternal and fetal morbidity and mortality, and FGM.

  7. Female genital mutilation/cutting in Africa.

    Science.gov (United States)

    Odukogbe, Akin-Tunde A; Afolabi, Bosede B; Bello, Oluwasomidoyin O; Adeyanju, Ayodeji S

    2017-04-01

    Female genital mutilation/cutting (FGM/C) is a traditional practice in which the external female genitalia is partially or totally incised or excised for a non-therapeutic reason, usually without the consent of the individual. FGM/C is common in Africa with varying prevalence in different countries, though the incidence is reducing because it is considered a human rights issue with tremendous advocacy for its elimination by mainly nongovernmental organizations. It is mainly underreported in many countries in Africa especially where it has been declared illegal. FGM/C is often performed by a nonmedical practitioner with the aim of fulfilling religious or cultural rites and sometimes for economic benefits with the resultant acute, intermediate and late complications. It is sometimes performed by medical practitioners when it is speciously believed that its medicalization reduces the complications associated with the practice. The sensitivity of FGM/C is amplified when compared to male circumcision and voluntary alterations of the female external genitalia like piercing and tattooing as similar practices. The magnitude of the physical and psychosocial consequences of FGM/C outweighs the presumed benefits of the procedures highlighting the need for improvement of the multiple preventive measures by all the stakeholders and in all the sectors.

  8. Hysterosalpingographic Appearances of Female Genital Tract Tuberculosis: Part II: Uterus

    OpenAIRE

    Ahmadi, Firoozeh; Zafarani, Fatemeh; Shahrzad, Gholam Shahrzad

    2014-01-01

    Female genital tuberculosis remains as a major cause of tubal obstruction leading to infertility, especially in developing countries. The global prevalence of genital tuberculosis has increased during the past two decades due to increasing acquired immunodeficiency syndrome. Genital tuberculosis (TB) is commonly asymptomatic and it is diagnosed during infertility investigations. Despite of recent advances in imaging tools such as computed tomography (CT) scan, magnetic resonanc...

  9. Female genital schistosomiasis : pathological features and density ...

    African Journals Online (AJOL)

    In the lower genital tract, the cervix accounted for thirty two (68%) cases. Interestingly fifteen (47%) of cases showed association with cervical dysplasia, invasive squamous cell carcinoma or human papilloma virus koliocytosis. Presentations in the lower genital tract were of ulceration, polyps or abnormal vaginal bleeding.

  10. Health information interventions for female genital mutilation.

    Science.gov (United States)

    Smith, Helen; Stein, Karin

    2017-02-01

    Providing information and education to women and girls living with female genital mutilation (FGM) could be an important influence on their healthcare-seeking behavior. Healthcare providers also need adequate knowledge and skills to provide good quality care to this population. Recent WHO guidelines on managing health complications from FGM contain best practice statements for health education and information interventions for women and providers. This qualitative evidence synthesis summarizes the values and preferences of girls and women living with FGM, and healthcare providers, together with other evidence on the context and conditions of these interventions. The synthesis highlights that healthcare providers lack skills and training to manage women, and women are concerned about the lack of discussion about FGM with providers. There is a need for more training for providers, and further research to understand how health information interventions may be perceived or experienced by women living with FGM in different contexts. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  11. Support growing for eradicating female genital cutting.

    Science.gov (United States)

    1999-12-01

    Female genital cutting (FGC), a prevalent practice in most African countries not just seriously endangers a girl's lifetime health, but it is also considered a human rights violation. In June 1999, the Intra-Agency Working Group on FGC held a symposium with US Agency for International Development (USAID) staff to explore ways of incorporating into USAID program activities to eradicate the practice of FGC. One of the presentations at the symposium concerned "circumcision with words". This ceremony is an alternative rite of passage; it is conducted through a 5-day seclusion, culminating in a 1-day celebration including feasting and gift giving. The alternative rites include 1) self-esteem and coping with criticism; 2) responsibility for one¿s own decision; 3) dating and courtship; 4) coping with peer pressure; 5) personal hygiene; 6) marriage; 7) pregnancy and sexually transmitted disease and AIDS prevention; 8) contraception; 9) FGC, early marriage, and gender empowerment, including the rights of the girl child; 10) respect for community; and 11) respect for elders. Alternative rites of passage are gaining community acceptance and by Kenya Medical Association. None of the girls who participated in the ceremony were circumcised later.

  12. Neurophysiology and pharmacology of female genital sexual response.

    Science.gov (United States)

    Giuliano, François; Rampin, Olivier; Allard, Julien

    2002-01-01

    Vaginal sexual arousal is a vasocongestive and neuromuscular event controlled by facilitatory parasympathetic and inhibitory sympathetic inputs. Autonomic preganglionic parasympathetic and inhibitory sympathetic fibers to the vagina and clitoris originate in the spinal cord in the sacral parasympathetic nucleus at the sacral level and in the dorsal gray commissure and the intermediolateral cell column at the thoracolumbar level, respectively. Parasympathetic fibers are conveyed by the pelvic nerve, and sympathetic fibers are conveyed by the hypogastric nerve and the paravertebral sympathetic chain. The activity of these spinal nuclei is controlled by descending projections from the brain and sensory afferens (conveyed in the pudendal, hypogastric, pelvic, and vagus nerves) from the genitalia. A key but unresolved issue concerns the neurotransmitters involved in the control of genital sexual arousal. At the peripheral level, acetylcholine plays a minor role in the regulation of vaginal blood flow, however, recent data suggests that it may be involved in the control of vaginal smooth muscle contractions. Vasoactive intestinal peptide and nitric oxide may be responsible for the increase in vaginal blood flow during sexual arousal, whereas noradrenaline is likely inhibitory. Within the central nervous system, serotoninergic projections from the brain to the spinal cord likely inhibit the induction of genital arousal by peripheral informations (spinal reflex). Although some neurotransmitters regulating the display of sexual behavior have been identified (for example, dopamine), their involvement in the control of genital sexual arousal has not been invested. Anatomical and electrophysiological data point to a contribution of the paraventricular nucleus of he hypothalamus and the median preoptic area, respectively, as key elements in the control of genital arousal. The recent development of models allowing the assessment of vaginal sexual arousal in anesthetized female

  13. Stopping female genital mutilation. An update.

    Science.gov (United States)

    Gamble, A

    1995-01-01

    There is widespread consensus among many individuals, countries, and organizations that female genital mutilation (FGM) is a human rights abuse. France, Britain, Sweden, and Switzerland have passed legislation forbidding medical personnel from performing FGM, eighteen African countries have made official statements against FGM, and FGM was an issue in the 1993 World Health Assembly, the 1993 World Human Rights Conference, and the 1994 International Conference on Population and Development. True change, however, depends upon a transformation in the informal economic, social, and political structures which perpetuate women's dependency upon marriage and men. The Research Action Information Network for the Bodily Integrity of Women (RAINBOW) and the Development Law and Policy Unit of the Columbia University School of Public Health introduced the Global Action Against FGM (GAAFGM) Project in June 1994. The project is designed to integrate action against FGM into existing health and human rights programs and to pool available resources against FGM. GAAFGM has also coordinated an interagency working group comprised of international agencies, in-country grassroots organizations, and women's groups, which met for the first time in November 1994. The project should provide considerable information and leadership on the issue. On another front, participants in the most recent preparatory meeting for the upcoming Beijing Conference noted the existence of a strong recognition that FGM is a problem upon which the international community should act. The author notes recent litigation brought by the Egyptian Organization for Human Rights against the grand sheik of Al-Azhar University for issuing a fatwa declaring female circumcision an Islamic duty. In addition, a Ghanaian may be granted refugee status in Canada on the basis of her efforts to avoid mutilation if deported to her country of origin.

  14. Female genital cutting among the Hausa community in Sagamu ...

    African Journals Online (AJOL)

    Results: One hundred and seventy seven females and 68 males were interviewed. The males had a higher level of education compared with the females (p<0.05). Female genital cutting was a prevalent practice in the community as 80% of all the respondents were aware of the practice and 69.9% of the females reported ...

  15. Surgical Treatment of Complication of Female Genital Mutilation in ...

    African Journals Online (AJOL)

    Surgical Treatment of Complication of Female Genital Mutilation in Pikine Hospital, Senegal. Abdoul A Diouf, Moussa Diallo, Aissatou Mbodj, Omar Gassama, Mamour Guèye, Jean C Moreau, Alassane Diouf ...

  16. [Ritualistic female genital mutilation. The sentiment of the women].

    Science.gov (United States)

    Allag, F; Abboud, P; Mansour, G; Zanardi, M; Quéreux, C

    2001-11-01

    Female genital mutilation (FGM) is considered as the most dangerous custom still ritually practiced and 2 million girls undergo the ordeal each year. This practice is anchored and fixed firmly in numerous African people's culture and Western countries are confronted to it through African immigrants. In order to understand the justifications and the consequences of FGM we interviewed 14 genitally mutilated African women living in France. Unfortunately and despite the conscious knowledge of consequences and absurd side of such practice, yet it seems to be perpetuated over the descendants. Educational approach is the best solution to fight female genital mutilation fixed firmly in numerous African people's culture.

  17. Clitoral keloids after female genital mutilation/cutting.

    Science.gov (United States)

    Birge, Özer; Akbaş, Murat; Özbey, Ertuğrul Gazi; Adıyeke, Mehmet

    2016-09-01

    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.

  18. ESHRE/ESGE female genital tract anomalies classification system-the potential impact of discarding arcuate uterus on clinical practice.

    Science.gov (United States)

    Knez, J; Saridogan, E; Van Den Bosch, T; Mavrelos, D; Ambler, G; Jurkovic, D

    2018-03-05

    What would be a potential impact of implementing the new ESHRE/European Society of Gynaecological Endoscopy (ESGE) female genital anomalies classification system on the management of women with previous diagnosis of arcuate uteri based on the modified American Society for Reproductive Medicine (ASRM) criteria? A significant number of women with previous diagnosis of arcuate uteri are reclassified as having partial septate uteri according to the new ESHRE/ESGE classification system which may increase the number of remedial surgical procedures. The ESHRE/ESGE classification system has defined measurement techniques, reference points and specific cut-offs to facilitate the differentiation between normal and septate uteri. These criteria have been arbitrarily defined and they rely on the measurement of uterine wall thickness and depth of distortion of uterine fundus. This was a retrospective cohort study. We searched our ultrasound clinic database from January 2011 to December 2014 to identify all women diagnosed with arcuate uterus on three-dimensional ultrasound according to the modified ASRM criteria. For each woman, the ultrasound images were stored in our clinical database and they were re-examined according to ESHRE/ESGE specifications. The presence and location of all acquired uterine anomalies, such as fibroids or adenomyosis was noted. We applied the two diagnostic approaches as specified by the ESHRE/ESGE classification: the main option (MO) and the alternative option (AO). We used the Kappa statistic to quantify the agreement between the two approaches. We also compared the number of previous miscarriages in women with normal and partial septate uteri according to the ESHRE/ESGE classification. Non-parametric Mann-Whitney and Kruskal-Wallis tests were used for the analyses and receiver-operating characteristic curves were constructed to assess the predictive values of the calculated uterine distortion indices for the detection of women at risk of suffering

  19. Changing cultural attitudes towards female genital cutting.

    Science.gov (United States)

    Vogt, Sonja; Mohmmed Zaid, Nadia Ahmed; El Fadil Ahmed, Hilal; Fehr, Ernst; Efferson, Charles

    2016-10-27

    As globalization brings people with incompatible attitudes into contact, cultural conflicts inevitably arise. Little is known about how to mitigate conflict and about how the conflicts that occur can shape the cultural evolution of the groups involved. Female genital cutting is a prominent example. Governments and international agencies have promoted the abandonment of cutting for decades, but the practice remains widespread with associated health risks for millions of girls and women. In their efforts to end cutting, international agents have often adopted the view that cutting is locally pervasive and entrenched. This implies the need to introduce values and expectations from outside the local culture. Members of the target society may view such interventions as unwelcome intrusions, and campaigns promoting abandonment have sometimes led to backlash as they struggle to reconcile cultural tolerance with the conviction that cutting violates universal human rights. Cutting, however, is not necessarily locally pervasive and entrenched. We designed experiments on cultural change that exploited the existence of conflicting attitudes within cutting societies. We produced four entertaining movies that served as experimental treatments in two experiments in Sudan, and we developed an implicit association test to unobtrusively measure attitudes about cutting. The movies depart from the view that cutting is locally pervasive by dramatizing members of an extended family as they confront each other with divergent views about whether the family should continue cutting. The movies significantly improved attitudes towards girls who remain uncut, with one in particular having a relatively persistent effect. These results show that using entertainment to dramatize locally discordant views can provide a basis for applied cultural evolution without accentuating intercultural divisions.

  20. Female Genital Mutilation among Edo People: The complications ...

    African Journals Online (AJOL)

    This prospective study on female genital mutilation among Edo people was based on female children and parents who presented on account of it at the University of Benin Teaching Hospital, Benin City, Nigeria, between January 2002 and December 2007. During the period, 51 female children aged 10 days and 18 years ...

  1. Female Genital Dialogues: Female Genital Self-Image, Sexual Dysfunction, and Quality of Life in Patients With Vitiligo With and Without Genital Affection.

    Science.gov (United States)

    Sarhan, Deena; Mohammed, Ghada F A; Gomaa, Amal H A; Eyada, Moustafa M K

    2016-01-01

    Vitiligo has a major effect on sexual health because of the disfiguring skin lesions affecting self-image and self-esteem. However, this topic has not explored. This article aimed to assess the effect of vitiligo on genital self-image, sexual function, and quality of life in female patients. This cross-sectional study included 50 sexually active women with vitiligo and 25 women without vitiligo. All participants subjected to full history taking and examination. Extent of vitiligo was assessed with the Vitiligo Area Scoring Index score, sexual function with the Female Sexual Function Index, genital self-image with Female Genital Self-Image Score and quality of life with the Dermatology Life Quality Index questionnaires. The main outcome measures were correlation between Vitiligo Area Scoring Index, Female Genital Self-Image Score, Female Sexual Function Index, and Dermatology Life Quality Index domains was determined using t test and Pearson correlation. This study revealed a negative correlation between the Vitiligo Area Scoring Index score and sexual satisfaction. Vitiligo Area Scoring Index and Dermatology Life Quality Index score was significantly correlated with Arabic Version of the Female Genital Self-Image Score alone and with Arabic Version of the Female Sexual Functioning Index alone and with both the Arabic Version of the Female Genital Self-Image Score and the Arabic Version of the Female Sexual Functioning Index (p <.05). Sexual and psychological assessment of patients with vitiligo is imperative to improve outcomes and increase patients' compliance with treatment.

  2. A review of the human vs. porcine female genital tract and associated immune system in the perspective of using minipigs as a model of human genital Chlamydia infection

    DEFF Research Database (Denmark)

    Lorenzen, Emma; Follmann, Frank; Jungersen, Gregers

    2015-01-01

    is not dominated by lactobacilli as in humans. The vaginal pH is around 7 in Göttingen Minipigs, compared to the more acidic vaginal pH around 3.5-5 in women. This review reveals important similarities between the human and porcine female reproductive tracts and proposes the pig as an advantageous supplementary...

  3. Clitoral Reconstruction Using a Vaginal Graft After Female Genital Mutilation.

    Science.gov (United States)

    Mañero, Ivan; Labanca, Trinidad

    2018-03-08

    Clitoral reconstruction after genital mutilation is a feasible and effective strategy to reduce clitoral pain, improve sexual pleasure, and restore vulvar appearance. We describe a novel surgical technique for clitorolabial reconstruction using a vaginal graft. We present a series of 32 consecutive women who underwent this procedure at Iván Mañero Clinic, Barcelona, Spain, and were prospectively followed. The total Female Sexual Function Index changed favorably from 16 before surgery to 29 after surgery (PFemale Self-Image Genital Scale changed favorably from 11 to 23 (Pgenital mutilation was associated with improved sexual function and genital aesthetic perception.

  4. Female genital mutilation in Iraqi Kurdistan: description and associated factors.

    Science.gov (United States)

    Saleem, Rozhgar A; Othman, Nasih; Fattah, Fattah H; Hazim, Luma; Adnan, Berivan

    2013-01-01

    The high prevalence of female genital mutilation has been a concern in Iraqi Kurdistan. This study was undertaken to estimate its prevalence and describe factors associated with its occurrence. A cross-sectional survey was undertaken from March to April 2011 of females aged up to 20 years using interviews and clinical examination. The survey included 1,508 participants with mean age of 13.5 years (SD 5.6). Overall female genital mutilation prevalence was 23%, and the mean age at which it had been performed was 4.6 years (SD 2.4). Type I (partial or total removal of the clitoris) comprised 76% of those who had had female genital mutilation; in 79% of cases the decision to perform it was made by the mother; and in 54% of cases it was performed by traditional birth attendants/midwives. Women aged 16 years and over were more likely to have had female genital mutilation compared to children aged below 6 years (OR 11.9, p Kurdistan region were more likely to have been circumcised. The study results show that female genital mutilation is a frequent practice in Iraqi Kurdistan. Attention and intervention is needed to address this aspect of the well-being of girls and women.

  5. Psychophysical properties of female genital sensation.

    Science.gov (United States)

    Farmer, Melissa A; Maykut, Caroline A; Huberman, Jackie S; Huang, Lejian; Khalifé, Samir; Binik, Yitzchak M; Apkarian, A Vania; Schweinhardt, Petra

    2013-11-01

    Provoked vestibulodynia (PVD) is characterized by the presence of vulvar touch and pain hypersensitivity. Pain with vaginal distension, which motivates treatment seeking and perpetuates distress, is frequently reported with PVD. However, the concordance between the perception of vulvar and vaginal sensation (ie, somatic and visceral genital sensations, respectively) remains unstudied in healthy women, as well as in clinical populations such as PVD. To evaluate the static and dynamic (time-varying) properties of somatic and visceral genital sensation, women with PVD (n=14) and age- and contraceptive-matched healthy controls (n=10) rated varying degrees of nonpainful and painful genital stimulation. Somatic (vulvar) mechanical sensitivity to nonpainul and painful degrees of force were compared to visceral (vaginal) sensitivity to nonpainful and painful distension volumes. Results indicated that healthy women showed substantial individual variation in and high discrimination of vulvar and vaginal sensation. In contrast, PVD was associated with vulvar allodynia and hyperalgesia, as well as vaginal allodynia. Modeling of dynamic perception revealed novel properties of abnormal PVD genital sensation, including temporal delays in vulvar touch perception and reduced perceptual thresholds for vaginal distension. The temporal properties and magnitude of PVD distension pain were indistinguishable from vaginal fullness in healthy controls. These results constitute the first empirical comparison of somatic and visceral genital sensation in healthy women. Findings provide novel insights into the sensory abnormalities that characterize PVD, including an experimental demonstration of visceral allodynia. This investigation challenges the prevailing diagnostic assessment of PVD and reconceptualizes PVD as a chronic somatic and visceral pain condition. Copyright © 2013. Published by Elsevier B.V.

  6. [Medical and legal aspects of genital mutilation and circumcision part I: female genital mutilation (FGM)].

    Science.gov (United States)

    Dettmeyer, Reinhard; Laux, Johannes; Friedl, Hannah; Zedler, Barbara; Bratzke, Hansjürgen; Parzeller, Markus

    2011-01-01

    Female genital mutilation (FGM) is considered to be against the law and against morality not only in Western countries, although a woman of age and able to consent may sometimes think differently. The procedure may have serious physical and emotional consequences for the girl or woman. Nevertheless there are attempts to justify the procedure with medical and hygienic pseudoarguments, ideology, freedom of religion, cultural identity and social adequacy. Outside the Western world, some people claim that religion and culture alone justify the practice. In Germany, parents can lose the right to determine the residence of their daughter, if she is faced with the risk of genital mutilation in order to prevent that the child or girl is taken to her home country. Genital mutilation as a gender-specific threat is recognized as a reason to grant asylum or prevent deportation. Proposals to make genital mutilation a separate punishable offence are presently discussed by the legislator.

  7. [Impact of female genital mutilation on the millennium goals].

    Science.gov (United States)

    Ruiz, Ismael Jiménez; Martínez, María Pilar Almansa; Bravo, María Del Mar Pastor

    2015-01-01

    To relate the Female Genital Mutilation as a negative factor for the achievement of the Millennium Development Goals 1, 3, 4, 5 and 6. Data collection was through review literature review between in the years 2014 and 2015 in the databases Medline/PubMed, Web of Science, LILACS, SCIELO, Tesis Doctorales TESEO and in the webs of WOK, UNICEF, UNAF and WHO using the descriptors: female circumcision, millennium development goals, rights of women. Articles published between years 2010 y 2015, were included and finally 24 articles were selected. The Female Genital Mutilation is based on gender discrimination, and reinforces and encourages the circle of poverty. This practice causes physical complications that may affect the infant mortality and morbidity, complications in pregnancy and childbirth and there is a relationship between the practice and the transmission of human immunodeficiency virus. The fight against Female Genital Mutilation contributes to the achievement of five of the eight Millennium Goals.

  8. Female Genital Mutilation: A Visual Reference and Learning Tool for Health Care Professionals.

    Science.gov (United States)

    Abdulcadir, Jasmine; Catania, Lucrezia; Hindin, Michelle Jane; Say, Lale; Petignat, Patrick; Abdulcadir, Omar

    2016-11-01

    Female genital mutilation comprises all procedures that involve partial or total removal of the external female genitalia or injury to the female genital organs for nonmedical reasons. Health care providers for women and girls living with female genital mutilation have reported difficulties in recognizing, classifying, and recording female genital mutilation, which can adversely affect treatment of complications and discussions of the prevention of the practice in future generations. According to the World Health Organization, female genital mutilation is classified into four types, subdivided into subtypes. An agreed-upon classification of female genital mutilation is important for clinical practice, management, recording, and reporting, as well as for research on prevalence, trends, and consequences of female genital mutilation. We provide a visual reference and learning tool for health care professionals. The tool can be consulted by caregivers when unsure on the type of female genital mutilation diagnosed and used for training and surveys for monitoring the prevalence of female genital mutilation types and subtypes.

  9. The Jewish and Christian view on female genital mutilation

    African Journals Online (AJOL)

    I. El-Damanhoury

    Abstract. Female genital mutilation (FGM) is a practice involving the removal of all or parts of the female external genitalia. It has been documented in 28 African countries and in some countries in Asia and the Middle. East, but due to increasing immigration from these countries to the western world, FGM has become a.

  10. INFANT-FEMALE GENITAL MUTILATION (IFGM) IN CITIES AND ...

    African Journals Online (AJOL)

    BLESSING

    dimensions to the practice of FGM in Nigeria, the role of women in propagating FGM and its child right ... Infant-Female Genital Mutilation (IFGM) in cities and the role of women in perpetuating FGM: a probe on why FGM ..... possession of vagina, clitoris or breast among other remarkable features of the female body, provides ...

  11. Anorectal carcinoma involving the female genital tract: the morbidity ...

    African Journals Online (AJOL)

    Background: Carcinoma of the colon and anorectum affect a younger age group in Africans, and patients often present late with advanced disease. Method: A retrospective review of 22 females treated for anorectal carcinoma. Results: Fourteen females had genital tract involvement; their mean age was 33.8 years. Thirteen ...

  12. X-ray diagnostics of female genitals in child age

    International Nuclear Information System (INIS)

    Willich, E.; Benz-Bohm, G.; Koeln Univ.

    1982-01-01

    The experiences of special X-ray diagnostics of female genitals are described, that were made in 41 children within a period of 12 years. The superiority of the X-ray-technique arises from the impossibility of the manual examination in newborn and infants and the avoidance of diagnostic techniques like laparoscopy or laparotomy. All the examination techniques are described. In intersexualmarked patients the discrimination into six types after Shopfner is preferred. Malformations and tumours are dealt with briefly. The relations between skeleton and female genitals are pointed out at the example of the gonadal dysgenesis. (orig.) [de

  13. Urinary and genital tract obstruction as a complication of female genital mutilation: case report and literature review.

    Science.gov (United States)

    Okwudili, Obi Anselm; Chukwudi, Onoh Robinson

    2012-01-01

    Female genital mutilation (FGM) is the partial or total removal of the female external genitalia or other deliberate injury to the female genital organs, either for cultural or non-therapeutic reasons. This barbaric act is accompanied by a variety of complications ranging from hemorrhage, fracture, infective complications, gynetresia, with its attendant sexual and obstetric difficulties, and death. A 23-year-old girl, with urinary and genital tract obstruction following female genital mutilation(infibulation) is presented. She was managed by elective defibulation, with a satisfactory outcome. Robust health education strategies are needed for the eradication of FGM.

  14. Hysterosalpingographic Appearances of Female Genital Tract Tuberculosis: Part II: Uterus

    Directory of Open Access Journals (Sweden)

    Firoozeh Ahmadi

    2014-03-01

    Full Text Available Female genital tuberculosis remains as a major cause of tubal obstruction leading to infertility, especially in developing countries. The global prevalence of genital tuberculosis has increased during the past two decades due to increasing acquired immunodeficiency syndrome. Genital tuberculosis (TB is commonly asymptomatic and it is diagnosed during infertility investigations. Despite of recent advances in imaging tools such as computed tomography (CT scan, magnetic resonance imaging (MRI and ultrasongraphy, hysterosalpingography has been considered as the standard screening test for evaluation of tubal infertility and as a valuable tool for diagnosis of female genital tuberculosis. Tuberculosis gives rise to various appearances on hysterosalpingography (HSG from non-specific changes to specific findings. The present pictorial review illustrates and describes specific and non-specific radiographic features of female genital tuberculosis in two parts. Part I presents specific findings of tuberculosis related to tubes such as "beaded tube", "golf club tube", "pipestem tube", "cobble stone tube" and the "leopard skin tube". Part II will describe adverse effects of tuberculosis on structure of endometrium and radiological specific findings, such as "T-shaped" tuberculosis uterus, "pseudo-unicornuate "uterus, "collar-stud abscess" and "dwarfed" uterus with lymphatic intravasation and occluded tubes which have not been encountered in the majority of non-tuberculosis cases.

  15. Surfactant protein D in the female genital tract

    DEFF Research Database (Denmark)

    Leth-Larsen, Rikke; Floridon, C; Nielsen, O

    2004-01-01

    Surfactant protein D (SP-D) plays a role in innate immunity against various pathogens and in vivo studies have demonstrated that SP-D also has anti-inflammatory properties. SP-D was originally demonstrated in alveolar type II cells, but recent studies have shown extrapulmonary expression of SP-D...... indicating a systemic role for the protein. This study describes the presence of SP-D in the female genital tract, the placenta and in amniotic fluid using immunohistochemistry and enzyme-linked immunosorbent assay. SP-D was observed in cells lining surface epithelium and secretory glands in the vagina......, cervix, uterus, fallopian tubes and ovaries. In the placenta, SP-D was seen in all villous and extravillous trophoblast subpopulations. Endometrial presence of SP-D in non-pregnant women varied according to stage of the menstrual cycle and was up-regulated towards the secretory phase. It is suggested...

  16. Surgical or medical interventions for female genital mutilation.

    Science.gov (United States)

    Smith, Helen; Stein, Karin

    2017-02-01

    Deinfibulation can prevent or treat gynecological and obstetric complications in women living with type III female genital mutilation (FGM), and subsequently improve childbirth outcomes. Recently published WHO guidelines recommend use of deinfibulation in both circumstances. However, to really impact practice, evidence-based guidance needs to be matched with evidence-based implementation strategies. This qualitative evidence synthesis provides information on the factors that facilitate or act as barriers to use of deinfibulation, and the context and conditions that are necessary for implementing the procedure, including healthcare providers' knowledge and experience, the service delivery environment, as well as broader health system contexts. This information is of great value for policy makers and others considering this as an option for better clinical care of women living with FGM. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  17. Impact of Female Genital Mutilation on Sexual Functioning, Self ...

    African Journals Online (AJOL)

    Impact of Female Genital Mutilation on Sexual Functioning, Self-Esteem and Marital Instability of Women in Ajegunle. ... Awareness about the adverse consequences of FGM should be intensified and psychological treatment especially post-traumatic stress disorder intervention for circumcised women is recommended.

  18. Support for the continuation of female genital mutilation among ...

    African Journals Online (AJOL)

    On multivariate logistic regression analysis, perception of gender role, sex, place of residence, highest education in the household and religion remained to be important predictors of attitude towards the continuation of female genital mutilation after adjustment for age and ethnicity. Adolescents who had low gender role ...

  19. Survey of Women's Opinions on Female Genital Mutilation (FGM) in ...

    African Journals Online (AJOL)

    Uche

    Objective: To determine women's views on aspects of female genital mutilation and the prevalence among the study population. Method: ... Conclusion: There is a high opinion against the practice of FGM in Southeast Nigeria, with the majority of the women showing support for .... Reduced sexual satisfaction. 21. 50.0.

  20. Practice of female genital cutting amongst adults in Ilorin Metropolis ...

    African Journals Online (AJOL)

    Practice of female genital cutting amongst adults in Ilorin Metropolis, north-central Nigeria. S.A. Aderibigbe, B.W. Alatishe-Muhammad, H.A. Ameen, A.G. Salaudeen, M.J. Saka, M.M.B. Uthman, O.A. Bolarinwa, T.M. Akande, H.O. Raji ...

  1. The Relationship between Female Genital Mutilation and HIV ...

    African Journals Online (AJOL)

    Abstract. Female genital mutilation (FGM) is an age-old practice that has since been linked with many health problems. This review aims to highlight some of the controversies trailing ... While many of the arguments are within scientific reasoning, the researches supporting the views seem to lack the necessary objectivity.

  2. Curbing Female Genital Mutilation: The Role of Information and ...

    African Journals Online (AJOL)

    Gender and Behaviour ... Popularizing the danger of female genital mutilation, partnering with NGOs, media campaign, organizing workshops & seminars, briefing & debriefing and mounting billboards were identified as some of the roles libraries and information can play in eradicating this injustice against women.

  3. Female Genital Mutilation: Perceptions and beliefs in a Nigerian ...

    African Journals Online (AJOL)

    Female Genital Mutilation: Perceptions and beliefs in a Nigerian rural community. H.O Bodunrin. Abstract. No Abstract Available. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/aa.v6i1.23080 · AJOL African Journals Online.

  4. Survey of Women's Opinions on Female Genital Mutilation (FGM) in ...

    African Journals Online (AJOL)

    Uche

    showed willingness to circumcise their daughters indicating considerable reduction in uptake of the practice. A larger ... Conclusion: There is a high opinion against the practice of FGM in Southeast Nigeria, with the majority of the women showing ... Keywords: Female genital mutilation; campaign against: Southeast Nigeria.

  5. Female genital mutilation: are we winning? | Makinde | East African ...

    African Journals Online (AJOL)

    Background: For more than 25 years, efforts have been geared towards curtailing the practice of female genital mutilation (FGM) in countries like Nigeria. This study was designed to see if all these efforts have made any impact in reducing the prevalence of FGM appreciably in the south-West of Nigeria. Objective: To ...

  6. Survey of Women's Opinions on Female Genital Mutilation (FGM) in ...

    African Journals Online (AJOL)

    Background: Female genital mutilation is known to exist especially in many third world countries including Nigeria with many women being victims of this harmful practice and its complications. The practice is rife in Southeast Nigeria and efforts have been made to discourage it. Objective: To determine women's views on ...

  7. Review: Female genital mutilation: A tragedy for women ...

    African Journals Online (AJOL)

    Female genital mutilation/cutting (FGM/FGC) constitutes a tragic health and human rights issue of girlsand women in a number of countries, mainly in Africa. The practice has serious health consequences,both physical and psychological. Attempts to eradicate the practice have not been successful over the pastfew decades.

  8. The Perspectives And Practices Of Female Genital Mutilation Among ...

    African Journals Online (AJOL)

    Context: Female genital mutilation is a gender based harmful practice that exposes women and the girl child to medical and obstetric complications. Accurate information is necessary for its eradication. Method: A cross-sectional study was conducted among 100 women aged 15-60 years at the University of Nigeria ...

  9. Female genital cutting: current practices and beliefs in western Africa

    NARCIS (Netherlands)

    Sipsma, Heather L; Chen, Peggy G; Ofori-Atta, Angela; Ilozumba, Ukwuoma O; Karfo, Kapouné; Bradley, Elizabeth H

    To conduct a cross-national comparative study of the prevalence and correlates of female genital cutting (FGC) practices and beliefs in western Africa. Data from women who responded to the Multiple Indicator Cluster Surveys between 2005 and 2007 were used to estimate the frequencies of ever having

  10. Factors and Problems Related to Female Genital Mutilation as Seen ...

    African Journals Online (AJOL)

    Objective: To determine the aetiological factors and problems related to female genital mutilation as seen in children at St. Gaspar Hospital. Data source: Secondary data were obtained from St. Gaspar Hospital, records, registers and patients files or case notes from children ward were retrieved and reviewed, later a special ...

  11. An institutional survey of female genital mutilation in Lagos, South ...

    African Journals Online (AJOL)

    Background: Female genital mutilation (FGM) as a procedure can have serious physical and psychological health consequences in girls and women. Objectives: To determine the prevalence of FGM and the socio-demographic factors which influence the practice among women in Lagos State. Methods: This was a ...

  12. Attitudes towards female genital cutting among pregnant women in ...

    African Journals Online (AJOL)

    Background: This study aimed to determine the attitudes of pregnant women attending the antenatal clinic at Federal Medical Centre, Owo, Ondo State, Nigeria, towards female genital cutting. Method: The study was conducted over a period of six months, between November 2010-April 2011, at the antenatal clinic of the ...

  13. Health Workers' Knowledge of and Experience with Female Genital ...

    African Journals Online (AJOL)

    The aim of this study is to assess the experience and the knowledge of the health workers practicing in our environment on Female genital cutting (FGC). Two hundred and fifty were interviewed with self-administered structured questionnaire. Their mean age was 35.2±8.3 years. Type I 82(66.6%) was the commonest FGC ...

  14. Female Genital Mutilation: A Literature Review of the Current Status ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    This article discusses the results of a literature review that has assessed the impact of Female Genital Mutilation (FGM) legislation in 28 countries (27 in Africa and Yemen) where FGM is concentrated. Evidence on the impact of FGM legislation was available on prevalence of FGM; changes in societal attitudes and ...

  15. The Frequency and Pattern of Female Genital Tract Malignancies at ...

    African Journals Online (AJOL)

    The acquired immune deficiency syndrome has considerably altered the pattern of female genital cancers.[1]. In developed countries, the introduction of routine screening and treatment for premalignant lesions of the cervix has lead to a dramatic fall in the incidence and mortality of cervical cancer over the past five decades.

  16. Female genital mutilation/cutting: Knowledge, practice and ...

    African Journals Online (AJOL)

    RESEARCH. Background. Despite global efforts at eradicating female genital mutilation/cutting (FGM/C), the act continues to be performed globally. Objective. To determine the experience of schoolteachers about FGM/C and their possible role in contributing to its eradication. Methods. A prospective cross-sectional survey ...

  17. Knowledge, attitude and practice of female genital mutilation among ...

    African Journals Online (AJOL)

    Background: Female genital mutilation (FGM) is a harmful traditional practice that is deeply rooted in Africa. It has been outlawed in Bayelsa state of Nigeria but there is evidence that its performance by traditional circumcisers and health professionals continues. Aim: The study aimed to determine the knowledge, attitude ...

  18. Female genital mutilation with coexisting pregnancy: case report ...

    African Journals Online (AJOL)

    Female Genital mutilation (FGM) is an ancient practice that is common among the Africans. It has found a place in the socio-cultural belief of the people despite several attempts that have been made for its eradication. We report the case of a 22-year-old woman who presented with the type IV FGM secondary to the ...

  19. Awareness and knowledge of female genital mutilation among ...

    African Journals Online (AJOL)

    Background: An estimated 130 million reported cases of female genital mutilation (FGM) occur globally, and every year at least 3 million girls and young women are at risk of undergoing this practice. This study was carried out to assess awareness and knowledge of FGM in a sub-urban community, Edo State, to help raise ...

  20. Female genital cutting/mutilation in Africa deserves special concern ...

    African Journals Online (AJOL)

    Ismail Khalaf Editor-in Chief

    Association (PAUSA) to give special concern to health problems in. Africa, the editorial board of the African .... Female genital cutting/mutilation in Africa deserves special concern: An overview. 121. The governments of all the ... Going with this, Egypt banned FGM in 2007, despite pressure from some Islamic groups [27].

  1. Confronting Female Genital Mutilation: The Role of Youth and ICTs ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2011-07-14

    Jul 14, 2011 ... How can we re-examine the impact of 25 years of concerted action aimed at eliminating female genital mutilation (FGM) – excision – in Francophone West Africa? Why, how, by whom and for whom has the digital revolution been used over the past 10 years to achieve that end? If young people – both male ...

  2. Gurya cutting and female genital fistulas in Niger: ten cases.

    Science.gov (United States)

    Ouedraogo, Itengre; McConley, Regina; Payne, Christopher; Heller, Alison; Wall, L Lewis

    2018-03-01

    The objective was to determine the contribution of female genital cutting to genital fistula formation in Niger from the case records of a specialist fistula hospital. A retrospective review was undertaken of the records of 360 patients seen at the Danja Fistula Center, Danja, Niger, between March 2014 and September 2016. Pertinent clinical and socio-demographic data were abstracted from the cases identified. A total of 10 fistulas resulting from gurya cutting was obtained: 9 cases of urethral loss and 1 rectovaginal fistula. In none of the cases was genital cutting performed for obstructed labor or as part of ritual coming-of-age ceremonies, but all cutting procedures were considered "therapeutic" within the local cultural context as treatment for dyspareunia, lack of interest in or unwillingness to engage in sexual intercourse, or female behavior that was deemed to be culturally inappropriate by the male spouse, parents, or in-laws. Clinical cure (fistula closed and the patient continent) was obtained in all 10 cases, although 3 women required more than one operation. Gurya cutting is an uncommon, but preventable, cause of genital fistulas in Niger. The socio-cultural context which gives rise to gurya cutting is explored in some detail.

  3. Female genital mutilation: a prospective view.

    Science.gov (United States)

    Dandash, K F; Refaat, A H; Eyada, M

    2001-01-01

    There continues to be a high rate of female circumcision being practiced in Egypt. A questionnaire covering circumcision status, circumstances of circumcision procedures, and attitudes towards circumcising their daughters was given to female students in nursing secondary schools. This population was chosen as a representative sample of future mothers who also will work in a very sensitive area related to female circumcision. Results showed that all the students surveyed were circumcised. The peak ages for circumcision performance were between 10 and 12 years. About 60% of operations were performed by physicians and about 80% were done under anaesthesia at home. Rural residence was the main variable influencing the continuation of this practice in a culture in which traditions and habits are strongly respected. This points to the difficulties that face any efforts to eradicate this process.

  4. [Female genital mutilations, forced marriages, and early pregnancies].

    Science.gov (United States)

    Henrion, Roger

    2003-01-01

    Female genital mutilations, as well as forcible childhood marriage and their correlate adolescent pregnancies are traditional practices which, not only violate the dignity, but also jeopardize the health, and even the life, of women and their children. The complications of genital mutilations are frequent for a number of reasons: the fact that the clitoris is highly vascularized, the nature of the mutilations, excision or infibulation, and the poor conditions of hygiene. The short term complications are pain, hemorrhage, shock, and urinary retention. Medium term complications include gangrene, septicemia, tetanus, pelvic inflammatory disease, HIV/AIDS, and hepatitis B or C infections. Serious sequelae may occur, including infertility and gynecologic disorders, and sexual life is invariably altered. The main obstetrical complications of genital mutilations are genital lacerations involving the labia minor and the perineum, which can lead to hemorrhage and sequelae such as urinary or anal incontinence, recto-vaginal and vesico-vaginal fistulas. The role of doctors, which is delicate because these customs are entrenched, is to detect genital mutilations, repair them and prevent them, by participating in health education programs. The consequences of forcible childhood marriage are serious, besides the fact that this is a disguised form of rape. The obstetrical risks favored by the underdevelopment of the uterus and the pelvis, include uterine rupture, preeclampsia and eclampsia, and obstetrical hemorrhage. The fetus/neonate are jeopardized by these complications, which can result in perinatal asphyxia and death, as well as the high rates of intrauterine growth retardation and preterm delivery. The impact of genital mutilations on delivery are compounded in childhood pregnancies for anatomical reasons, but also because these adolescents or children are extremely vulnerable and have poor access to perinatal care. In France, as well as in Africa, non-governmental and

  5. Tumorigenic Effects of Tamoxifen on the Female Genital Tract

    Directory of Open Access Journals (Sweden)

    Kaei Nasu M.D., Ph.D.

    2008-01-01

    Full Text Available Tamoxifen is widely used for endocrine treatment and breast cancer prevention. It acts as both an estrogen antagonist in breast tissue and an estrogen agonist in the female lower genital tract. Tamoxifen causes severe gynecologic side effects, such as endometrial cancer. This review focuses on the effects of prolonged tamoxifen treatment on the human female genital tract and considers its tumorigenicity in the gynecologic organs through clinical data analysis. Tamoxifen is associated with an increased incidence of benign endometrial lesions such as polyps and hyperplasia and a two- to four-fold increased risk of endometrial cancer in postmenopausal patients. Moreover, the incidence of functional ovarian cysts is significantly high in premenopausal tamoxifen users. To prevent tamoxifen from having severe side effects in gynecologic organs, frequent gynecological examination should be performed for both premenopausal and postmenopausal patients with breast cancer who are treated with this drug.

  6. Leadership for Cultural Transformation: Addressing Female Genital Mutilation in Kenya

    Directory of Open Access Journals (Sweden)

    Kerubo Abuya

    2015-06-01

    Full Text Available The cultural practice of female genital mutilation persists, with grave implications for girls’ and women’s health. The cultural reasons behind the practice are complex. It is therefore essential that critique of the practice come from members of the affected communities. This paper presents a thoughtful review of current community views and proposes an alternative cultural narrative using cultural transformation theory to shift community norms.

  7. Female genital mutilation/cutting type IV in Cambodia: a case report

    OpenAIRE

    Abdulcadir, Jasmine; Irion, Olivier; de Tejada, Bego?a Martinez

    2015-01-01

    Key Clinical Message Nontherapeutic female genital modifications can cause short? and long?term consequences. Caregivers should promote women's self knowledge on genitals' anatomy and physiology, and psychophysical and sexual health. They should also inform on possible negative consequences of vulvar nontherapeutic alterations requested and avoid the medicalization of female genital mutilation.

  8. Female genital mutilation/cutting type IV in Cambodia: a case report.

    Science.gov (United States)

    Abdulcadir, Jasmine; Irion, Olivier; de Tejada, Begoña Martinez

    2015-12-01

    Nontherapeutic female genital modifications can cause short- and long-term consequences. Caregivers should promote women's self knowledge on genitals' anatomy and physiology, and psychophysical and sexual health. They should also inform on possible negative consequences of vulvar nontherapeutic alterations requested and avoid the medicalization of female genital mutilation.

  9. Female Genital Mutilation as a Concern for Special Operations and Tactical Emergency Medical Support Medics.

    Science.gov (United States)

    Wittich, Arthur C

    Female genital mutilation (FGM), frequently called female genital cutting or female circumcision, is the intentional disfigurement of the external genitalia in young girls and women for the purpose of reducing libido and ensuring premarital virginity. This traditional, nontherapeutic procedure to suppress libido and prevent sexual intercourse before marriage has been pervasive in Northern Africa, the Middle East, and the Arabian peninsula for over 2,500 years. FGM permanently destroys the genital anatomy while frequently causing multiple and serious complications. The International Federation of Gynecology and Obstetrics proposed a classification system of FGM according to the specific genital anatomy removed and the extensiveness of genital disfigurement. Although it has been ruled illegal in most countries, FGM continues to be performed worldwide. With African, Asian, and Middle Eastern immigration to the United States and Europe, western countries are experiencing FGM in regions where these immigrants have concentrated. As deployments of Special Operations Forces (SOF) increase to regions in which FGM is pervasive, and as African, Asian, and Middle Eastern immigration to the United States increases, SOF and Tactical Emergency Medical Support (TEMS) medics will necessarily be called upon to evaluate and treat complications resulting from FGM. The purpose of this article is to educate SOF/TEMS medical personnel about the history, geographic regions, classification of procedures, complications, and medical treatment of patients with FGM. 2017.

  10. A five-year review of female genital tract malignancies in Sokoto ...

    African Journals Online (AJOL)

    It is recommended that this process is accelerated through heightened awareness of the female genital cancers among members of the community and health care providers. In addition, innovative approaches to screening and treatment of precancerous cervical lesions and improved service delivery systems are required.

  11. Medicalization of female genital mutilation/cutting

    Directory of Open Access Journals (Sweden)

    G.I. Serour

    2013-09-01

    In some Muslim countries where FGM/C is prevalent it is often wrongly quoted that the basis for performing FGM/C is religious instruction. FGM/C has no religious basis what so ever and has been condemned by Al-Azhar based on several verses in the Holy Quraan that relates explicitly or implicitly to female circumcision. The use of the gender term “Sunna circumcision” is nothing but a form of deceit used to misguide people and give the impression that this act is one of the Islamic practices. As for the traditions attributed to Prophet Mohamed (PBUH, scholars of the past and present have agreed that none of these traditions are authentic and therefore should not be attributed to the Prophet (PBUH.

  12. Vaccines for Chlamydia infections of the female genital tract.

    Science.gov (United States)

    Hafner, Louise M; McNeilly, Celia

    2008-02-01

    Genital infection with Chlamydia trachomatis is an escalating global public health concern causing considerable morbidity and socioeconomic burden worldwide. Although antibiotics are used to treat symptomatic urogenital infections, chlamydial infection remains asymptomatic in approximately 50% of infected men and 70% of infected women. The major clinical manifestations of genital chlamydial infection in women include mucopurulent cervicitis, endometritis and pelvic inflammatory disease. Genital infection with C. trachomatis markedly enhances the risk for reproductive tract sequelae in women, including tubal factor infertility, chronic pain and ectopic pregnancy. Definitive infection control of chlamydial infections will likely be achievable through a safe and efficacious vaccine. This will require identifying protective chlamydial antigens in animal models as well as identifying effective adjuvants and delivery systems that target subunit vaccines to immune inductive sites or secondary lymphoid tissues, and will be safe for use in humans.

  13. [Sexual function and clitoral reconstruction after female genital mutilation].

    Science.gov (United States)

    Abdulcadir, Jasmine; Bianchi-Demicheli, Francesco; Petignat, Patrick

    2017-03-15

    Evidence on sexual function of women living with female genital mutilation (FGM) and on clitoral reconstruction after FGM is limited. Such surgery is performed in case of chronic clitoral pain, clitoral dyspareunia or for female identity reasons. In this article we summarize the anatomical, psychosexual and sociocultural factors that influence sexual function of women with FGM and the available data on clitoral reconstruction. Surgical resection of the fibrous tissue around the clitoris, with eventual excision of painful post-traumatic neuromas, could improve pain and sexual function. In asymptomatic women, multidisciplinary non-surgical management could be equally or more beneficial and less risky than surgery.

  14. Measurements of female genital appearance in Chinese adults seeking genital cosmetic surgery: a preliminary report from a gynecological center.

    Science.gov (United States)

    Cao, Yujiao; Li, Qiang; Zhou, Chuande; Li, Fengyong; Li, Senkai; Zhou, Yu

    2015-05-01

    Accurate and comprehensive measurements of the external genitalia in female adults are of great significance in surgery designs and for aesthetic evaluation in genital plastic surgeries. The authors carried out a 319-case study and provided baseline data and morphometric reference for plastic surgery involving the genital deformity caused by trauma or burns and male-to-female transsexual operations. Our study design recruited 319 women referred to the out-patient clinic from August 2010 to August 2013. From each individual we measured 16 parameters and assessed the significance of variations in age, height, weight, BMI, and marital status (as a proxy for parity). We tried to establish a female external genitalia database of the population presenting for cosmetic surgery and define the general proportions of female genitalia in Chinese adults from the data we obtained. A wide range of values was noted in female genital measurements especially in labia minora parameters. Four parameters, including clitoral prepuce length, clitoris to urethra, labial length, and perineal body length had a proportional relationship to some extent. The position of the clitoris and urethral orifice was found to be regular in female adults. Compared with unmarried women, perineal body length decreased (P = 0.048), while the apex to perineum (bilateral) and labial length increased (P = 0.005, 0.006, cosmetic surgery. Although the ranges of genital measurements vary, there is a proportional relationship in female genital appearance, which should be heeded in surgical designs and genital aesthetic evaluation.

  15. Magnetic resonance imaging of male and female genitals during coitus and female sexual arousal

    NARCIS (Netherlands)

    Schultz, WW; van Andel, P; Sabelis, [No Value; Mooyaart, E

    1999-01-01

    Objective To find out whether taking images of the male and female genitals during coitus is feasible and to find out whether former and current ideas about the anatomy during sexual intercourse and during female sexual arousal are based on assumptions or on facts. Design Observational study Setting

  16. Bibliometric analysis of literature on female genital mutilation: (1930 - 2015).

    Science.gov (United States)

    Sweileh, Waleed M

    2016-10-10

    Female genital mutilation/cutting (FGM/C) is a common harmful traditional practice in many communities in Africa and to a lesser extent in Middle East and other regions in the world. In order to better understand publishing on this topic, we conducted a bibliometric study on FGM/C. Bibliometric analyses can be used as an indicator of the extent of interaction of researchers, health authorities, and communities with a particular health issue. Scopus database was used to retrieve data on FGM/C. Keywords used were "female genital mutilation", "female genital circumcision", "female genital cutting" and "female circumcision". Specifically, the number of publications, top productive countries and institutions, highly cited articles, citation analysis, co-authorships, international collaboration, role of African countries, top active authors, and journals involved in publishing articles on FGM/C were reviewed and analyzed. We indirectly assessed the impact of publications using total number of citations received, average number of citations per article, Hirsch-index, percentage of highly cited articles, and journal's impact factor. One thousand and thirty-five publications on FGM/C were retrieved. The h-index of retrieved articles was 37. A steep rise in number of publications was noticed in mid-1990s and again in 2012. More than half of retrieved articles were published from 2006 - 2015. A total of 65 countries contributed. The top ten productive countries included ones from Northern America, Europe and Africa. Nigeria and Egypt were the most active African countries in FGM/C publications. At least nine African academic institutions were actively involved on FGM/C publications. Articles on FGM/C that received the highest number of citations were those that focused on negative physical and psychosexual consequences of FGM/C. Journal topic areas were obstetrics/gynecology, public health, and psychological sociology. Collaboration between African and European countries on

  17. A Decolonizing Methodology for Health Research on Female Genital Cutting.

    Science.gov (United States)

    Werunga, Jane; Reimer-Kirkham, Sheryl; Ewashen, Carol

    2016-01-01

    In this article, critical perspectives including postcolonial feminism, African feminism, and intersectionality are presented as having decolonizing methodological potential whereby the Western narrative surrounding the practice of female genital cutting, particularly in the context of migration, is reexamined. In addition, multiple intersecting influences on affected women's realities are accounted for and a critical consciousness that serves to inform praxis, address social determinants of health, and promote health equity is encouraged. The inclusion of an African feminist perspective, a traditionally marginalized critical perspective, serves to further decolonize some long-held erroneous beliefs about the sexuality, subjectivity, and embodiment of the African woman.

  18. African, male attitudes on female genital mutilation: an Australian survey.

    Science.gov (United States)

    Shahid, Usama; Rane, Ajay

    2017-11-01

    Female genital mutilation (FGM) is a traditional practice where female genital organs are altered for non-medical reasons. The custom is outlawed in Australia and associated with an array of medical consequences. Due to the recent influx of migrants from regions endemic to FGM, the practice is becoming a growing concern locally. This federal government funded study aimed to elicit the poorly understood perceptions that young, Sub-Saharan African, migrant males residing in Townsville, Australia have on FGM. Through piloted questionnaires we found that amongst the 67 participants, 23.9% believed that FGM should be allowed under Australian Law. The independent predictors of supportive attitudes in favour of FGM were having resided in Australia for five or less years (p = .016, 95% CI 0.99-8.09) and coming from a basic educational background (high school or TAFE) (p = .003, 95% CI 1.3-12.4). This study also found that participant perceptions on FGM were amenable to change through educational interventional strategies. Impact statement Female genital mutilation (FGM) is a traditional practice where female genital organs are altered for non-medical reasons. The role that males play in the continuation of this outlawed practice remains poorly understood. No research has ever been conducted in Australia looking at the perception that young, migrant males have on FGM. Several European-based studies have examined the perceptions of older, poorly educated, migrant male cohorts. Generally, these studies show that the attitudinal support for FGM and intention to practice remains relatively high amongst these cohorts. This study examined the attitudes of a young, Sub-Saharan African, migrant, male cohort residing in Australia. This adds to the literature base by establishing the perceptions and associated socio-demographic variables of this unique and influential subset of the migrant population. This directly facilitates the development of interventional strategies

  19. Reconstructive surgery after female genital mutilation: a prospective cohort study.

    Science.gov (United States)

    Foldès, Pierre; Cuzin, Béatrice; Andro, Armelle

    2012-07-14

    Women who have undergone female genital mutilation rarely have access to the reconstructive surgery that is now available. Our objective was to assess the immediate and long-term outcomes of this surgery. Between 1998 and 2009, we included consecutive patients with female genital mutilation aged 18 years or older who had consulted a urologist at Poissy-St Germain Hospital, France. We used the WHO classification to prospectively include patients with type II or type III mutilation. The skin covering the stump was resected to reveal the clitoris. The suspensory ligament was then sectioned to mobilise the stump, the scar tissue was removed from the exposed portion and the glans was brought into a normal position. All patients answered a questionnaire at entry about their characteristics, expectations, and preoperative clitoris pleasure and pain, measured on a 5-point scale. Those patients who returned at 1 year for follow-up were questioned about clitoris pain and functionality. We compared data from the 1-year group with the total group of patients who had surgery. We operated on 2938 women with a mean age of 29·2 (SD 7·77 years; age at excision 6·1, SD 3·5 years). Mali, Senegal, and Ivory Coast were the main countries of origin, but 564 patients had undergone female genital mutilation in France. The 1-year follow-up visit was attended by 866 patients (29%). Expectations before surgery were identity recovery for 2933 patients (99%), improved sex life for 2378 patients (81%), and pain reduction for 847 patients (29%). At 1-year follow-up, 363 women (42%) had a hoodless glans, 239 (28%) had a normal clitoris, 210 (24%) had a visible projection, 51 (6%) had a palpable projection, and three (0·4%) had no change. Most patients reported an improvement, or at least no worsening, in pain (821 of 840 patients) and clitoral pleasure (815 of 834 patients). At 1 year, 430 (51%) of 841 women experienced orgasms. Immediate complications after surgery (haematoma, suture

  20. Facts and controversies on female genital mutilation and Islam.

    Science.gov (United States)

    Rouzi, Abdulrahim A

    2013-02-01

    Female genital mutilation (FGM) is a very ancient traditional and cultural ritual. Strategies and policies have been implemented to abandon this practice. However, despite commendable work, it is still prevalent, mainly in Muslim countries. FGM predates Islam. It is not mentioned in the Qur'an (the verbatim word of God in Islam). Muslim religious authorities agree that all types of mutilation, including FGM, are condemned. 'Sensitivity' to cultural traditions that erroneously associate FGM with Islam is misplaced. The principle of 'do no harm', endorsed by Islam, supersedes cultural practices, logically eliminating FGM from receiving any Islamic religious endorsement.

  1. Some Ethical Considerations Regarding Medicalization of Female Genital Mutilation/cutting (Female Circumcision)

    OpenAIRE

    Ahmed R. A. Ragab

    2008-01-01

    According to each society's condition the ethical attitude of the individual may be colored by the attitude of the society. It is therefore not surprising to find what is ethical in one society might not be ethical in another. Female Genital Cutting, as an example, is seen in some societies as a must and something good for the whole community in general and for girls in particular, while in others, it is seen as mutilation and violation of human rights. The practice of female genital cutting ...

  2. Standard Operating Procedures for Female Genital Sexual Pain

    DEFF Research Database (Denmark)

    Fugl-Meyer, Kerstin S; Bohm-Starke, Nina; Damsted Petersen, Christina

    2012-01-01

    and psychological disorders are highlighted, and different somatic and psychological assessment and treatment modalities are discussed. Methods.  The Standard Operating Procedures (SOP) committee was composed of a chair and five additional experts. No corporate funding or remuneration was received. The authors...... therapeutic interventions. However, this international expert group will recommend guidelines for management of female GSP. Conclusions.  GSP disorders are complex. It is recommended that their evaluation and treatment are performed through comprehensive somato-psychological multidisciplinary approach. Fugl......Introduction.  Female genital sexual pain (GSP) is a common, distressing complaint in women of all ages that is underrecognized and undertreated. Definitions and terminology for female GSP are currently being debated. While some authors have suggested that GSP is not per se a sexual dysfunction...

  3. Evidence-based policy responses to strengthen health, community and legislative systems that care for women in Australia with female genital mutilation / cutting.

    Science.gov (United States)

    Varol, Nesrin; Hall, John J; Black, Kirsten; Turkmani, Sabera; Dawson, Angela

    2017-05-18

    The physical and psychological impact of female genital mutilation / cutting (FGM/C) can be substantial, long term, and irreversible. Parts of the health sector in Australia have developed guidelines in the management of FGM/C, but large gaps exist in community and professional knowledge of the consequences and treatment of FGM/C. The prevalence of FGM/C amongst Australian women is unknown. Our article reviews the literature on research on FGM/C in Australia, which focuses on health system response to women and girls with FGM/C. Recommendations are made for policy reform in health, legislation, and community programs to provide the best healthcare, protect children, and help communities abandon this harmful practice. Midwives and doctors in Australia acknowledged a lack of knowledge on FGM/C, clinical guidelines and consequences for maternity care. In a metropolitan Australian hospital with specialised FGM/C care, women with FGM/C had similar obstetric outcomes as women without FGM/C, underlining the importance of holistic FGM/C clinics. Greater focus on integration of refugee and migrant populations into their new cultures may be an important way of facilitating the abandonment of this practice, as is education of communities that practise FGM/C, and experts involved in the care and protection of children. Men could be important advocates for protecting women and girls from violence and FGM/C through a man-to-man strategy with programs focussing on men's health and other personal issues, education, and communication. The Australian Government has identified gender-based violence as an area of priority and has been implementing a National plan to reduce violence against women and their children 2010-2022. A multidisciplinary network of experts on FGM/C could be established within this taskforce to develop well-defined and rapid referral pathways to care for and protect these children, as well as coordinate education and prevention programs to help communities

  4. Female genital mutilation : a hidden epidemic (statement from the European Academy of Paediatrics)

    NARCIS (Netherlands)

    Sauer, Pieter J. J.; Neubauer, David

    Female genital mutilation or female circumcision is frequently performed worldwide. It is estimated by the World Health Organisation that worldwide, 100-140 million girls and women currently have to live with the consequences of female genital mutilation. The article argues that the tradition is one

  5. [Female genital mutilation meets Swedish health care. Female genital mutilation is one of many forms of discrimination of women in the world].

    Science.gov (United States)

    Andersson, C

    2001-05-16

    About 27,000 women from countries in which female genital mutilation (FGM) is a common practice are presently living in Sweden. This means that FGM is a phenomenon that directly affects the Swedish health care system. Knowledge and understanding of the background, meaning and consequences of FGM are a prerequisite for effective prevention, proper clinical handling and supportive reception of the women. To avoid a stigmatizing reception it is also important to understand the situation of genitally mutilated women, and to become aware of the identity crisis many of them experience when they come to Sweden and lose their identity as "normal" women. It is essential to remember that female genital mutilation is one of many forms of discrimination affecting girls and women around the world. This discrimination knows no national or cultural borders and varies in expression and extent. In order to offer optimal care and reception of women who have been socialized into a gender role that is often seen as completely different from the gender role that Swedish society is said to embrace, it is of the utmost importance to first take a critical look beneath the veil of alleged gender equality of Swedish women.

  6. [Male perceptions of sequelae associated with female genital mutilation].

    Science.gov (United States)

    Jiménez-Ruiz, Ismael; Almansa Martínez, Pilar; Pastor Bravo, María Del Mar

    2016-01-01

    To explore men's knowledge of the negative consequences of female genital mutilation (FGM) to women's health in countries where this practice is performed. A qualitative methodology was used with an ethnomethodological approach. Both individual and group semi-structured interviews concerning FGM were conducted with 25 men, selected by triple sampling. A study presentation letter was provided to participants, together with an informed consent declaration. Permission was also procured to record the interviews in audio format. Data analysis was performed using the Atlas Ti7 software. Those participants against FGM are aware of the range of complications this practice can cause, being able to identify physical, obstetric, psychological, sexuality and social consequences in women subjected to FGM. However, those men who are in favour display a general ignorance of the problems resulting from this practice. Participants from countries where FGM is performed who are against this practice are more aware of the negative consequences than those who claim to be in favour. The design of awareness-raising programmes and other tools to combat female genital mutilation must highlight the implications for women's and girls' health, and include family-targeted campaigns which involve men in the process of eradicating this practice. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  7. [Herpes simplex virus and malignancies of female genital organs].

    Science.gov (United States)

    Cokić-Damjanović, J; Horvat, E; Balog, A

    2001-01-01

    Primary herpes simplex virus (HSV) infections of female genital tract usually end with remission, while the virus remains in the organism--almost in the sacral ganglion in a latent form, protected from humoral and cellular immunity. Stress induces the virus and the result is recurrent genital infection. Frequent exacerbations damage some parts of vital cellular structures without cytolysis, but stimulate malignant transformations. Vulvar (portio vaginalis uteri) and endometrial tumor tissue samples were analyzed for HSV by direct and indirect fluorescent antibody technique (FAT). Pre and postoperative sera samples were analyzed for presence of anti-HSV antibodies--IgM and IgG by Elisa-Enzygnost method. Acellular filtrates obtained by ultrasonic destruction of malignant tissues were used as inoculum for rabbit corneal scarification. Out of 63 tissue samples, 42 were positive for HSV antigen i.e. 67.3%. According to location 50% of vulvar, 76% PVU and 65% of endometrial tissues were positive. This antigen induces production of virus specific antibodies. Two types of antigens are known: the so-called T-antigen persisting in the cell nucleus and cell-surface antigen--product of the viral genome and can be evidenced by immunofluorescence method. Anti HSV antibodies were present in 63 preoperative serum samples and belonged to IgG group, but not one to IgM, implying a long and chronic course of infection excluding acute primary. Out of 38 postoperative serums the titer of antibodies decreased in 36 evidently, but in two samples remained unchanged. Two samples of endometrial and one from PVU origin contained HSV antigen type one. In the remaining 16 samples HSV 2 antigen was present. Rabbit corneal scarification was the proof of complete infectious virus in malignant tissues. Acellular filtrate of malignant tissues served as inoculum. Corneas of examined rabbits showed a mild inflammation after 24 hours which disappeared in the next 24 hours. We could not isolate the

  8. For the sake of purity (and control). Female genital mutilation.

    Science.gov (United States)

    Gilbert, D

    1993-01-01

    In 1973 approximately 1 million girls will be victimized by female genital mutilation (FGM), widely practiced in more than 20 African nations from Mauritania to the Ivory Coast in the west, to Egypt and North Tanzania in the east, as well as in Oman, Bahrain, North and South Yemen, and the United Arab Emirates. FGM takes place among the Moslem populations of the Philippines, Indonesia, and Malaysia and the Jewish Falashas in Ethiopia. FGM is practiced on babies just a few days old to girls right before marriage or young women pregnant with their first child. The most extreme mutilation is called infibulation. In Somalia, almost 100% of the women are infibulated, and so are more than 80% of the women in north and central Sudan. In Ethiopia/Eritrea, Mali, and Sierra Leone, 90% of the women have undergone some form of genital mutilation. The rate reaches 70% in Burkina Faso; 60% in Kenya, Gambia, and the Ivory Coast; and 50% in Senegal, Egypt, Guinea Bissau, and Nigeria. The mutilation often results in accumulation of menstrual blood and pelvic inflammatory disease often leading to infertility. Between 20% and 25% of infertility in Sudan has been attributed to female genital mutilation. The practice of FGM has existed for centuries, and some claim it originated in the Nile Valley during the Pharaonic era. On the other hand, Muslim countries like Iraq, Syria, and Tunisia do not practice FGM. The London Black Women's Health Action Project set up an educational network to prevent mutilations and to dispel the myth of religion about FGM. FORWARD convened the First Study Conference on Genital Mutilation of Girls in Europe in 1992 and deemed FGM a form of child abuse. Local campaigns in Africa, Asia, and the Arab world educate against FGM. The Inter-Africa Committee on Traditional Practices Affecting the Health of Women and Children, based in Addis Ababa, Ethiopia, has offices in more than 20 African nations to sensitize the public about the harmful effects of FGM. In

  9. Exploring Female Genital Cutting Among Survivors of Torture.

    Science.gov (United States)

    Akinsulure-Smith, Adeyinka M; Chu, Tracy

    2017-06-01

    Though the practice of female genital cutting (FGC) has been framed as a form of gender-based torture, few studies have examined the prevalence and impact of the practice among documented survivors of torture. This article presents a secondary analysis of data from 514 African-born women at an interdisciplinary clinic for survivors of torture. Results indicate few demographic differences between those who experienced FGC and those who had not, though a larger proportion of the FGC group were West African and identified as Muslim. Many with FGC were in the process of applying for asylum, reported sexual and psychological torture, and cited gender as a basis for their persecution. The FGC group evidenced unique correlates related to immigration status and psychological and sexual torture experiences that the non-FGC group did not. Findings indicate that female survivors of torture with FGC represent a distinct group with specific mental health needs.

  10. The Jewish and Christian view on female genital mutilation

    Directory of Open Access Journals (Sweden)

    I. El-Damanhoury

    2013-09-01

    Full Text Available Female genital mutilation (FGM is a practice involving the removal of all or parts of the female external genitalia. It has been documented in 28 African countries and in some countries in Asia and the Middle East, but due to increasing immigration from these countries to the western world, FGM has become a worldwide human rights and health issue. Contrary to the belief that it is a practice carried out by Muslims only, it is also practiced by Christians and a minority group of Ethiopian Jews. However, FGM is neither mentioned in the Torah, nor in the Gospels, and – like in Islam – bodily mutilation is condemned by both religions. In fact, FGM is a mix of mainly cultural and social factors which may put tremendous pressure on the members of the society in question.

  11. Estimating the prevalence of female genital mutilation in Portugal.

    Science.gov (United States)

    Teixeira, A L; Lisboa, M

    2016-10-01

    Due to globalized migratory processes, female genital mutilation/cutting (FGM/C) has spread to other countries, including countries in Europe, where, with a few exceptions, it remains a concealed problem. To the authors' knowledge, this is the first national extensive study to estimate the prevalence of FGM/C in Portugal. Prevalence estimation. Using extrapolation of country-of-origin prevalence data and the 2011 Census data, this study estimated: the prevalence of FGM/C in Portugal among women of reproductive age (15-49 years) and among all women aged ≥15 years; and the number of girls aged females who have undergone or are at risk of undergoing FGM/C. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  12. Female behaviour and the interaction of male and female genital traits mediate sperm transfer during mating.

    Science.gov (United States)

    Friesen, C R; Uhrig, E J; Mason, R T; Brennan, P L R

    2016-05-01

    Natural selection and post-copulatory sexual selection, including sexual conflict, contribute to genital diversification. Fundamental first steps in understanding how these processes shape the evolution of specific genital traits are to determine their function experimentally and to understand the interactions between female and male genitalia during copulation. Our experimental manipulations of male and female genitalia in red-sided garter snakes (Thamnophis sirtalis parietalis) reveal that copulation duration and copulatory plug deposition, as well as total and oviductal/vaginal sperm counts, are influenced by the interaction between male and female genital traits and female behaviour during copulation. By mating females with anesthetized cloacae to males with spine-ablated hemipenes using a fully factorial design, we identified significant female-male copulatory trait interactions and found that females prevent sperm from entering their oviducts by contracting their vaginal pouch. Furthermore, these muscular contractions limit copulatory plug size, whereas the basal spine of the male hemipene aids in sperm and plug transfer. Our results are consistent with a role of sexual conflict in mating interactions and highlight the evolutionary importance of female resistance to reproductive outcomes. © 2016 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2016 European Society For Evolutionary Biology.

  13. Are obstetric outcomes affected by female genital mutilation?

    Science.gov (United States)

    Balachandran, Aswini A; Duvalla, Swapna; Sultan, Abdul H; Thakar, Ranee

    2018-03-01

    Female genital mutilation (FGM) has been associated with adverse obstetric and neonatal outcomes, such as postpartum haemorrhage (PPH), perineal trauma, genital fistulae, obstructed labour and stillbirth. The prevalence of FGM has increased in the UK over the last decade. There are currently no studies available that have explored the obstetric impact of FGM in the UK. The aim of our study was to investigate the obstetric and neonatal outcomes of women with FGM when compared with the general population. We conducted a retrospective case-control study of consecutive pregnant women with FGM over a 5-year period between 1 January 2009 and 31 December 2013. Each woman with FGM was matched for age, ethnicity, parity and gestation with subsequent patients without FGM (control cohort) over the same 5-year period. Outcomes assessed were mode of delivery, duration of labour, estimated blood loss, analgaesia, perineal trauma and foetal outcomes. A total of 242 eligible women (121 FGM, 121 control) were identified for the study. There was a significant increase in the use of episiotomy in the FGM group (p = 0.009) and a significant increase in minor PPH in the control group during caesarean sections (p = 0.0001). There were no differences in all other obstetric and neonatal parameters. In our unit, FGM was not associated with an increased incidence of adverse obstetric and foetal morbidity or mortality.

  14. A large multicenter outcome study of female genital plastic surgery.

    Science.gov (United States)

    Goodman, Michael P; Placik, Otto J; Benson, Royal H; Miklos, John R; Moore, Robert D; Jason, Robert A; Matlock, David L; Simopoulos, Alex F; Stern, Bernard H; Stanton, Ryan A; Kolb, Susan E; Gonzalez, Federico

    2010-04-01

    Female Genital Plastic Surgery, a relatively new entry in the field of Cosmetic and Plastic Surgery, has promised sexual enhancement and functional and cosmetic improvement for women. Are the vulvovaginal aesthetic procedures of Labiaplasty, Vaginoplasty/Perineoplasty ("Vaginal Rejuvenation") and Clitoral Hood Reduction effective, and do they deliver on that promise? For what reason do women seek these procedures? What complications are evident, and what effects are noted regarding sexual function for women and their partners? Who should be performing these procedures, what training should they have, and what are the ethical considerations? This study was designed to produce objective, utilizable outcome data regarding FGPS. 1) Reasons for considering surgery from both patient's and physician's perspective; 2) Pre-operative sexual functioning per procedure; 3) Overall patient satisfaction per procedure; 4) Effect of procedure on patient's sexual enjoyment, per procedure; 5) Patient's perception of effect on her partner's sexual enjoyment, per procedure; 6) Complications. This cross-sectional study, including 258 women and encompassing 341 separate procedures, comes from a group of twelve gynecologists, gynecologic urologists and plastic surgeons from ten centers in eight states nationwide. 104 labiaplasties, 24 clitoral hood reductions, 49 combined labiaplasty/clitoral hood reductions, 47 vaginoplasties and/or perineoplasties, and 34 combined labiaplasty and/or reduction of the clitoral hood plus vaginoplasty/perineoplasty procedures were studied retrospectively, analyzing both patient's and physician's perception of surgical rationale, pre-operative sexual function and several outcome criteria. Combining the three groups, 91.6% of patients were satisfied with the results of their surgery after a 6-42 month follow-up. Significant subjective enhancement in sexual functioning for both women and their sexual partners was noted (p = 0.0078), especially in patients

  15. The Female Genital Self-Image Scale (FGSIS): validation among a sample of female college students.

    Science.gov (United States)

    DeMaria, Andrea L; Hollub, Ariane V; Herbenick, Debby

    2012-03-01

    Gynecological exams continue to be underused among young women, possibly due to a woman's genital self-image. The purpose of this study was to (i) examine college women's genital image using the Female Genital Self-Image Scale (FGSIS); (ii) assess the reliability, validity, and factor structure of data collected on the FGSIS; and (iii) examine the relationship between FGSIS scores and gynecological exam behaviors. Data were collected in November/December 2010 from 450 undergraduate women. Descriptive statistics were utilized to analyze demographic variables. A comprehensive psychometric assessment of the FGSIS included: (i) a reliability assessment of internal consistency; (ii) conducting a confirmatory factor analysis (CFA) to identify factor structure; and (iii) structural equation modeling and predictive discriminant analysis to asses the predictive qualities of the FGSIS on gynecological exam behavior. CFA analyses yielded a two-factor FGSIS structure: X(2) (12, N=450)=49.77; Pself-image than those who had not (t (449)=-2.501; P=0.01). Data collected using the FGSIS were found to be valid and reliable in this sample, further supporting the utility of the scale and aiding in the understanding of college women's genital image using an underlying two-factor approach. This has important implications for the development of sexual health and women's health programs and discussions. Specifically, a two-factor FGSIS can aid medical and health professionals in better understanding relationships between genital image and gynecological exam behavior. © 2012 International Society for Sexual Medicine.

  16. Criminal enforcement in the area of female genital mutilation in France, England and the Netherlands: a comparative law perspective

    NARCIS (Netherlands)

    Kool, Renée; Wahedi, S.

    2014-01-01

    The criminal justice system in Western countries is ever more frequently facing the question of how to deal with immigrants’ cultural practices, such as honour killings, blood revenges and female circumcision, better known as ‘Female Genital Mutilation’, that are considered to be in violation of

  17. Reconciling female genital circumcision with universal human rights.

    Science.gov (United States)

    Gordon, John-Stewart

    2017-09-18

    One of the most challenging issues in cross-cultural bioethics concerns the long-standing socio-cultural practice of female genital circumcision (FGC), which is prevalent in many African countries and the Middle East as well as in some Asian and Western countries. It is commonly assumed that FGC, in all its versions, constitutes a gross violation of the universal human rights of health, physical integrity, and individual autonomy and hence should be abolished. This article, however, suggests a mediating approach according to which one form of FGC, the removal of the clitoris foreskin, can be made compatible with the high demands of universal human rights. The argument presupposes the idea that human rights are not absolutist by nature but can be framed in a meaningful, culturally sensitive way. It proposes important limiting conditions that must be met for the practice of FGC to be considered in accordance with the human rights agenda. © 2017 John Wiley & Sons Ltd.

  18. Female genital mutilation: A tragedy for women's reproductive health

    Directory of Open Access Journals (Sweden)

    Hamid Rushwan

    2013-09-01

    Full Text Available Female genital mutilation/cutting (FGM/FGC constitutes a tragic health and human rights issue of girls and women in a number of countries, mainly in Africa. The practice has serious health consequences, both physical and psychological. Attempts to eradicate the practice have not been successful over the past few decades. Medicalisation of the practice has added to its propagation, and this is not valid from ethical and professional standpoints. Further efforts need to be exerted to eliminate the practice and alleviate the sufferings that millions of girls and women worldwide are unnecessarily subjected to. This article reviews the problem and discusses the consequences to health for women and girls, and suggests ways to eradicate the practice.

  19. Female genital mutilation: the role of medical professional organizations.

    Science.gov (United States)

    Bazi, Tony

    2017-04-01

    Female genital mutilation (FGM) refers to alteration of the external genitalia of girls without medical benefit. It is estimated by United Nations agencies that 200 million living girls and women have been subjected to different forms of FGM worldwide. Despite the criminalization of the procedure in the vast majority of countries where it is practiced, the decline in the incidence of this ritual is far from satisfactory. Immediate and long-term ill effects are well documented. Most publications of relevance originate from countries outside the map of FGM. In addition, there are major gaps in research related to this issue, considering the magnitude of the problem. International medical organizations and societies should assume their responsibility by providing a platform to professionals engaged in the prevention and treatment of the consequences of FGM, especially those living in the communities where the practice is endemic.

  20. Female genital mutilation: what do we know so far?

    Science.gov (United States)

    Siddig, Israa

    2016-09-08

    Female genital mutilation (FGM) is a practice that is now familiar to UK health professionals. It continues to be a problem in high-risk populations and affects girls and women throughout their lives. Complications related to FGM are poorly reported and documented. Health professionals, therefore, must be aware of the adverse effects and how they affect obstetric, gynaecological and sexual function and general quality of life. They must also be sensitive towards the psychological and emotional issues relating to FGM. Sociocultural barriers make research and data-collection difficult in a cohort of women who prefer not to discuss or disclose such intimate issues. New guidelines on the management of health consequences in FGM have been published, but evidence is of poor quality.

  1. Typical and unusual cases of female genital tuberculosis

    Directory of Open Access Journals (Sweden)

    E. Kulchavenya

    2014-01-01

    Full Text Available Tuberculosis is a disease with myriad presentations and manifestations; it can affect any organ or tissue, excluding only hair and nails. Doctors who are not familiar with extrapulmonary tuberculosis often overlook this disease. Urogenital tuberculosis (UGTB is the second most common form of TB in countries with severe epidemic situation and the third most common form in regions with low incidence of TB. The term “Urogenital tuberculosis” includes kidney tuberculosis; male and female tuberculosis and urinary tract tuberculosis as complication of kidney tuberculosis. We describe rarest case of tuberculosis of a placenta in young woman, suffered from genital tuberculosis, which was overlooked before delivery, as well as typical tubo-ovarian tuberculomas.

  2. Dismantling the man-made myths upholding female genital mutilation.

    Science.gov (United States)

    Jiménez Ruiz, Ismael; Almansa Martínez, Pilar; Alcón Belchí, Carolina

    2017-05-01

    Female genital mutilation (FGM) is internationally considered an affront to human rights and an act of violence against women and young girls. Furthermore, it hierarchizes and perpetuates inequality and denies women and girls the right to physical and psychosexual integrity. The aim of this study is to detect the weak points and false premises underlying male justification of FGM and to present demythologization as a health education tool. We used a qualitative methodology with an ethonursing focus via semistructured individual and group interviews in 25 men associated with FGM. Our results found that nine myths and their mythologization are presented through the masculine voices of those associated with this tradition. These myths are used as justification by men and women in order to uphold the practice of FGM. Demythologization as a nursing intervention based on reorienting or restructuring models of cultural care allows us to work against the false premises making up the myths which act to protect this tradition.

  3. Female genital mutilation: knowledge, attitude and practices of Flemish midwives.

    Science.gov (United States)

    Cappon, Sien; L'Ecluse, Charlotte; Clays, Els; Tency, Inge; Leye, Els

    2015-03-01

    health professionals in Belgium are confronted with female genital mutilation (FGM). To date, no survey to assess knowledge, attitudes and practices on FGM was conducted among midwives in the Northern region of Belgium. the objective of this study was to assess the knowledge, attitude and practices of Flemish midwives regarding female genital mutilation (FGM). we used a quantitative design, using KAP study (semi-structured questionnaire). labour wards, maternity wards and maternal intensive care units (MIC) in 56 hospitals in Flemish region of Belgium. 820 midwives, actively working in labour wards, maternity wards and maternal intensive care units (MIC). 820 valid questionnaires (40.9%) were returned. More than 15% of the respondents were recently confronted with FGM. They were mostly faced with the psychological and sexual complications caused by FGM. Few respondents were aware of existing guidelines regarding FGM in their hospitals (3.5%). The results also showed that only 20.2% was aware of the exact content of the law. The majority of midwives condemned the harmful traditional practice: FGM was experienced as a form of violence against women or a violation of human rights. Only 25.9% declared that FGM forms a part of their midwifery program. The vast majority of respondents (92.5%) indicated a need for more information on the subject. this study indicated that midwives in Flanders are confronted with FGM and its complications and highlighted the gaps in the knowledge of Flemish midwives regarding FGM. This may interfere with the provision of adequate care and prevention of FGM for the new-born daughter. there is an important need for appropriate training of (student)midwives concerning FGM as well as for the development and dissemination of clear guidelines in Flemish hospitals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Uterine artery embolization: The interventional treatment of female genital diseases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woong Hee [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Yang, Seung Boo [Dept. of Radiology, Soonchunhyang University Gumi Hospital, Gumi (Korea, Republic of); Goo, Dong Erk; Kim, Yong Jae [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of); Lee, Jae Myeong [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Kang, Chae Hoon [Dept. of Radiology, Gangneung Asan Hospital, Gangneung (Korea, Republic of); Ohm, Joon Young [Dept. of Radiology, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon (Korea, Republic of); Kim, Young Jun [Dept. of Radiology, Presbyterian Medical Center, Jeonju (Korea, Republic of)

    2017-01-15

    The uterus is the major female sex organ and is essential for pregnancy. The organ is located in the pelvic cavity. It is usually fist-sized with its volume changing from 75 to 200 cc depending on the menstrual cycle. There are various diseases associated with the uterus, including malignancy, uterine myoma, postpartum hemorrhage, and vascular malformation. The conventional surgical treatment for these diseases is hysterectomy. However, hysterectomy has some risk, and there may be complications associated with the surgery and anesthesia. In addition, hysterectomy results in loss of fertility and loss of female characteristics, both of which may lead to emotional problems. After uterine artery embolization (UAE) was performed for post-partum bleeding in 1979 and for uterine myoma in 1995, interventional treatment of UAE replaced the existing surgical treatment of hysterectomy. UAE is performed widely as a minimally invasive treatment modality that can preserve the uterus, make pregnancy and childbirth possible and resolve emotional problems. The interventional treatment has become increasingly popular to treat various female genital diseases.

  5. Female genital mutilation/cutting: will it continue?

    Science.gov (United States)

    Mohammed, Ghada F; Hassan, Magdy M; Eyada, Moustafa M

    2014-11-01

    Female genital mutilation/cutting (FGM/C) is a prevalent, deeply rooted traditional practice in Egypt. Specification of the motives behind the continuation of FGM/C in Egyptian community and evaluation of the sexual function in women with FGM/C. This cross-sectional study, involved 2,106 sexually active female participants with FGM/C. Full history-taking and general examination to evaluate the type of FGM/C were conducted. Sexual function was assessed by using the Female Sexual Function Index (FSFI) questionnaire. Enumerate and specify the motivational factors and its percent among the participants. The correlation between FGM/C and FSFI domain scores was done with Pearson's correlation. Tradition, cleanliness, and virginity were the most common motives empowering the continuation of FGM/C (100%), followed by men's wish, esthetic factors, marriage, and religion factors (45.2-100%). Type I FGM/C was the most common, followed by type II. There was only negative correlation between the type II FGM/C and sexual satisfaction. No statistically significant difference between type I and non-FGM/C was found. FGM/C remains high. A variety of socio-cultural myths, religious misbelievers, and hygienic and esthetic concerns were behind the FGM/C. Overall, a large proportion of the participants supported the continuation of FGM/C in spite of adverse effect and sexual dysfunction associated with FGM/C. © 2014 International Society for Sexual Medicine.

  6. Towards a solution concerning female genital mutilation? An approach from within according to Islamic legal opinions

    OpenAIRE

    Jens Kutscher

    2011-01-01

    Female circumcision is a tradition that is widespread and not restricted to predominantly Muslim countries. It is prevalent among all religious groups in many parts of Africa and Western Asia, whether they are Coptic Christians, Ethiopian Jews, or Arab Muslims. Female genital cutting or—more to the point—female genital mutilation (FGM), generally referred to as circumcision, occurs in at least five different forms. Circumcision is essentially a powerful bodily sign of the human—male and femal...

  7. Health complications of female genital mutilation in Sierra Leone

    Directory of Open Access Journals (Sweden)

    Bjälkander O

    2012-07-01

    Full Text Available Owolabi Bjälkander,1 Laurel Bangura,2 Bailah Leigh,3 Vanja Berggren,1 Staffan Bergström,1 Lars Almroth11Division of Global Health, Department of Public Health, Karolinska Institutet, Stockholm, Sweden; 2Inter Africa Committee, Sierra Leone; 3Department of Community Health, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra LeoneAbstract: Sierra Leone has one of the highest rates of female genital mutilation (FGM in the world, and yet little is known about the health consequences of the practice.Purpose: To explore whether and what kind of FGM-related health complications girls and women in Sierra Leone experience, and to elucidate their health care-seeking behaviors.Patients and methods: A feasibility study was conducted to test and refine questionnaires and methods used for this study. Thereafter, a cross-section of girls and women (n = 258 attending antenatal care and Well Women Clinics in Bo Town, Bo District, in the southern region and in Makeni Town, Bombali District, in the northern region of Sierra Leone were randomly selected. Participants answered interview-administrated pretested structured questionnaires with open-ended-questions, administrated by trained female personnel.Results: All respondents had undergone FGM, most between 10 and 14 years of age. Complications were reported by 218 respondents (84.5%, the most common ones being excessive bleeding, delay in or incomplete healing, and tenderness. Fever was significantly more often reported by girls who had undergone FGM before 10 years of age compared with those who had undergone the procedure later. Out of those who reported complications, 187 (85.8% sought treatment, with 89 of them visiting a traditional healer, 75 a Sowei (traditional circumciser, and 16 a health professional.Conclusion: The high prevalence rate of FGM and the proportion of medical complications show that FGM is a matter for public health concern in Sierra Leone. Girls who

  8. Posttraumatic Stress Disorder Relapse and Clitoral Reconstruction After Female Genital Mutilation.

    Science.gov (United States)

    Abdulcadir, Jasmine; Bianchi Demicheli, Francesco; Willame, Alexia; Recordon, Nathalie; Petignat, Patrick

    2017-02-01

    Evidence on clitoral reconstruction after female genital mutilation is lacking. A woman with female genital mutilation experiencing clitoral pain during sex consulted to undergo clitoral reconstruction. The surgery was complicated by a wound infection responsible for severe postoperative pain. Such genital pain made our patient recall the traumatic experience of genital mutilation and experience a relapse of posttraumatic stress disorder symptoms. She reported anxiety; spontaneous, intrusive recurrent memories of the cutting; hypervigilance; and depressed mood. We successfully treated the infection and posttraumatic stress disorder. At 6 months postsurgery, she reported no clitoral pain and improved sexual function. Genital pain after clitoral reconstruction may cause recall of memories of the genital mutilation. We recommend multidisciplinary comprehensive psychosexual care and adequate analgesia.

  9. Sublingual immunization with nonreplicating antigens induces antibody-forming cells and cytotoxic T cells in the female genital tract mucosa and protects against genital papillomavirus infection.

    Science.gov (United States)

    Cuburu, Nicolas; Kweon, Mi-Na; Hervouet, Catherine; Cha, Hye-Ran; Pang, Yuk-Ying S; Holmgren, Jan; Stadler, Konrad; Schiller, John T; Anjuère, Fabienne; Czerkinsky, Cecil

    2009-12-15

    We have recently reported that the sublingual (s.l.) mucosa is an efficient site for inducing systemic and mucosal immune responses. In this study, the potential of s.l. immunization to induce remote Ab responses and CD8(+) cytotoxic responses in the female genital tract was examined in mice by using a nonreplicating Ag, OVA, and cholera toxin (CT) as an adjuvant. Sublingual administration of OVA and CT induced Ag-specific IgA and IgG Abs in blood and in cervicovaginal secretions. These responses were associated with large numbers of IgA Ab-secreting cells (ASCs) in the genital mucosa. Genital ASC responses were similar in magnitude and isotype distribution after s.l., intranasal, or vaginal immunization and were superior to those seen after intragastric immunization. Genital, but not blood or spleen, IgA ASC responses were inhibited by treatment with anti-CCL28 Abs, suggesting that the chemokine CCL28 plays a major role in the migration of IgA ASC progenitors to the reproductive tract mucosa. Furthermore, s.l. immunization with OVA induced OVA-specific effector CD8(+) cytolytic T cells in the genital mucosa, and these responses required coadministration of the CT adjuvant. Furthermore, s.l. administration of human papillomavirus virus-like particles with or without the CT adjuvant conferred protection against genital challenge with human papillomavirus pseudovirions. Taken together, these findings underscore the potential of s.l. immunization as an efficient vaccination strategy for inducing genital immune responses and should impact on the development of vaccines against sexually transmitted diseases.

  10. Hysterosalpingographic Appearances of Female Genital Tract Tuberculosis: Part I. Fallopian Tube

    OpenAIRE

    Ahmadi, Firoozeh; Zafarani, Fatemeh; Shahrzad, Gholam

    2013-01-01

    Female genital tuberculosis (TB) remains as a major cause of tubal obstruction leading to infertility, especially in developing countries. The global prevalence of genital tuberculosis has increased during the past two decades due to increasing acquired immunodeficiency syndrome (AIDS). Genital TB is commonly asymptomatic, and it is diagnosed during infertility investigations. Despite of recent advances in imaging tools, such as computerized tomography (CT) scan, magnetic reson...

  11. Female genital cutting in Hargeisa, Somaliland: is there a move towards less severe forms?

    Science.gov (United States)

    Lunde, Ingvild Bergom; Sagbakken, Mette

    2014-05-01

    According to several sources, little progress is being made in eliminating the cutting of female genitalia. This paper, based on qualitative interviews and observations, explores perceptions of female genital cutting and elimination of the phenomenon in Hargeisa, Somaliland. Two main groups of participants were interviewed: (1) 22 representatives of organisations whose work directly relates to female genital cutting; and (2) 16 individuals representing different groups of society. It was found that there is an increasing use of medical staff and equipment when a girl undergoes the procedure of female genital cutting; the use of terminology is crucial in understanding current perceptions of female genital cutting; religion is both an important barrier and facilitator of elimination; and finally, traditional gender structures are currently being challenged in Hargeisa. The findings of this study suggest that it is important to consider current perceptions on practices of female genital cutting and on abandonment of female genital cutting, in order to gain useful knowledge on the issue of elimination. The study concludes that elimination of female genital cutting is a multifaceted process which is constantly negotiated in a diversity of social settings. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  12. The ongoing violence against women: Female Genital Mutilation/Cutting.

    Science.gov (United States)

    Muteshi, Jacinta K; Miller, Suellen; Belizán, José M

    2016-04-18

    Female Genital Mutilation/Cutting (FGM/C) comprises different practices involving cutting, pricking, removing and sometimes sewing up external female genitalia for non-medical reasons. The practice of FGM/C is highly concentrated in a band of African countries from the Atlantic coast to the Horn of Africa, in areas of the Middle East such as Iraq and Yemen, and in some countries in Asia like Indonesia. Girls exposed to FGM/C are at risk of immediate physical consequences such as severe pain, bleeding, and shock, difficulty in passing urine and faeces, and sepsis. Long-term consequences can include chronic pain and infections. FGM/C is a deeply entrenched social norm, perpetrated by families for a variety of reasons, but the results are harmful. FGM/C is a human rights issue that affects girls and women worldwide. The practice is decreasing, due to intensive advocacy activities of international, national, and grassroots agencies. An adolescent girl today is about a third less likely to be cut than 30 years ago. However, the rates of abandonment are not high enough, and change is not happening as rapidly as necessary. Multiple interventions have been implemented, but the evidence base on what works is lacking. We in reproductive health must work harder to find strategies to help communities and families abandon these harmful practices.

  13. Some Ethical Considerations Regarding Medicalization of Female Genital Mutilation/cutting (Female Circumcision

    Directory of Open Access Journals (Sweden)

    Ahmed R. A. Ragab

    2008-01-01

    Full Text Available According to each society's condition the ethical attitude of the individual may be colored by the attitude of the society. It is therefore not surprising to find what is ethical in one society might not be ethical in another. Female Genital Cutting, as an example, is seen in some societies as a must and something good for the whole community in general and for girls in particular, while in others, it is seen as mutilation and violation of human rights. The practice of female genital cutting is a complex issue that ties the traditional gender roles, superstition, local concepts on health and sexuality, as well as several other social relations. Worldwide, an estimated 130 million girls and women have undergone FGC. The current paper examines medicalization of female genital cutting from ethical point of view. The paper discusses the issue in the following themes: definition of the practice, the justifications of the practice, the complications and lastly the ethical reflections. The paper argues that laws that prohibit the practice would not work, without wide socio-cultural change; any effort to eradicate the practice would not succeed.

  14. The first step toward diagnosing female genital schistosomiasis by computer image analysis

    DEFF Research Database (Denmark)

    Holmen, Sigve Dhondup; Kleppa, Elisabeth; Lillebø, Kristine

    2015-01-01

    Schistosoma haematobium causes female genital schistosomiasis (FGS), which is a poverty-related disease in sub-Saharan Africa. Furthermore, it is co-endemic with human immunodeficiency virus (HIV), and biopsies from genital lesions may expose the individual to increased risk of HIV infection...

  15. Urinary and Genital Tract Obstruction as a Complication of Female ...

    African Journals Online (AJOL)

    vaginosis, and genital herpes and obstetric complications including perinatal death.[1,3-10] All types of FGM have been shown to be associated with complications. In this report, we present the case of a 23-year-old. Nigerian girl, with obstructed micturition and genital tract obstruction, as a complication of Type 3 FGM, with ...

  16. DETERMINANTS OF FEMALE GENITAL MUTILATION PRACTICES IN EAST GOJJAM ZONE, WESTERN AMHARA, ETHIOPIA.

    Science.gov (United States)

    Andualem, Mulusew

    2016-07-01

    Female genital mutilation is one of the harmful traditional practices among women and girls. More than 130 million girls and women live today who have undergone female genital mutilation. In Ethiopia, a high prevalence (74.3% national and 68.5% in Amhara region) has been reported. This study was aimed to identify determinant factors of female genital mutilation practices in East Gojjam Zone, Western Amhara, Ethiopia community based cross sectional study was conducted among 730 women aged 15-49 years and having children female genital mutilation. 718 women and 805 daughters participated in the study. FGM prevalence was 689 (96%) and 403 (49%) among women and daughtersfemale genital mutilation. Daughters' age, parent education level, residence, women circumcision history, culture, health education, frequent health extension workers follow up and participation in anti FGM interventions were risk factors to female genital mutilation practice. Female genital mutilation practices continues to be a major problem to women and daughter <5 years of age in the study area. A number of factors were associated with FGM practices including daughters’ age, parent education level, residence, health education, culture, mothers circumcision history, frequent health extensions workers follow up and participation in anti FGM interventions were determinants to higher FGM practices.

  17. [Habits and traditions of female college students related to intimate clothing, genital adornments, genital hair removal and sexual practices].

    Science.gov (United States)

    Giraldo, Paulo César; Polo, Renata Colbachini; do Amaral, Rose Luce Gomes; Reis, Virgínia Vieitez; Beghini, Joziani; Bardin, Marcela Grigol

    2013-09-01

    To describe the practices and care with the genital area of female college students. A descriptive analytical study evaluated the habits and traditions of 364 students from the University of Campinas (Unicamp) regarding the use of underwear, body piercings, tattoos, hair removal and sexual practices. A questionnaire with 42 questions assessed the most current practices among female college students. All questions were self answered and the questionnaires, without any identification, were placed in sealed ballot boxes to ensure the confidentiality of information. The responses were tabulated in Microsoft® Excel 2007 to obtain univariate analysis. The mean age of the college students in the study was 21 years (SD ± 2.7), and 84% were white. The volunteers who participated in this study were from the biological science area (50%), the exact science area (29%) or the humanity area (21%). It was observed that 61.8% of the respondents wear cotton panties, but at the same time 75.4% wear tight jeans, and only 18.4% wore no panties when sleeping. Only one participant reported having had genital piercing and none of them reported tattooing. Most female college students do genital waxing, and approximately 1/3 of them do so completely. After hair removal, 2/3 apply an anti-inflammatory and/or moisturizer to the region. Only 62% use condoms and 17.6% use a lubricant during intercourse. Half of them receive oral sex, 17.9% practice anal sex and 26.6% of them report feeling pain during sexual intercourse. Vaginal discharge after intercourse was reported in 25.6% of the cases. Young female college students from Brazilian public universities have many inadequate care habits related to their genital area. They do not use genital piercing and tattoos, but report having pain during sexual intercourse and vaginal discharge after sex in a large number of cases.

  18. Female genital mutilation in African and African American women's literature

    Directory of Open Access Journals (Sweden)

    Darja Marinšek

    2007-12-01

    Full Text Available The article builds on the existing dispute between African and African American women writers on the competence of writing about female genital mutilation (FGM, and tries to determine the existence and nature of the differences between the writings of these two groups. The author uses comparative analysis of two popular African and African American novels, comparing their ways of describing FGM, its causes and consequences, the level ob objectivity and the style of the narrations.This is followed by a discussion on the reasons for such differences, incorporating a larger circle of both African and African American women authors, at the same time analysing the deviance within the two groups. While the differences between African American writers are not that great, as they mostly fail to present the issue from different points of view, which is often the result of their lack of direct knowledge of the topic, African authors' writing is in itself discovered to be ambivalent and not at all invariable. The reasons for such ambivalence are then discussed in greater context, focusing on the effect of the authors' personal contact with circumcision as well as their knowledge and acceptance of Western values. The author concludes by establishing the African ambivalent attitude towards FGM, which includes different aspects of the issue, as the most significant difference between their and African American writers' description of this practice.

  19. An overview of female genital mutilation in Nigeria.

    Science.gov (United States)

    Okeke, Tc; Anyaehie, Usb; Ezenyeaku, Cck

    2012-01-01

    Nigeria, due to its large population, has the highest absolute number of female genital mutilation (FGM) worldwide, accounting for about one-quarter of the estimated 115-130 million circumcised women in the world. The objective of this review is to ascertain the current status of FGM in Nigeria. Pertinent literature on FGM retrieved from internet services [Google search on FGM in Nigeria, www.online Nigeria, PubMed of the national library of medicine www.medconsumer. Info/tropics/fgm.htm, Biomedcentral and African Journal Online (AJOL) (FGM)] and textbooks, journals, and selected references for proper understanding of the topic was included in this review. The national prevalence rate of FGM is 41% among adult women. Evidence abound that the prevalence of FGM is declining. The ongoing drive to eradicate FGM is tackled by World Health Organization, United Nations International Children Emergency Fund, Federation of International Obstetrics and Gynecology (FIGO), African Union, The economic commission for Africa, and many women organizations. However, there is no federal law banning FGM in Nigeria. There is need to eradicate FGM in Nigeria. Education of the general public at all levels with emphasis on the dangers and undesirability of FGM is paramount.

  20. Missed opportunities for diagnosis of female genital mutilation.

    Science.gov (United States)

    Abdulcadir, Jasmine; Dugerdil, Adeline; Boulvain, Michel; Yaron, Michal; Margairaz, Christiane; Irion, Olivier; Petignat, Patrick

    2014-06-01

    To investigate missed opportunities for diagnosing female genital mutilation (FGM) at an obstetrics and gynecology (OB/GYN) department in Switzerland. 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. 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. Opportunities to identify FGM are frequently missed. Measures should be taken to improve FGM diagnosis and care. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  1. Female genital mutilation: knowledge, attitudes and practices of Flemish gynaecologists.

    Science.gov (United States)

    Leye, Els; Ysebaert, Ilse; Deblonde, Jessika; Claeys, Patricia; Vermeulen, Gert; Jacquemyn, Yves; Temmerman, Marleen

    2008-06-01

    To assess the knowledge, attitudes and practices with regard to female genital mutilation (FGM) among gynaecologists in Flanders, Belgium. A questionnaire-based survey was sent to 724 Flemish gynaecologists and trainees. Three-hundred-and-thirty-four questionnaires were returned. The survey revealed gaps in the knowledge of FGM and the provision of care by Flemish gynaecologists to women who had been mutilated. It also appeared that FGM was not properly addressed in the basic and specialized medical training in Flanders, that little was known about codes of conduct issued by the hospitals when these were not lacking altogether, and that knowledge about legislation concerning FGM was deficient. There was much confusion whether re-infibulation is authorized, and what its legal status is. Some respondents considered cosmetic vaginal surgery as a form of FGM and many were in favour of the medicalization of FGM. Gynaecologists were most commonly confronted with complaints related to sexual problems caused by FGM. Finally, the study also showed that only about a third of the gynaecologists were discouraging women from having their daughters excised. There is a need for a thorough discussion among all those concerned of the ethical and legal aspects of re-infibulation, medicalization of FGM and cosmetic vaginal surgery.

  2. Psychological and counselling interventions for female genital mutilation.

    Science.gov (United States)

    Smith, Helen; Stein, Karin

    2017-02-01

    Women and girls living with female genital mutilation (FGM) are more likely to experience psychological problems than women without FGM. As well as psychological support, this population may need additional care when seeking surgical interventions to correct complications of FGM. Recent WHO guidelines recommend cognitive behavioral therapy for women and girls experiencing anxiety disorders, depression, or post-traumatic stress disorder. The guidelines also suggest that preoperative counselling for deinfibulation, and psychological support alongside surgical interventions, can help women manage the physiological and psychological changes following surgery. This synthesis summarizes evidence on women's values and preferences, and the context and conditions that may be required to provide psychological and counselling interventions. Understanding women's views, their own ways of coping, as well social and cultural factors that influence women's mental well-being, may help identify the types of interventions this population needs at different times and stages of their lives. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  3. Effect of female genital mutilation/cutting on sexual functions.

    Science.gov (United States)

    Biglu, Mohammad-Hossein; Farnam, Alireza; Abotalebi, Parvaneh; Biglu, Sahar; Ghavami, Mostafa

    2016-12-01

    Female Genital Mutilation/Cutting (FGM/C) or female circumcision is the procedure of eliminating some or all parts of the external female genitalia. FGM/C is carried out by traditional circumcisers. They usually use cutting tools like a blade or straight-razor. Although FGM/C is well described in the African continent and some Arabic countries, data from Iran are scarce. The major objective of this current study was to investigate the effects of FGM/C on the female sexual function of married women compared to the non-circumcised women in the Kurdistan province of Iran. A case-control study was conducted in a sample of 280 married women (140 circumcised-women and 140 non-circumcised-women) who referred to the healthcare centers for vaccination, midwifery, or family planning services. Participants were requested to complete the Persian-translated version of the Female Sexual Function Index. The total score of the FSFI and its individual domains. Of the circumcised women, 51.4% reported circumcision procedures before the age of 3 years. Religion motivation (53.6%) was mentioned as the most important factor for the family leading to FGM/C. Almost all operations were performed by traditional circumcisers. Non-circumcised women had significantly higher Persian-FSFI total score (25.3 ± 4.34) compared to the circumcised women (17.9 ± 5.39). Sexual function in women with FGM/C is adversely altered. In Kurdistan province women, FGM/C is associated with reduction of scores of Persian-FSFI on all domain scores. Education in general and informing the people that FGM/C is not a religious Hadith certainly would have a great impact on the suffering of the women from FGM/C as well as the level of "desire, arousal, lubrication, orgasm, satisfaction, and pain in the sexual function of women". Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Clitoral reconstruction after female genital mutilation/cutting: case studies.

    Science.gov (United States)

    Abdulcadir, Jasmine; Rodriguez, Maria I; Petignat, Patrick; Say, Lale

    2015-01-01

    Clitoral reconstruction following female genital mutilation/cutting (FGM/C) is a new surgical technique reported to be a feasible and effective strategy to reduce clitoral pain, improve sexual pleasure, and restore a vulvar appearance similar to uncircumcised women. However, data on safety, care offered, and evaluation of sexual and pain outcomes are still limited. This study aims to present the care offered and clinical outcomes of two women who received multidisciplinary care, including psychosexual treatment, with clitoral reconstruction. We report their long-term outcomes, and the histology of the removed periclitoral fibrosis. We report the cases of two women with FGM/C types II and III who requested clitoral reconstruction for different reasons. One woman hoped to improve her chronic vulvar pain, as well as improve her sexual response. The other woman requested surgery due to a desire to reverse a procedure that was performed without her consent, and a wish to have a genital appearance similar to non infibulated women. They both underwent psychosexual evaluation and therapy and surgery. The histology of the periclitoral fibrosis removed during surgery was analyzed. At 1-year postoperatively, the first woman reported complete disappearance of vulvar pain and improved sexual pleasure, including orgasm. Our second patient also described improved sexuality at 1-year follow-up (increased sexual desire, lubrication, vulvar pleasure, and sensitiveness), which she attributed to a better self body image and confidence. Both women reported feeling satisfied, happy, and more beautiful. We show a positive outcome in pain reduction and improved sexual function, self body image, and gender after psychosexual therapy and clitoral reconstruction. More evidence is needed about clitoral reconstruction to develop guidelines on best practices. Until research is conducted that rigorously evaluates clitoral reconstruction for its impact on pain and sexuality, we advise always

  5. Health complications of female genital mutilation in Sierra Leone

    Science.gov (United States)

    Bjälkander, Owolabi; Bangura, Laurel; Leigh, Bailah; Berggren, Vanja; Bergström, Staffan; Almroth, Lars

    2012-01-01

    Sierra Leone has one of the highest rates of female genital mutilation (FGM) in the world, and yet little is known about the health consequences of the practice. Purpose To explore whether and what kind of FGM-related health complications girls and women in Sierra Leone experience, and to elucidate their health care-seeking behaviors. Patients and methods A feasibility study was conducted to test and refine questionnaires and methods used for this study. Thereafter, a cross-section of girls and women (n = 258) attending antenatal care and Well Women Clinics in Bo Town, Bo District, in the southern region and in Makeni Town, Bombali District, in the northern region of Sierra Leone were randomly selected. Participants answered interview-administrated pretested structured questionnaires with open- ended-questions, administrated by trained female personnel. Results All respondents had undergone FGM, most between 10 and 14 years of age. Complications were reported by 218 respondents (84.5%), the most common ones being excessive bleeding, delay in or incomplete healing, and tenderness. Fever was significantly more often reported by girls who had undergone FGM before 10 years of age compared with those who had undergone the procedure later. Out of those who reported complications, 187 (85.8%) sought treatment, with 89 of them visiting a traditional healer, 75 a Sowei (traditional circumciser), and 16 a health professional. Conclusion The high prevalence rate of FGM and the proportion of medical complications show that FGM is a matter for public health concern in Sierra Leone. Girls who undergo FGM before 10 years of age seem to be more vulnerable to serious complications than those who are older at the time of FGM. It is important that health care personnel are aware of, and look for possible complications from FGM, and encourage girls and women to seek medical care for their problems. PMID:22870046

  6. Female genital mutilation among Iraqi Kurdish women: a cross-sectional study from Erbil city.

    Science.gov (United States)

    Yasin, Berivan A; Al-Tawil, Namir G; Shabila, Nazar P; Al-Hadithi, Tariq S

    2013-09-08

    Iraqi Kurdistan region is one of the areas where female genital mutilation is reportedly widely practiced but inadequately studied. The aim of this study was to determine (i) the prevalence of female genital mutilation among Muslim Kurdish women in Erbil city, (ii) the patterns and types of female genital mutilation, (iii) the factors associated with this practice and (iv) women's knowledge and attitudes towards this practice. A cross-sectional study was conducted in the primary health care centers and the Maternity Teaching Hospital in Erbil city, involving 1987 women aged 15-49 years. Data were obtained about female genital mutilation status and knowledge and perception towards this practice. The participants were clinically examined to verify the self-reported female genital mutilation status. The self-reported prevalence of female genital mutilation was 70.3%, while it was 58.6% according to clinical examination of the women's genitalia. The most common type of female genital mutilation was type I (99.6%) and the most common age at which mutilation was performed was 4-7 years (60.2%). This practice was mostly performed by traditional birth attendants (72.5%). Only 6.4% of mutilated women reported having complications after mutilation, most commonly bleeding (3.6%). The practice was more reported among housewives (OR = 3.3), those women whose mothers were mutilated (OR = 15.1) or with unknown mutilation status (OR = 7.3) and those women whose fathers were illiterate (OR = 1.4) or could only read and write (OR = 1.6). The common reasons for practicing female genital mutilation were cultural tradition (46.7%) and dictate of religion (38.9%). Only 30% of the participants were aware about the health consequences of female genital mutilation. More than one third (36.6%) of the women support the practice and 34.5% have intention to mutilate their daughters. Prevalence of female genital mutilation among Muslim Kurdish women in Erbil city is very

  7. Nurses and requests for female genital mutilation: cultural rights versus human rights.

    Science.gov (United States)

    Sala, R; Manara, D

    2001-05-01

    In this article we focus on female genital mutilation. We analyse this problem as one of the most important issues of multiculturalism, which is also coming to the attention of the public in Italy as a consequence of the growing number of immigrants from African countries. The fundamental problem is about the acceptability of this practice: can female genital mutilation be permitted and, if so, on what basis? We will try to cope with this as a genuine conflict between culture-relative values and universal values, such as human rights. Some attention will be drawn to Italian law. Finally, the impact on nurses of requests for genital mutilation will be described.

  8. Isolated vasculitis involving the female genital tract: clinicopathologic spectrum and phenotyping of inflammatory cells.

    Science.gov (United States)

    Abu-Farsakh, H; Mody, D; Brown, R W; Truong, L D

    1994-06-01

    Isolated vasculitis involving the female genital tract (IVF) is rare. Although both giant cell arteritis (GCA) and polyarteritis nodosa (PAN) types of involvement have been documented, several clinicopathologic features of IVF are not clearly understood. We wish to report two cases of IVF (one GCA and one PAN) and compare them with previously reported cases. Including our two cases, we found a total of 33 reported cases of IVF, which included 18 GCA and 15 PAN. In cases of GCA, all parts of the female genital tract were involved with roughly comparable frequency, whereas in the case of PAN, the cervix is uniformly involved, with the vulva and myometrium being affected once and twice, respectively. In all cases of GCA and most cases of PAN, the vasculitis represented an incidental finding upon microscopic examination of the female genital tract removed for unrelated problems; however, in one case of PAN, vaginal bleeding probably related to vasculitis-induced cervical ulcer was reported. In either category, no clearcut pattern of predisposing factors was identified and, at the time of diagnosis, none of the patients had any diseases known to be associated with vasculitis, such as connective tissue disease, rheumatoid arthritis, or drug hypersensitivity. Although antineutrophilic cytoplasmic antibodies were recently described as sensitive and specific markers for systemic vasculitis, tests for these antibodies were not done on previously reported cases and were negative for both current cases. Long-term follow-up in IVF indicates that even without any specific treatment for vasculitis, systemic involvement did not occur.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Female genital mutilation in children presenting to Australian paediatricians.

    Science.gov (United States)

    Zurynski, Yvonne; Phu, Amy; Sureshkumar, Premala; Cherian, Sarah; Deverell, Marie; Elliott, Elizabeth J

    2017-06-01

    The WHO reports that female genital mutilation/cutting (FGM/C) is an ancient cultural practice prevalent in many countries. FGM/C has been reported among women resident in Australia. Our paper provides the first description of FGM/C in Australian children. Cross-sectional survey conducted in April-June 2014. Paediatricians and other child health specialists recruited through the Australian Paediatric Surveillance Unit were asked to report children aged <18 years with FGM/C seen in the last 5 years, and to provide data for demographics, FGM/C type, complications and referral for each case. Of 1311 eligible paediatricians/child health specialists, 1003 (76.5%) responded. Twenty-three (2.3%) respondents had seen 59 children with FGM/C and provided detailed data for 31. Most (89.7%) were identified during refugee screening and were born in Africa. Three (10.3%) were born in Australia: two had FGM/C in Australia and one in Indonesia. All parents were born overseas, mainly Africa (98.1%). Ten children had WHO FGM/C type I, five type II, five type III and six type IV. Complications in eight children included recurrent genitourinary infections, menstrual, sexual, fertility and psychological problems. Nineteen children (82.6%) were referred to obstetrics/gynaecology: 16 (69.9%) to social work and 13 (56.5%) to child protection. This study confirms that FGM/C is seen in paediatric clinical practice within Australia. Paediatricians need cultural awareness, education and resources to help them identify children with FGM/C and/or at risk of FGM/C, to enable appropriate referral and counselling of children, families and communities to assist in the prevention of this practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. [Algorithm for the prevention of female genital mutilation. Case study from primary care].

    Science.gov (United States)

    Alcón Belchí, Carolina; Jiménez Ruiz, Ismael; Pastor Bravo, María del Mar; Almansa Martínez, Pilar

    2016-03-01

    Create and implement a protocol for identifying and preventing female genital mutilation in a municipality of the Region of Murcia. A bibliographical review and significant databases were consulted for the creation of the algorithm performance. These include Cuiden, Dialnet, Medes, Medline, and other documentary sources of interest. The instrument for data collection was completed by interviewing parents of girls at risk. The multi-disciplinary team was formed; the female genital mutilation risk cases were collected, and were summoned to the nursing consulting room. Two girls had been mutilated, the rest were at risk of female genital mutilation, and in one case the risk was imminent. The algorithm designed guides practitioners in their performance, achieving an effective detection and prevention of genital mutilation of girls. This is a first approach to the development of a regional protocol. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  11. Male genital morphology and its influence on female mating preferences and paternity success in guppies.

    Directory of Open Access Journals (Sweden)

    Clelia Gasparini

    Full Text Available In internally fertilizing species male genitalia often show a higher degree of elaboration than required for simply transferring sperm to females. Among the hypotheses proposed to explain such diversity, sexual selection has received the most empirical support, with studies revealing that genital morphology can be targeted by both pre-and postcopulatory sexual selection. Until now, most studies have focused on these two episodes of selection independently. Here, we take an alternative approach by considering both components simultaneously in the livebearing fish, Poecilia reticulata. We allowed females to mate successively (and cooperatively with two males and determined whether male genital length influenced the female's propensity to mate with a male (precopulatory selection, via female choice and whether male genital size and shape predicted the relative paternity share of subsequent broods (postcopulatory selection, via sperm competition/cryptic female choice. We found no evidence that either episode of sexual selection targets male genital size or shape. These findings, in conjunction with our recent work exposing a role of genital morphology in mediating unsolicited (forced matings in guppies, further supports our prior speculation that sexual conflict may be an important broker of genital evolution in this species.

  12. Male Genital Morphology and Its Influence on Female Mating Preferences and Paternity Success in Guppies

    Science.gov (United States)

    Gasparini, Clelia; Pilastro, Andrea; Evans, Jonathan P.

    2011-01-01

    In internally fertilizing species male genitalia often show a higher degree of elaboration than required for simply transferring sperm to females. Among the hypotheses proposed to explain such diversity, sexual selection has received the most empirical support, with studies revealing that genital morphology can be targeted by both pre-and postcopulatory sexual selection. Until now, most studies have focused on these two episodes of selection independently. Here, we take an alternative approach by considering both components simultaneously in the livebearing fish, Poecilia reticulata. We allowed females to mate successively (and cooperatively) with two males and determined whether male genital length influenced the female's propensity to mate with a male (precopulatory selection, via female choice) and whether male genital size and shape predicted the relative paternity share of subsequent broods (postcopulatory selection, via sperm competition/cryptic female choice). We found no evidence that either episode of sexual selection targets male genital size or shape. These findings, in conjunction with our recent work exposing a role of genital morphology in mediating unsolicited (forced) matings in guppies, further supports our prior speculation that sexual conflict may be an important broker of genital evolution in this species. PMID:21799825

  13. Innate immunity and the sensing of infection, damage and danger in the female genital tract.

    Science.gov (United States)

    Sheldon, Iain Martin; Owens, Siân-Eleri; Turner, Matthew Lloyd

    2017-02-01

    Tissue homeostasis in the female genital tract is challenged by infection, damage, and even physiological events during reproductive cycles. We propose that the evolutionarily ancient system of innate immunity is sufficient to sense and respond to danger in the non-pregnant female genital tract. Innate immunity produces a rapidly inducible, non-specific response when cells sense danger. Here we provide a primer on innate immunity and discuss what is known about how danger signals are sensed in the endometrium and ovary, the impact of inflammatory responses on reproduction, and how endocrinology and innate immunity are integrated. Endometrial epithelial and stromal cells, and ovarian granulosa cells express pattern recognition receptors, similar to cells of the innate immune system. These pattern recognition receptors, such as the Toll-like receptors, bind pathogen-associated or damage-associated molecular patterns. Activation of pattern recognition receptors leads to inflammation, recruitment of immune cells from the peripheral circulation, and phagocytosis. Although the inflammatory response helps maintain or restore endometrial health, there may also be negative consequences for fertility, including perturbation of oocyte competence. The intensity of the inflammatory response reflects the balance between the level of danger and the systems that regulate innate immunity, including the endocrine environment. Understanding innate immunity is important because disease and inappropriate inflammatory responses in the endometrium or ovary cause infertility. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Female genital mutilation: a hidden epidemic (statement from the European Academy of Paediatrics).

    Science.gov (United States)

    Sauer, Pieter J J; Neubauer, David

    2014-02-01

    Female genital mutilation or female circumcision is frequently performed worldwide. It is estimated by the World Health Organisation that worldwide, 100-140 million girls and women currently have to live with the consequences of female genital mutilation. The article argues that the tradition is one of the causes, while another four possible reasons for undergoing such cruel mutilation of young girls exist. Today, there exists a classification of at least four different ways of such mutilation which has no health benefits, and it harms girls and women in many ways. Long-term consequences like recurrent urinary tract infections, dysmenorrhea, sexual problems, infertility and complications both for the mother and infant at delivery are mentioned. Female genital mutilation is a violation of the fundamental human rights, as well as a savage breach of the integrity and personality. The European Academy of Paediatrics advises its members to initiate appropriate counselling for parents and female adolescents regarding the risk of female genital mutilation and strongly condemns female genital mutilation and councils its members not to perform such procedures.

  15. QTL for the species-specific male and female genital morphologies in Ohomopterus ground beetles.

    Science.gov (United States)

    Sasabe, Masataka; Takami, Yasuoki; Sota, Teiji

    2010-12-01

    Animals with internal fertilization often exhibit marked diversification in genital morphology among closely related species. However, our knowledge of the genetic architecture underlying genital evolution is still limited. We constructed genetic linkage maps and analysed quantitative trait loci (QTL) for F(2) hybrids of two closely related species of the carabid beetles Carabus (Ohomopterus) iwawakianus and C. (O.) maiyasanus, which show matching male and female genital shapes within species, but marked differences in genital morphologies between species. The linkage maps comprised both amplified fragment length polymorphism and microsatellite markers. Composite interval mapping to detect QTL for three traits of male copulatory piece (length, width, weight) and two traits for female vaginal appendix (length, width) resulted in the detection of one to five significant QTL for each trait. The QTL explained large proportions of phenotypic variance. Thus, the interspecific difference in the genital morphologies appeared to be determined by relatively small numbers of genes with large genetic effects. QTL of different traits for the same or different sexes co-occurred on five of eight linkage groups with significant QTL; in particular, three QTL for different male and female genital traits occurred almost at the same position. Each of the male genital traits showed uniform signs of additive genetic effects, suggesting that directional selection has led to species-specific morphologies. However, the signs of additive genetic effects in each female genital trait were not uniform, suggesting that coevolution between sexes is not necessarily concerted. This result requires further assessment because the sample size of F(2) females was small. © 2010 Blackwell Publishing Ltd.

  16. Female genital mutilation of a karyotypic male presenting as a female with delayed puberty

    Directory of Open Access Journals (Sweden)

    Gisselsson D

    2006-03-01

    Full Text Available Abstract Background Female genital mutilation (FGM is commonly practiced mainly in a belt reaching from East to West Africa north of the equator. The practice is known across socio-economic classes and among different ethnic, religious, and cultural groups. Few studies have been appropriately designed to measure the health effects of FGM. However, the outcome of FGM on intersex individuals has never been discussed before. Case presentation The patient first presented as a female with delayed puberty. Hormonal analysis revealed a normal serum prolactin level of 215 Mu/L, a low FSH of 0.5 Mu/L, and a low LH of 1.1 Mu/L. Type IV FGM (Pharaonic circumcision had been performed during childhood. Chromosomal analysis showed a 46, XY karyotype and ultrasonography verified a soft tissue structure in the position of the prostate. Conclusion FGM pose a threat to the diagnosis and management of children with abnormal genital development in the Sudan and similar societies.

  17. Condition dependence of male and female genital structures in the seed beetle Callosobruchus maculatus (Coleoptera: Bruchidae).

    Science.gov (United States)

    Cayetano, L; Bonduriansky, R

    2015-07-01

    Theory predicts that costly secondary sexual traits will evolve heightened condition dependence, and many studies have reported strong condition dependence of signal and weapon traits in a variety of species. However, although genital structures often play key roles in intersexual interactions and appear to be subject to sexual or sexually antagonistic selection, few studies have examined the condition dependence of genital structures, especially in both sexes simultaneously. We investigated the responses of male and female genital structures to manipulation of larval diet quality (new versus once-used mung beans) in the bruchid seed beetle Callosobruchus maculatus. We quantified effects on mean relative size and static allometry of the male aedeagus, aedeagal spines, flap and paramere and the female reproductive tract and bursal spines. None of the male traits showed a significant effect of diet quality. In females, we found that longer bursal spines (relative to body size) were expressed on low-quality diet. Although the function of bursal spines is poorly understood, we suggest that greater bursal spine length in low-condition females may represent a sexually antagonistic adaptation. Overall, we found no evidence that genital traits in C. maculatus are expressed to a greater extent when nutrients are more abundant. This suggests that, even though some genital traits appear to function as secondary sexual traits, genital traits do not exhibit heightened condition dependence in this species. We discuss possible reasons for this finding. © 2015 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2015 European Society For Evolutionary Biology.

  18. Spatial modelling and mapping of female genital mutilation in Kenya

    Science.gov (United States)

    2014-01-01

    Background Female genital mutilation/cutting (FGM/C) is still prevalent in several communities in Kenya and other areas in Africa, as well as being practiced by some migrants from African countries living in other parts of the world. This study aimed at detecting clustering of FGM/C in Kenya, and identifying those areas within the country where women still intend to continue the practice. A broader goal of the study was to identify geographical areas where the practice continues unabated and where broad intervention strategies need to be introduced. Methods The prevalence of FGM/C was investigated using the 2008 Kenya Demographic and Health Survey (KDHS) data. The 2008 KDHS used a multistage stratified random sampling plan to select women of reproductive age (15–49 years) and asked questions concerning their FGM/C status and their support for the continuation of FGM/C. A spatial scan statistical analysis was carried out using SaTScan™ to test for statistically significant clustering of the practice of FGM/C in the country. The risk of FGM/C was also modelled and mapped using a hierarchical spatial model under the Integrated Nested Laplace approximation approach using the INLA library in R. Results The prevalence of FGM/C stood at 28.2% and an estimated 10.3% of the women interviewed indicated that they supported the continuation of FGM. On the basis of the Deviance Information Criterion (DIC), hierarchical spatial models with spatially structured random effects were found to best fit the data for both response variables considered. Age, region, rural–urban classification, education, marital status, religion, socioeconomic status and media exposure were found to be significantly associated with FGM/C. The current FGM/C status of a woman was also a significant predictor of support for the continuation of FGM/C. Spatial scan statistics confirm FGM clusters in the North-Eastern and South-Western regions of Kenya (p < 0.001). Conclusion This suggests that the

  19. [Female genital prolapse surgery using ultra lightweight polypropylene mesh].

    Science.gov (United States)

    Filimonov, V B; Vasin, R V; Vasina, I V; Kaprin, A D; Kostin, A A

    2017-06-01

    To compare the results of female genital prolapse (FGP) surgery via vaginal access using lightweight and ultra-lightweight polypropylene mesh. From 2007 to 2011, 93 women aged from 46 to 71 years with II-IV stage FGP (POP-Q classification) were examined and underwent the vaginal extra-peritoneal colpopexy using polypropylene implants in the Department of Urology. Patients were divided into 2 groups. In patients of group 1 (n=50) the surgery was performed according to a newly developed technique using perforated ultra-lightweight (surface density 19 g/m2) domestically manufactured polypropylene implant. In group 2, a standard trocar set with light (surface density of 42.7 g/m2) foreign-made polypropylene implants was used. Long-term follow-up was from 1 to 5 years. General surgical complications (urinary bladder injury, blood loss over 300 ml, perineal and vaginal hematomas) were detected in 2 (4%) patients of group 1 and in 7 (16.3%) patients of group 2. The most common specific mesh-related complication was the vaginal wall erosion, which was observed in 4 (9.3%) patients of group 2 and in 1 (2%) patient of group 1. FGP recurrence was diagnosed in 5 (10%) patients of group 1 in the non-treated part and in 8 (18.6%) patients of group 2. Three patients (7%) in group 2 developed recurrent cystocele due to the shrinkage of the mesh implant which was not observed in group 1. At 12 month follow-up, the results of FGP surgical treatment were estimated as good (full functional recovery and no FGP recurrence) in 41 (82%) and 32 (74.4%) patients of groups 1 and 2, respectively. We have developed a method of vaginal extra-peritoneal colpopexy using a perforated ultra-lightweight polypropylene implant. This technique has resulted in the absence of recurrence in the treated part of FGP, and 4.1, 4.2 and 4.7 fold reductions in the incidence of general surgical complications, vaginal wall erosions and perineal and vaginal hematomas, respectively, compared with FGP patients

  20. The Frequency and Pattern of Female Genital Tract Malignancies at ...

    African Journals Online (AJOL)

    The data were analyzed using SPSS version 12 (SPSS Inc., Chicago, IL, USA) and the results expressed in descriptive statistics by simple percentages. Results: One hundred and sixty six (166) cases of genital malignancies were recorded during the 6‑year review. Majority of the patients were in the fifth and sixth decades ...

  1. Lymphomas of the female genital tract in Ibadan | Odukogbe ...

    African Journals Online (AJOL)

    Study Design: Records of subjects were analysed for their sociodemographic and clinicopathological characteristics, recruiting only those who satisfy the criteria for diagnosing genital tract lymphomas according to Kosari et al1. Retrievable archival paraffin blocks of subjects were also analysed using immunophenotyping.

  2. Visceral Effect of Female Genital Mutilation as Explained by Married ...

    African Journals Online (AJOL)

    These included self-reproach, poor self-image, painful menstrual periods and severe bleeding. Men whose partners were genitally mutilated confirmed that their wives faced these challenges. Based on these findings, it is recommended that counselling and education should be given to groups that still enforce this practice.

  3. Prevalence of female genital mutilation among female infants in Kano, Northern Nigeria.

    Science.gov (United States)

    Garba, I D; Muhammed, Z; Abubakar, I S; Yakasai, I A

    2012-08-01

    To determine the prevalence and type of female genital mutilation (FGM) among female infants, reasons and attitude of the mothers to the practice. A cross sectional descriptive study. Tertiary centre in Kano Northern Nigeria. A Pretested questionnaire was administered for mothers of female infants presenting for routine immunization in Aminu Kano Teaching Hospital (AKTH). A total of 250 questionnaires were administered, but only 200 were properly filled and this was used for the analysis. Prevalence and type of FGM, reason for and attitude of mothers towards FGM. Twenty-six infants had FGM during the period of study, giving a prevalence rate of 13 %. The mean age at cutting was 8 days ± 7.3. The commonest type of FGM was type I accounting for 96.2 % of the cases. Tradition/culture was the commonest reason for mutilation accounting for 73.1 %, other reasons included; religious in 11.5 %, hygienic in 11.5 % and to preserve virginity in 3.8 %. Traditional barbers were the commonest operators in 80.8 % of cases, followed by the nurse/midwife in 15.4 % of cases. The fathers were the main decision makers in 46.2 %, followed by both parents in 26.9 % and grandparents in 15.4 % of the cases. 84 % of mothers were not in support of the practice. Thirteen percent of the clients would circumcise all their daughters. Forty-eight percent of the clients were of the opinion that FGM cause harm to the victims. Four percent of those whose daughters were yet to be circumcised will do so later. Female genital cutting is still practiced in our environment. Educational enlightenment is fundamental in changing public opinion as well as in offering reasonable alternative to FGM. Campaign against the practice of FGM should be encouraged to eradicate its practice.

  4. Evaluation of Body Image and Sexual Satisfaction in Women Undergoing Female Genital Plastic/Cosmetic Surgery

    OpenAIRE

    Goodman, Michael P; Placik, Otto J; Matlock, David L; Simopoulos, Alex F; Dalton, Teresa A; Veale, David; Hardwick-Smith, Susan

    2016-01-01

    BACKGROUND: Little prospective data exists regarding the procedures constituting female genital plastic/cosmetic surgery (FGPS).OBJECTIVES: To evaluate whether the procedures of labiaplasty and vaginoperineoplasty improve genital self image, and evaluate effects on sexual satisfaction.METHODS: Prospective cohort case-controlled study of 120 subjects evaluated at baseline, 6, 12, and 24 months postoperative, paired with a demographically similar control group. Interventions include labiaplasty...

  5. Evolution of external female genital mutilation: why do males harm their mates?

    Science.gov (United States)

    Mouginot, Pierick; Uhl, Gabriele; Fromhage, Lutz

    2017-11-01

    Sperm competition may select for male reproductive traits that influence female mating or oviposition rate. These traits may induce fitness costs to the female; however, they may be costly for the males as well as any decrease in female fitness also affects male fitness. Male adaptations to sperm competition manipulate females by altering not only female behaviour or physiology, but also female morphology. In orb-weaving spiders, mating may entail mutilation of external structures of the female genitalia, which prevents genital coupling with subsequent males. Here, we present a game theoretical model showing that external female genital mutilation is favoured even under relatively high costs of mutilation, and that it is favoured by a high number of mate encounters per female and last-male sperm precedence.

  6. Estradiol-treated female mice as surrogate hosts for Neisseria gonorrhoeae genital tract infections

    Directory of Open Access Journals (Sweden)

    Ann E. Jerse

    2011-07-01

    Full Text Available Historically, animal modeling of gonorrhea has been hampered by the exclusive adaptation of Neisseria gonorrheae to humans. Genital tract infection can be established in female mice that are treated with 17β-estradiol, however, and many features of experimental murine infection mimic human infection. Here we review the colonization kinetics and host response to experimental murine gonococcal infection, including mouse strain differences and evidence that IL-17 responses, TLR4, and T-regulatory cells play a role in infection. We also discuss the strengths and limitations of the mouse system and the potential of transgenic mice to circumvent host restrictions. Additionally, we review studies with genetically defined mutants that demonstrate a role for sialyltransferase and the MtrC-MtrD-MtrE active efflux pump in evading innate defenses in vivo, but not for several factors hypothesized to protect against the phagocytic respiratory burst and H2O2-producing lactobacilli. Experimental infection of estradiol-treated mice has also revealed the existence of non-host restricted iron sources in the female genital tract and the influence of hormonal factors on colonization kinetics and selection for opacity (Opa protein expression. Recent work by others with estradiol-treated mice that are transgenic for human carcinoembryonic adhesion molecules (CEACAMs supports a role for Opa proteins in enhancing cellular attachment and thus reduced shedding of N. gonorrhoeae. Finally we discuss the use of the mouse model in product testing and a recently developed gonorrhea chlamydia coinfection model.

  7. Reconstructive surgery for female genital mutilation starts sexual functioning in Sudanese woman: a case report.

    Science.gov (United States)

    Fazari, Atif B E; Berg, Rigmor C; Mohammed, Wafaa A; Gailii, Enas B; Elmusharaf, Khalifa

    2013-11-01

    Female genital mutilation (FGM) involves the partial or complete removal of the external female genitalia and/or other injury to the female genital organs whether for cultural or other nontherapeutic reasons. The study aims to describe the method of and findings from reconstructive surgery for FGM victims. We present a case of a 24-year-old Sudanese female, who had undergone ritual FGM type III as a young girl. She had suffered from a large, vulval mass for the last 6 years and came to the clinic because of apareunia. We performed mass excision and reconstructive surgery of the mutilated genital tissue. The giant mass was successfully removed. Remaining genital tissues were approximated and sutured, with hemostasis assured for the reconstructed organs on each side. Reconstructive surgery for women who suffer sexual consequences from FGM is feasible, with a high degree of client acceptance and satisfaction. It restores some of women's natural genital anatomy, and offers the potential for improved female sexuality. © 2013 International Society for Sexual Medicine.

  8. Searching for "voices": feminism, anthropology, and the global debate over female genital operations.

    Science.gov (United States)

    Walley, C J

    1997-08-01

    This article lays the groundwork for a feminist and anthropological political response to female genital "operations" that transcends the current debate over the phenomenon, which is couched in terms of cultural relativism or of politically-informed outrage. After an introduction, the study considers the politics involved in assigning a name to the procedure and explains the author's reason for choosing female genital "operation" over the more commonly used "circumcision," "mutilation," or "torture." In the next section, clitoridectomy is contextualized through a recounting of the circumstances under which the procedure was performed in the western Kenyan village of Kikhome in 1988. This discussion focuses on the ceremonies surrounding the circumcisions of young men and women, the author's attempts to discover how the young women involved really felt about the tradition, and a review of the anthropological literature on the significance and impact of these practices. The analysis then examines the international controversy surrounding female genital mutilation and provides an overview of the colonial discourse on female genital mutilation in Africa to expose 1) the origins of justifications for colonial dominance in the dominance of non-Western women by non-Western men and 2) the fact that use of cultural arguments that fuse women and tradition can support culturally-defined power relationships. The article concludes with a consideration of who is qualified to speak out against female genital mutilation given the fact that all women and all debates are the products of longstanding, tenacious power relationships.

  9. Female genital mutilation and monandry in an orb-web spider.

    Science.gov (United States)

    Nakata, Kensuke

    2016-02-01

    Monandry, in which a female has only one mating partner during the reproductive period, is established when a female spontaneously refrains from re-mating, or when a partner male interferes with the attempts of a female to mate again. In the latter case, however, females often have countermeasures against males, which may explain why polyandry is ubiquitous. Here, I demonstrate that the genital appendage, or scape, of the female orb-web spider (Cyclosa argenteoalba) is injured after her first mating, possibly by her first male partner. This female genital mutilation (FGM) permanently precludes copulation, and females appear to have no countermeasures. FGM is considered to confer a strong advantage to males in sexual conflicts over the number of female matings, and it may widely occur in spiders. © 2016 The Author(s).

  10. Evaluation of Body Image and Sexual Satisfaction in Women Undergoing Female Genital Plastic/Cosmetic Surgery.

    Science.gov (United States)

    Goodman, Michael P; Placik, Otto J; Matlock, David L; Simopoulos, Alex F; Dalton, Teresa A; Veale, David; Hardwick-Smith, Susan

    2016-10-01

    Little prospective data exists regarding the procedures constituting female genital plastic/cosmetic surgery (FGPS). To evaluate whether the procedures of labiaplasty and vaginoperineoplasty improve genital self image, and evaluate effects on sexual satisfaction. Prospective cohort case-controlled study of 120 subjects evaluated at baseline, 6, 12, and 24 months postoperative, paired with a demographically similar control group. Interventions include labiaplasty, clitoral hood reduction, and/or aesthetic vaginal tightening, defined as perineoplasty + "vaginoplasty" (aka "vaginal rejuvenation."). Outcome measures include body image, genital self-image, sexual satisfaction, and body esteem. As a group, study patients tested at baseline showing body dissatisfaction, negative genital self-image, and poorer indices of sexual satisfaction. Preoperative body image of study patients were in a range considered to be mild to moderately dysmorphic, but matched controls at one and two years; genital self-image scores at entry were considerably lower than controls, but by 2-year follow-up had surpassed control value at entry. Similarly, sexual satisfaction values, significantly lower at entry, equaled at one, and surpassed control values, at 2 years. Postoperatively, at all points in time, these differences in body image and genital self-image disappeared, and sexual satisfaction markedly improved. Overall body esteem did not differ between study and control groups, with the exception of the genital esteem quotient, which improved after surgery. Women requesting and completing FGPS, when tested by validated instruments, at entry report sexual dissatisfaction and negative genital self-image. When tested at several points in time after surgery up to two years, these findings were no longer present. When performed by an experienced surgeon, FGPS appears to provide sexual and genital self-image improvement. 2 Therapeutic. © 2016 The American Society for Aesthetic Plastic Surgery

  11. Correction of Free Radical Lipid Oxidation in Internal Female Genital Inflammatory Diseases

    Directory of Open Access Journals (Sweden)

    A. D. Belyaevsky

    2008-01-01

    Full Text Available The paper descries a specific view on the mechanism responsible for development of the resistance of an inflammatory process in the female genital tract to drugs and on the role of a free radical process activation factor in the pathogenesis of the disease. Emphasis is laid on the importance of measures to diminish cell membrane permeability, by correcting their structural and functional states with antioxidants. Key words: inflammatory processes in the female genital organs, lipid peroxidation, antioxidative defense, cell membrane structural and functional state.

  12. Towards a solution concerning female genital mutilation? An approach from within according to Islamic legal opinions

    Directory of Open Access Journals (Sweden)

    Jens Kutscher

    2011-01-01

    Full Text Available Female circumcision is a tradition that is widespread and not restricted to predominantly Muslim countries. It is prevalent among all religious groups in many parts of Africa and Western Asia, whether they are Coptic Christians, Ethiopian Jews, or Arab Muslims. Female genital cutting or—more to the point—female genital mutilation (FGM, generally referred to as circumcision, occurs in at least five different forms. Circumcision is essentially a powerful bodily sign of the human—male and female—covenant with God. In the Quran it is reaffirmed in sura al-Nahl and quoted as example in the fatwas endorsing circumcision. It seems to be true that men are hardly involved in the actual decision in favour of female genital cutting. A man should not interfere in the decision of women to be circumcised. It is practiced and transmitted among women and midwives. Only sometimes is a (male or female physician involved. On the basis of Islamic normativity, mirrored in fatwas, this paper aims to examine a very ambivalent approach concerning female genital mutilation.

  13. Hysterosalpingographic Appearances of Female Genital Tract Tuberculosis: Part I. Fallopian Tube

    Directory of Open Access Journals (Sweden)

    Firoozeh Ahmadi

    2014-01-01

    Full Text Available Female genital tuberculosis (TB remains as a major cause of tubal obstruction leading to infertility, especially in developing countries. The global prevalence of genital tuberculosis has increased during the past two decades due to increasing acquired immunodeficiency syndrome (AIDS. Genital TB is commonly asymptomatic, and it is diagnosed during infertility investigations. Despite of recent advances in imaging tools, such as computerized tomography (CT scan, magnetic resonance imaging (MRI and ultrasongraphy, hysterosalpingography is still the standard screening test for evaluation of tubal infertility and a valuable tool for diagnosis of female genital tuberculosis. Tuberculosis gives rise to various appearances on hysterosalpingography (HSG from non-specific changes to specific findings. The present pictorial review illustrates and describes specific and non-specific radiographic features of female genital tuberculosis in two parts. Part I presents specific findings of tuberculosis related to tubes such as "beaded tube", "golf club tube", "pipestem tube", "cobble stone tube" and "leopard skin tube". Part II describes adverse effects of tuberculosis on structure of endometrium and radiological specific findings such as "dwarfed" uterus with lymphatic intravasation and occluded tubes, "T-shaped" tuberculosis uterus, "pseudounicornuate" uterus and "Collar-stud abscess", which have not been encountered in the majority of non-tuberculosis cases.

  14. Female genital mutilation among mothers and daughters in Harar, eastern Ethiopia.

    Science.gov (United States)

    Oljira, Teshome; Assefa, Nega; Dessie, Yadeta

    2016-12-01

    To assess the practice of female genital mutilation (FGM) among mothers and daughters, and to investigate sociodemographic factors influencing the practice of FGM in Harar, Ethiopia. A community-based cross-sectional study was conducted among women aged 15 years or older who had at least one living daughter younger than 12 years via the Harar Health and Demographic Surveillance System 2013. Data were collected through face-to-face interviews. The practice of FGM was compared between mothers and their daughters. Whether the daughter had undergone FGM was included as an outcome variable in bivariate and multivariate analyses. Among 842 mothers, 669 (79.5%) reported that they had undergone FGM themselves, and 160 (19.0%) that their daughter had undergone FGM. Traditional practitioners were said to be the major performers of FGM by 151 (94.4%) mothers. Mothers whose daughter was mutilated mentioned social acceptance (144 [90.0%] women) and better marriage prospects (96 [60.0%]) as the major benefits. Genital mutilation of daughters was significantly associated with maternal age, education to grade 1-4, and FGM experience. Amhara ethnic origin was significantly associated with a reduced likelihood of FGM among daughters. Over one generation, the incidence of FGM has reduced. Increasing advocacy against FGM and enforcement of law should be emphasized. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Microbial Composition Predicts Genital Tract Inflammation and Persistent Bacterial Vaginosis in South African Adolescent Females.

    Science.gov (United States)

    Lennard, Katie; Dabee, Smritee; Barnabas, Shaun L; Havyarimana, Enock; Blakney, Anna; Jaumdally, Shameem Z; Botha, Gerrit; Mkhize, Nonhlanhla N; Bekker, Linda-Gail; Lewis, David A; Gray, Glenda; Mulder, Nicola; Passmore, Jo-Ann S; Jaspan, Heather B

    2018-01-01

    Young African females are at an increased risk of HIV acquisition, and genital inflammation or the vaginal microbiome may contribute to this risk. We studied these factors in 168 HIV-negative South African adolescent females aged 16 to 22 years. Unsupervised clustering of 16S rRNA gene sequences revealed three clusters (subtypes), one of which was strongly associated with genital inflammation. In a multivariate model, the microbiome compositional subtype and hormonal contraception were significantly associated with genital inflammation. We identified 40 taxa significantly associated with inflammation, including those reported previously ( Prevotella , Sneathia , Aerococcus , Fusobacterium , and Gemella ) as well as several novel taxa (including increased frequencies of bacterial vaginosis-associated bacterium 1 [BVAB1], BVAB2, BVAB3, Prevotella amnii , Prevotella pallens , Parvimonas micra , Megasphaera , Gardnerella vaginalis , and Atopobium vaginae and decreased frequencies of Lactobacillus reuteri , Lactobacillus crispatus , Lactobacillus jensenii , and Lactobacillus iners ). Women with inflammation-associated microbiomes had significantly higher body mass indices and lower levels of endogenous estradiol and luteinizing hormone. Community functional profiling revealed three distinct vaginal microbiome subtypes, one of which was characterized by extreme genital inflammation and persistent bacterial vaginosis (BV); this subtype could be predicted with high specificity and sensitivity based on the Nugent score (≥9) or BVAB1 abundance. We propose that women with this BVAB1-dominated subtype may have chronic genital inflammation due to persistent BV, which may place them at a particularly high risk for HIV infection. Copyright © 2017 American Society for Microbiology.

  16. Female genital mutilation and its effects: Implications for counselling ...

    African Journals Online (AJOL)

    This study tried to establish if there is any relationship between promiscuity and FGM, if circumcised females suffer depression more than the uncircumcised females and, if circumcised females have less difficulty than their uncircumcised counterparts in becoming sexually aroused and attaining orgasm. Three null ...

  17. Pattern of female genital tract malignancy at the University of Nigeria ...

    African Journals Online (AJOL)

    Results: Relative frequency of the female genital tumours shows that cancer of the uterine cervix was the commonest with 77(65.8%). This was followed by ovarian cancer contributing 19(16.2%) , uterine cancer accounted for 15(12.8%), vulval (4.3%) and vaginal cancers(0.9%). The highest parity rate was amongst the ...

  18. Female Genital Cutting and Children's Rights: Implications for Social Work Practice

    Science.gov (United States)

    Dustin, Donna; Davies, Liz

    2007-01-01

    Female genital cutting (FGC) is an ancient practice that affects girls and young women around the world, defining the identity of women in cultures where it is practiced. FGC is carried out for a range of social and cultural reasons. The United Kingdom as a point of inward migration receives families from countries and cultures where FGC is the…

  19. Rwandan female genital modification: elongation of the Labia minora and the use of local botanical species

    NARCIS (Netherlands)

    Koster, M.; Price, L.L.

    2008-01-01

    The elongation of the labia minora is classified as a Type IV female genital mutilation by the World Health Organization. However, the term mutilation carries with it powerful negative connotations. In Rwanda, the elongation of the labia minora and the use of botanicals to do so is meant to increase

  20. Infant-female genital mutilation (IFGM) in cities and the role of ...

    African Journals Online (AJOL)

    It is often presumed that female genital mutilation (FGM) is only a rural phenomenon but in recent times, FGM persists in most cities in Nigeria. Its persistence in most Nigerian cities seems to be as a result of the post partum birthing rituals known as omugwo among eastern Nigerians. Empirical data was collected through ...

  1. Key points for abolishing Female Genital Mutilation from the perspective of the men involved.

    Science.gov (United States)

    Ruiz, Ismael Jiménez; Martínez, Pilar Almansa; Del Mar Pastor Bravo, María

    2016-03-01

    female Genital Mutilation is internationally considered an affront on human rights and an act of violence against women and young girls. Furthermore, it hierarchises and perpetuates inequality and denies the right to bodily and psychosocial integrity of women and young girls. to detect the key points for the abolition of Female Genital Mutilation as well as the necessary resources for its eradication. a qualitative methodology with an ethnonursing perspective, via semi-structured interviews, held both individually and in groups, in 21 men familiar with Female Genital Mutilation. through the voices of men familiar with this tradition, five key points are presented for its gradual eradication: sensitisation and awareness building, team action, abolition-promoting media, focusing action on rural areas and applying educational means before punitive ones. awareness-raising via the combined efforts of families, communities and governments, together with the promotion of health education programmes in demonstrating the complications derived from this practice, play a vital part in eradicating Female Genital Mutilation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Female Genital Mutilation: Proposals for Change. Minority Rights Group International Report. [Revised].

    Science.gov (United States)

    Dorkenoo, Efua; Elworthy, Scilla

    In Africa today, women's voices are being raised against female genital mutilation. Inspired by the United Nations Decade for Women, this report seeks to present information in a logical, coherent manner to stimulate support for eradication of the practice. It describes steps African governments, Western states, and international agencies can take…

  3. Trends in the prevalence of female genital muti-lation and its effect ...

    African Journals Online (AJOL)

    Rational: Female genital mutilation (FGM) is prevalent in northern Ghana, as the practice is seen as a passage rite to women adulthood and thus undertaken just before marriage. Objectives: We determined the changes in trend of FGM in deliveries at the Navrongo War Memo-rial hospital, and compared the outcomes and ...

  4. A study of female genital swabs in primary health care centres in Jos, Nigeria

    Directory of Open Access Journals (Sweden)

    Samuel Nwadioha

    2011-03-01

    Full Text Available Objective: To detect some common microbial agents of female genital discharges in order to improve the current syndromic management of abnormal vaginal discharge. Methods: A prospective study of female genital swabs collected from Primary Health Care Centres, Jos, and analysed for microscopy, culture and sensitivity in Jos University Teaching Hospital, December 2006 to December 2007 was carried out. Results: Microbial agents were detected in 70% (700 of a total 1 000 female genital swabs studied. Candida species peaked with 42.0% (420 out of the 1000 samples, followed by Gardnerella vaginalis, an agent of bacterial vaginosis with 26.0%. The distribution of abnormal vaginal discharge was highest in young adults aged 21 to 30 years. Conclusions: It is concluded that abnormal vaginal discharge is most prevalent in the young sexually active age group with Candida species as the commonest agent. We recommend prevention, early diagnosis and prompt treatment of infective female genital discharge in order to reduce the menace of HIV transmission.

  5. A Study of Isolates from Female Genital Swab Specimens in a ...

    African Journals Online (AJOL)

    Infective vaginal discharge, when left untreated, is a possible risk of acquisition of HIV/AIDS as well as other complications. To detect some common microbial agents of vaginal discharge in order to improve the current syndromic management of abnormal vaginal discharge. A prospective study of female genital swabs ...

  6. Are There “Stages of Change” in the practice of Female Genital ...

    African Journals Online (AJOL)

    In recent years there has been growing interest in developing theoretical models for understanding behaviour change with respect to the practice of female genital cutting (FGC). Drawing on extensive qualitative data collected in Senegal and The Gambia, the research reported here explores whether and how theoretical ...

  7. Impact of Female Genital Mutilation on second stage of labour in ...

    African Journals Online (AJOL)

    ... 629(32.1%) were circumcised and 1332(67.9%) were uncircumcised. There was no significant difference in the mode of delivery and episiotomy. Conclusion: FGM places women at a greater risk during childbirth, endangering their health and their babies compared to uncircumcised. Key words: Female Genital Mutilation, ...

  8. SUPPORT FOR THE CONTINUATION OF FEMALE GENITAL MUTILATION AMONG ADOLESCENTS IN JIMMA ZONE, SOUTHWEST ETHIOPIA.

    Science.gov (United States)

    Mariam, Abebe G; Hailemariam, Assefa; Belachew, Tefera; Michael, Kifle W; Lindstrom, David

    2009-01-01

    Female genital mutilation/cutting is a harmful practice which has effect on female's wellbeing. However, the practice has continued to prevail in many cultures. Research on the social determinants of the practice and its continuation are scarce. The objective of this study was to assess whether attitude towards the continuation of female genital mutilation is predicted by gender role perception among adolescents in Jimma zone. This study used data collected in the first round of Jimma Longitudinal Family Survey of Youth. A total of 2084 adolescents were identified from 3700 households and one adolescent were interviewed from each household using structured questionnaire. Data on the socio-demographic characteristics, religiosity, access to electronic media, perception of gender role, attitude towards continuation of Female circumcision was collected. Descriptive and multivariate statistical techniques were used to analyze the data using SPSS for windows version 16.0. Statically tests were performed at the level of significance of 5%. Of the 2084 adolescents, 1146 (55.0%) were aged 12-14 years, 1025 (49.2%) females and 749 (35.9%) from rural areas. The majority, 1289 (61.9%) were Muslims and 1351 (64.8%) Oromo. Five hundred seventy three (28.1%) of the male youth did not agree to the importance of marrying a circumcised girl. However, 149 (13.8%) and 258 (12.7%) agreed that it is very important and important, to marry a circumcised girl, respectively. On multivariate logistic regression analysis, perception of gender role, sex, place of residence, highest education in the household and religion remained to be important predictors of attitude towards the continuation of female genital mutilation after adjustment for age and ethnicity. Adolescents who had low gender role perception were 1.4 times more likely to have a positive attitude towards the continuation of the female genital mutilation (OR: 95%CI, 1.41: 1.02-1.94). Female adolescents were 36% less likely to

  9. [The voice of women subjected to female genital mutilation in the Region of Murcia (Spain)].

    Science.gov (United States)

    Ballesteros Meseguer, Carmen; Almansa Martínez, Pilar; Pastor Bravo, María del Mar; Jiménez Ruiz, Ismael

    2014-01-01

    To explore the perceptions of a group of women who underwent female genital mutilation on the impact of this practice on their sexual and reproductive health. We performed a phenomenological qualitative study in a sample of 9 sub-Saharan Africa women, whose mean age was 30 years old and who had lived in Spain for 1 to 14 years. These women underwent genital mutilation in their countries of origin. Data was collected using a socio-demographic survey and an in-depth, structured personal interview. Subsequently, we performed a thematic discourse analysis. The discourses were grouped into four categories related to participants' perceptions of female genital mutilation. These categories were intimate relationships, pregnancy, childbirth, and social impact. The practice of female genital mutilation is maintained due to social and family pressure, transmitted from generation to generation and silenced by women themselves. This practice affects their sexual and reproductive health, as demonstrated by anorgasmia and dyspareunia. The women were satisfied with the healthcare received during pregnancy and childbirth. Nevertheless, most of them were not satisfied with family planning. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  10. Prevalence of female genital mutilation and parents' attitude among ...

    African Journals Online (AJOL)

    Specifically, it examines the current prevalence of the practice and its perception among urban working parents. The study participants consisted of 1583 female parents selected by accidental sampling technique from government offices in three urban cities of Osun State, Nigeria. The “Practice of Female Circumcision” ...

  11. Eradicating Female Genital Mutilation: Case Series Evaluating the ...

    African Journals Online (AJOL)

    2012r

    the victims intended to circumcise her daughters for cultural reasons but rescinded the decision after ... and Asia and culture remains the commonest reason; others include controlling female sexuality, guaranteeing ... as a neonate; a Christian and had two female siblings who were circumcised but without complaints.

  12. Genital examination training: assessing the effectiveness of an integrated female and male teaching programme.

    Science.gov (United States)

    McBain, Lynn; Pullon, Susan; Garrett, Sue; Hoare, Kath

    2016-11-22

    Learning to undertake intimate female and male examinations is an important part of medical student training but opportunities to participate in practical, supervised learning in a safe environment can be limited. A collaborative, integrated training programme to provide such learning was developed by two university teaching departments and a specialist sexual health service, utilising teaching associates trained for intimate examinations in a simulated clinical educational setting. The objective of this research was to determine changes in senior medical students' self- reported experience and confidence in performing male and female genital examinations, before and after participating in a new clinical teaching programme. A quasi-experimental mixed methods design, using pre and post programme questionnaires and focus groups, was used to assess the effectiveness of the programme. The students reported greatly improved skill, confidence and comfort levels for both male and female genital examination following the teaching programme. Skill, confidence and comfort regarding male examinations were rated particularly low on the pre-teaching programme self- assessment, but post-programme was rated at similar levels to the female examination. This integrated female-male teaching programme (utilising trained teaching associates as simulated patients in a supervised clinical teaching environment) was successful in increasing senior medical students' skills and levels of confidence in performing genital examinations. There were differences between female and male medical students in their learning. Suggestions for improvement included providing more detailed instruction to some clinical supervisors about their facilitation role in the session.

  13. Female genital cosmetic surgery: Investigating the role of the general practitioner.

    Science.gov (United States)

    Harding, Tristan; Hayes, Jenny; Simonis, Magdalena; Temple-Smith, Meredith

    2015-01-01

    Labiaplasty, the surgical reduction of the labia minora, has significantly increased in demand in Australia. Although general practice is one gatekeeper for patients requesting labiaplasty, as a referral is necessary to claim Medicare entitlements, there is little information available to assist general practitioners (GPs) in managing these requests for female genital cosmetic surgery. Semi-structured interviews were conducted with health professionals, including GPs, gynaecologists and plastic surgeons. Participants were recruited through the Victorian Primary Care Practice-based Research Network (VicReN), clinical teaching hospitals and snowball sampling. All interviews were digitally recorded, transcribed, and analysed using content and thematic analysis. Twenty-seven interviews were conducted. All participants were aware of genital labiaplasty; many had patients who were concerned about genital appearance, for which information had often been sought opportunistically. All participants agreed on the need for resources to inform women of normal genital appearance. This novel study demonstrates a need for clinical resources for GPs managing requests for genital labiaplasty.

  14. Variability of human immunodeficiency virus-1 in the female genital reservoir during genital reactivation of herpes simplex virus type 2.

    Science.gov (United States)

    LeGoff, J; Roques, P; Jenabian, M-A; Charpentier, C; Brochier, C; Bouhlal, H; Gresenguet, G; Frost, E; Pepin, J; Mayaud, P; Belec, L

    2015-09-01

    Clinical and subclinical genital herpes simplex virus type 2 (HSV-2) reactivations have been associated with increases in human immunodeficiency virus (HIV)-1 genital shedding. Whether HSV-2 shedding contributes to the selection of specific genital HIV-1 variants remains unknown. We evaluated the genetic diversity of genital and blood HIV-1 RNA and DNA in 14 HIV-1/HSV-2-co-infected women, including seven with HSV-2 genital reactivation, and seven without as controls. HIV-1 DNA and HIV-1 RNA env V1-V3 sequences in paired blood and genital samples were compared. The HSV-2 selection pressure on HIV was estimated according to the number of synonymous substitutions (dS), the number of non-synonymous substitutions (dN) and the dS/dN ratio within HIV quasi-species. HIV-1 RNA levels in cervicovaginal secretions were higher in women with HSV-2 replication than in controls (p0.02). Plasma HIV-1 RNA and genital HIV-1 RNA and DNA were genetically compartmentalized. No differences in dS, dN and the dS/dN ratio were observed between the study groups for either genital HIV-1 RNA or plasma HIV-1 RNA. In contrast, dS and dN in genital HIV-1 DNA were significantly higher in patients with HSV-2 genital reactivation (p genital HIV-1 DNA was slightly higher in patients with HSV-2 genital replication, indicating a trend for purifying selection (p 0.056). HSV-2 increased the genetic diversity of genital HIV-1 DNA. These observations confirm molecular interactions between HSV-2 and HIV-1 at the genital tract level. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  15. A Case of Chronic Abdominal Neuropathic Pain and Burning after Female Genital Cutting

    Directory of Open Access Journals (Sweden)

    Vicky Hadid

    2015-01-01

    Full Text Available Introduction. Female genital cutting is prevalent in the Middle Eastern and African countries. This ritual entails not only immediate complications such as infection, pain, and haemorrhage, but also chronic ones including dysmenorrhea and dyspareunia. However, there is limited data on neuropathic pain secondary to female genital mutilation when searching the literature. Case. This case discusses a 38-year-old female with a history of infibulation who presented with a chronic burning abdominal and anterior vulvar pain including the related investigations and treatment. Discussion. This case brings to light the additional delayed complication of this ritual: sensory neuropathy. Our goal is to educate health professionals to be aware of these complications and to appropriately investigate and treat them in order to find a solution to relieve the patients’ symptoms.

  16. Married women's negotiation for safer sexual intercourse in Kenya: Does experience of female genital mutilation matter?

    Science.gov (United States)

    Chai, Xiangnan; Sano, Yujiro; Kansanga, Moses; Baada, Jemima; Antabe, Roger

    2017-12-01

    Married women's ability to negotiate for safer sex is important for HIV prevention in sub-Saharan Africa, including Kenya. Yet, its relationship to female genital mutilation is rarely explored, although female genital mutilation has been described as a social norm and marker of womanhood that can control women's sexuality. Drawing on the social normative influence theory, this study addressed this void in the literature. We analysed data from the 2014 Kenya Demographic and Health Survey using logistic regression. Our sample included 8,602 married women. Two indicators of safer sex, namely the ability to refuse sex and the ability to ask for condom use, were explored. We found that women who had undergone genital mutilation were significantly less likely to report that they can refuse sex (OR=0.87; pnegotiate for safer sex through gendered socialization and expectations. Based on these findings, several policy implications are suggested. For instance, culturally sensitive programmes are needed that target both married women who have undergone genital mutilation and their husbands to understand the importance of safer sexual practices within marriage. Copyright © 2017. Published by Elsevier B.V.

  17. The socio-cultural-symbolic nexus in the perpetuation of female genital cutting: a critical review of existing discourses

    OpenAIRE

    Esho, Tammary; Van Wolputte, Steven; Enzlin, Paul

    2011-01-01

    Female Genital Cutting (FGC), also known as Female Genital Mutilation (FGM) and Female Circumcision (FC), continues to be a prevalent practice in many parts of the world and especially in Africa. This is somewhat perplexing given the concerted efforts aimed at eradicating this practice. This article argues that the perpetuation of FGC is due to the unintended effects of marginalization experienced by individuals and groups of women as a result of the approach of some of the anti-FGC global di...

  18. [Immunity of the female genital tract mucosa and mechanisms of papillomavirus evasion].

    Science.gov (United States)

    Riethmuller, D; Seilles, E

    2000-12-01

    Human papillomaviruses (HPV) are responsible for many cutaneous and mucosal lesions. Some viral genotypes are considered to be the causal agents of cervical cancer. Natural genital HPV infection seems to be poorly immunogenic because of its nonproductive and noninflammatory characteristics and also because of the different mechanisms developed by the virus to counteract the immune response. Knowledge of the immune system organization and its regulation in the human female genital tract needs to be clarified. It is mostly "programmed" to ensure a humoral response. Nevertheless, secretory IgA, that are particularly efficient for anti-infectious mucosal immunity are poorly present in physiological vaginal secretions. These distinctive features could explain part of the relative immune deficiency against HPV. Moreover, reduction or loss of MCH1 molecules and a defect in antigen presentation to cytotoxic lymphocytes could in part explain the cytotoxicity deficiency. There is however clear evidence that cellular immune response plays a major role in the control and course of HPV infection. This response varies according to the grade of the lesion and to the oncogenic potential of the infecting HPV. A deficiency in induction of cellular cytotoxicity mechanisms seems to be involved in the persistence of HPV infection and so in carcinogenesis. Finally, worldwide cervical cancer incidence (5000000 new cases per year) warrants effective vaccine developments. Two strategies, one preventive and one therapeutic, are now under study. Vaccine adjustments are based first on humoral immunity induction with production of neutralizing antibodies for prophylaxis and second on cellular immunity induction to kill cells with viral oncoprotein expression for therapy.

  19. Special Issue: Female Genital Cutting/Mutilation in Africa

    African Journals Online (AJOL)

    Psychosocial and sexual aspects of female circumcision · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. S Abdel-Azim, 141-142. http://dx.doi.org/10.1016/j.afju.2012.12.005 ...

  20. Attitudes to female genital mutilation/cutting among male ...

    African Journals Online (AJOL)

    1 Department of Obstetrics and Gynecology, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria ... female virginity until marriage and heightening male sexual satisfaction and ... Onyago MA, Owoko S, Oguttu M. Factors that influence male involvement in sexual and reproductive health in ...

  1. Perception and Practice of Female Genital Cutting in a Rural ...

    African Journals Online (AJOL)

    Up to 53.5% were circumcised by traditional birth attendants. The belief that FGM should be discontinued increased with educational level. The practice of FGC was high in this community. Increased female education, community involvement and legislation are needed to reduce this practice. (Afr J Reprod Health 2012; ...

  2. Being Victims or Beneficiaries? Perspectives on Female Genital ...

    African Journals Online (AJOL)

    The results indicate that the complexity of the persistence of FGC and RI goes far beyond being explained by subconscious patriarchal and maternalistic actions, related to socially constructed concepts of normality, female identity, tradition and religion in a “silent” culture between men and women. African Journal of ...

  3. Female genital mutilation: a case for asylum in Europe

    Directory of Open Access Journals (Sweden)

    Fadela Novak-Irons

    2015-05-01

    Full Text Available With some 71% of female EU asylum applicants from FGM-practising countries estimated to be survivors of this harmful traditional practice, it is time to accept that this subject demands greater scrutiny and a more dedicated response.

  4. Genital tract abnormalities among female sex workers who douche ...

    African Journals Online (AJOL)

    Vaginal douche products have been associated with cervical cancer. We examined female sex workers (FSWs) in Nigeria who douche with lemon or lime juice and compared the findings with that of nonusers. We obtained Pap smears and performed colposcopy of the vulva, vagina and cervix. A total of 374 FSWs ...

  5. Management of type III female genital mutilation in Birmingham, UK: a retrospective audit.

    Science.gov (United States)

    Paliwal, Priya; Ali, Sarah; Bradshaw, Sally; Hughes, Alison; Jolly, Kate

    2014-03-01

    to audit clinical management of women with type III female genital mutilation (FGM) according to local guidelines. Secondary objectives were to describe the population that uses the service and compare obstetric outcomes of intrapartum deinfibulation and antenatal deinfibulation. retrospective audit. a hospital midwifery-led FGM specialist service in Birmingham, UK. 253 women with type III FGM who gave birth between January 2008 and December 2009 METHODS: retrospective case analysis using patient records. proportion of women managed according to locally agreed criteria for the management of FGM; obstetric outcomes including perineal tears, episiotomy rates, estimated blood loss, infant APGAR scores and indications for caesarean section. 91 (36%) women booked into antenatal care after 16 weeks gestation. Only 26 (10.3%) were managed fully according to guidelines. The area with poorest performance was child protection, where the presence of normal genitalia was documented in only 52 (38.8%) of medical notes following birth of a female infant. The majority of women (214, 84.6%) had been deinfibulated in a previous pregnancy. Of the 39 infibulated at booking, only 9 (23.1%) were deinfibulated antenatally, the rest opted for intrapartum deinfibulation. Women who had intrapartum deinfibulation had a higher average blood loss and more tears than those deinfibulated antenatally, although this was not statistically significant. alternative systems should be considered to improve documentation of child protection related information. Further research is needed to confirm or refute the adverse findings among those that delayed deinfibulation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Female genital mutilation/cutting: risk management and strategies for social workers and health care professionals

    Directory of Open Access Journals (Sweden)

    Costello S

    2015-12-01

    Full Text Available Susan Costello School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia Abstract: Female genital mutilation/cutting (FGM/C is a traditional practice originating in Africa. Its worst forms cause irreparable harm to girls and women and have no medical justification. Based on a literature review of global responses to FGM/C and conversations with Australian women who migrated from FGM/C practicing countries, this paper provides some background on FGM/C and its epidemiology, outlining its prevalence, types, and health risks and complications for women and girls. It discusses risk-prevention strategies, first, for health practitioners in identifying, screening, and supporting women affected by FGM/C and, second, for welfare and social workers and health care professionals to identify, work with, and prevent girls from being cut. Consistent with international trends in addressing the risks of FGM/C, the paper suggests practice responses for coordinated responses between professionals, communities from practicing countries, and governments of different countries. Keywords: female genital mutilation, female genital cutting, female circumcision, child protection, risk management 

  7. Female genital mutilation and cutting: An anatomical review and alternative rites.

    Science.gov (United States)

    Puppo, Vincenzo

    2017-01-01

    The World Health Organization reports that more than 200 million women currently alive have been subjected to female genital mutilation/cutting (FGM/C) worldwide, and three million girls continue to be at risk each year. FGM/C today is women's business. The vulva is formed by the labia majora and the vestibule, with its erectile apparatus. These structures are located under the urogenital diaphragm, behind the pubic symphysis in the anterior perineal region. The clitoris is entirely an external genital organ: the glans and body covered by the prepuce are visible/free while the roots are hidden. FGM/C procedures are classified into four types. Infibulation is the narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning of the labia minora and/or the labia majora, with or without removal of the clitoris. Deinfibulation is necessary to improve health and well-being and to allow intercourse or facilitate childbirth. Clitoral reconstruction is feasible for genitally mutilated patients. Female genital cosmetic surgery should be classed as FGM/C type IV. Both immediate and long-term complications are associated with FGM/C. It remains primarily a cultural rather than a religious practice. Different interventions have been used to persuade communities to abandon it. Alternative rites of passage are seen as an important strategy for eliminating this harmful practice. Such alternative rituals avoid genital cutting and involve educating girls about family life and women's roles, exchange of gifts, celebration, and a public declaration for community recognition. FGM/C is a violation of human rights and must be abandoned. Clin. Anat. 30:81-88, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  8. Research gaps in the care of women with female genital mutilation: an analysis.

    Science.gov (United States)

    Abdulcadir, J; Rodriguez, M I; Say, L

    2015-02-01

    Female genital mutilation (FGM) includes procedures involving the partial or total removal of the external female genitals for non-therapeutic reasons. They can have negative psychosexual and health consequences that need specific care. In this paper, we review some key knowledge gaps in the clinical care of women with FGM, focusing on obstetric outcomes, surgical interventions (defibulation and clitoral reconstruction), and the skills and training of healthcare professionals involved in the prevention and management of FGM. We identify research priorities to improve the evidence necessary to establish guidelines for the best multidisciplinary care, communication, and prevention, and to improve health-promotion measures for women with FGM. © 2014 Royal College of Obstetricians and Gynaecologists.

  9. [Fatal female genital mutilation in a 10-year-old girl].

    Science.gov (United States)

    Sow, A; Diagne, G; Keita, Y; Sow, O; Ndiath, A; Ouattara, A; Sarr, M-L; Sylla, A; Moreira, C

    2017-10-01

    Female genital mutilation (FGM) comprises all procedures involving partial or total removal of the external genitalia and/or any other procedures affecting the female genitalia, for cultural or religious reasons or for nontherapeutic purposes in general. FGM is responsible for a number of short-, medium-, and long-term complications that can engage the vital and functional prognosis, especially in African countries. We report on a case in a 10-year-old girl who underwent genital mutilation, a traditional type of total excision during the neonatal period. She was followed for urethral meatus stenosis, which then was complicated by obstructive chronic kidney failure and urinary sepsis, whose progression was fatal. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  10. A rare cause of infertility: A late complication of female genital mutilation

    Directory of Open Access Journals (Sweden)

    Ferjaoui Mohamed Aimen

    2016-05-01

    Full Text Available Female genital mutilation is a cultural practice in many African and Asian societies based usually on religious beliefs. This practice made by a non medical and traditional practitioner with non sterile instruments is a source of many complications such as infection, acute and chronic pain, life-threatening hemorrhage, sexual dysfunction, and rarely epidermal inclusion cysts. We report a case of a large epidermal inclusion cyst in a 36-year-old patient, 30 years after a female genital mutilation (FGM. The patient complains of a two-year-secondary infertility with a self-imaging alteration and a sexual dysfunction. The managment of this complication was based on surgery with a psychological support and sexual therapies.

  11. Male and female genital cutting among Southern Thailand's Muslims: rituals, biomedical practice and local discourses.

    Science.gov (United States)

    Merli, Claudia

    2010-10-01

    This paper explores how local people in a province in southern Thailand perceive the practice of male and female genital cutting. In order to understand the importance placed on these practices, a comparison is drawn between the two and also between the male circumcision and the Buddhist ordination of monks as rites of passage. Discourses on the exposure or concealment of male and female bodies, respectively, witness to the relevance of both the local political-historical context and biomedical hegemony to gendered bodies. The comparisons evince the need to reflect upon the theoretical and ethical implications of studying genital cutting and focusing exclusively on one of the two practices rather than, as this paper claims to be necessary, considering them as inextricably connected.

  12. FGMReview: design of a knowledge management tool on female genital mutilation.

    Science.gov (United States)

    Martínez Pérez, Guillermo; Turetsky, Risa

    2015-11-01

    Web-based literature search engines may not be user-friendly for some readers searching for information on female genital mutilation. This is a traditional practice that has no health benefits, and about 140 million girls and women worldwide have undergone it. In 2012, the website FGMReview was created with the aim to offer a user-friendly, accessible, scalable, and innovative knowledge management tool specialized in female genital mutilation. The design of this website was guided by a conceptual model based on the use of benchmarking techniques and requirements engineering, an area of knowledge from the computer informatics field, influenced by the Transcultural Nursing model. The purpose of this article is to describe this conceptual model. Nurses and other health care providers can use this conceptual model to guide their methodological approach to design and launch other eHealth projects. © The Author(s) 2014.

  13. Female Genital Mutilation/Cutting: The Secret World of Women as Seen by Men

    OpenAIRE

    Kaplan, Adriana; Cham, Babucarr; Njie, Lamin A.; Seixas, Ana; Blanco, Sandra; Utzet, Mireia

    2013-01-01

    Efforts aimed at the abandonment of Female Genital Mutilation/Cutting (FGM/C) in the communities where it is deeply rooted have extensively considered and addressed women's perceptions on the issue, leaving those of men barely acknowledged. Although the practice is generally confined to the secret world of women, it does not mean that men cannot be influential. Indeed, men can play an important role in prevention. In order to address this gap, and having as background an extensive ethnographi...

  14. Female genital cutting: an evidence-based approach to clinical management for the primary care physician.

    Science.gov (United States)

    Hearst, Adelaide A; Molnar, Alexandra M

    2013-06-01

    The United States has more than 1.5 million immigrants from countries in Africa and the Middle East where female genital cutting (FGC) is known to occur. Often, FGC occurs in infancy and childhood in the countries where it is practiced, but patients of any age can present with complications. Lack of understanding of this common problem can potentially alienate and lower quality of care for this patient population. We provide an introduction to the practice of FGC and practice guidelines for the primary care physician. We reviewed original research, population-based studies, and legal research from PubMed, Scopus, CINAHL plus, PsycINFO, and Legal Trac. The terms searched included female genital cutting, female genital circumcision, and female genital mutilation alone and with the term complications or health consequences; no limit on date published. Legal databases were searched using the above terms, as well as international law and immigration law. Editorials and review articles were excluded. This review discusses the different types of FGC, important cultural considerations for physicians caring for patients with FGC, the common early and late medical complications and their management, and psychosocial issues associated with FGC. Current laws pertaining to FGC are briefly reviewed, as well as implications for patients seeking asylum status in the United States because of FGC. Finally, the article presents evidence-based, culturally sensitive approaches to discussions of FGC with girls and women for whom this is an issue. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  15. Female genital mutilation/cutting: risk management and strategies for social workers and health care professionals

    OpenAIRE

    Costello, Susan

    2015-01-01

    Susan Costello School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia Abstract: Female genital mutilation/cutting (FGM/C) is a traditional practice originating in Africa. Its worst forms cause irreparable harm to girls and women and have no medical justification. Based on a literature review of global responses to FGM/C and conversations with Australian women who migrated from FGM/C practicing countries, this paper provides some background on FGM/C and its epi...

  16. Overactive bladder after female genital mutilation/cutting (FGM/C) type III

    Science.gov (United States)

    Abdulcadir, Jasmine; Dällenbach, Patrick

    2013-01-01

    A 27-year-old Somali woman with type III a–b female genital mutilation/cutting, consulted because of slow micturition, voiding efforts, urgency and urge incontinence (overactive bladder). She also referred primary dysmenorrhoea and superficial dyspareunia making complete sexual intercourses impossible. We treated her by defibulation and biofeedback re-educative therapy. We also offered a multidisciplinary counselling. At 5 months follow-up, urgency and urge incontinence had resolved and she became pregnant. PMID:24096069

  17. Eradicating Female Genital Mutilation; a Viable Reality. Raising Awareness in the Men Involved

    OpenAIRE

    Jiménez-Ruiz, Ismael; Almansa Martínez, Pilar; Gombau Giménez, Laura

    2017-01-01

    Female Genital Mutilation (FGM) is considered by a number of International Organizations as an affront on human rights and an act of violence against women and young girls. Furthermore, being the result of an intense discrimination between genders, it hierarchizes and perpetuates inequality and denies women the right to physical and psychosexual integrity. Aims. To endeavour towards the eradication of FGM via the testimony of men from countries where this practice is performed. Methodology. A...

  18. Help or hinder? : Journalists affecting the future of female genital mutilation in a patriarchal society

    OpenAIRE

    Hallonsten, Sofia

    2016-01-01

    Is it possible to cover an issue as a journalist to the extent that you are practically a human rights activist, and still contribute to its continuation by unconsciously upholding the values causing the issue? This study asks the question if journalists help or hinder the elimination of female genital mutilation (FGM), and puts forth the thesis that journalists as a collective in fact are affecting the development more negatively through their attitudes than positively through their actions....

  19. Development and validation of the female genital self-image scale.

    Science.gov (United States)

    Herbenick, Debra; Reece, Michael

    2010-05-01

    Women's sexual function may be influenced by various factors including medical conditions, trauma or abuse, medications, relationship dynamics, relaxation, mood, and body image. However, few studies have explored the influence of a woman's genital self-image on her sexual function or behaviors. The purpose of this study was to establish a reliable and valid measure of female genital self-image, the Female Genital Self-Image Scale (FGSIS), and to assess the relationship between scores on the FGSIS and women's sexual function. The FGSIS was developed in two stages. Phase One involved an analysis of cross-sectional paper-based survey data and a review of the literature. Phase Two involved a cross-sectional internet-based administration of the scale items to a total of 1,937 women. Psychometric properties of the scale were evaluated through the use of reliability analysis, factor analysis, and score differences based on women's experience of orgasm from receiving cunnilingus or from self-masturbation with a vibrator. Correlation analysis was used to explore the relationship between female genital self-image and scores on the Female Sexual Function Index (FSFI). The scale was found to have sufficient reliability (Cronbach's alpha = 0.88) and one factor that explained 59.23% of the variance. Women who had ever experienced orgasm as a result of cunnilingus or self-masturbation with a vibrator and women who reported having had a gynecological exam in the previous 12 months had significantly higher FGSIS scores than those who had not (P self-image was found to be positively related to women's sexual function.

  20. Improving estimates of the prevalence of Female Genital Mutilation/Cutting among migrants in Western countries

    OpenAIRE

    Livia Elisa Ortensi; Patrizia Farina; Alessio Menonna

    2015-01-01

    Background: Female Genital Mutilation/Cutting (FGM/C) is an emerging topic in immigrant countries as a consequence of the increasing proportion of African women in overseas communities. Objective: While the prevalence of FGM/C is routinely measured in practicing countries, the prevalence of the phenomenon in western countries is substantially unknown, as no standardized methods exist yet for immigrant countries. The aim of this paper is to present an improved method of indirect estimation ...

  1. Diagnostic value of female genital malignant tumors by using 111In-bleomycin scintigraphy

    International Nuclear Information System (INIS)

    Kida, Toshiyuki; Ikeda, Masanori; Saito, Masaru

    1978-01-01

    In order to know if it is possible to objectively decide the extent of infiltration of female genital malignant tumors into parametrium by using 111 In-bleomycin scintigraphy, a fundamental and clinical investigation was made. The radiochemical purity and stability of 111 In-BLM were comparatively unchangeable. When this complex was kept at room temperature for a week, there was not more than 2% of the free 111 In. As to blood clearance, when the blood radioactivity of 111 In-BLM 5 minutes after the injection was counted as 100%, about 80% of the radioactivity was cleared from the blood in 48 hours. Over 50% of the radioactivity was excreted into the urine in 48 hours. Of 29 cases of female genital malignant tumors, 23 cases (79%) showed positive images. Therefore 111 In-BLM was found to be one of the suitable radiopharmaceuticals for the diagnosis of female genital malignant tumors. 111 In-BLM scintigraphy was of great use for deciding the extent of the invasion of carcinoma cervicis uteri into parametrium and for the search of metastasis. (author)

  2. Distribution of Chlamydia Trachomatis Genotypes in Infective Diseases of the Female Lower Genital Tract.

    Science.gov (United States)

    Chen, Yujie; Chen, Jing; Yang, Lan; Jiang, Yanming; Li, Li; Yi, Wenjuan; Lan, Lifang; Zhang, Liuhong

    2017-09-17

    The purpose of this study was to investigate the distribution of Chlamydia trachomatis (CT) genotypes in infective diseases of the female lower genital tract, especially in cervical diseases. This study included 128 CT-positive women. DNA was extracted from cervical swabs. Omp1 gene PCR-RFLP and sequencing were used to confirm the subtypes of CT. The association of subtypes with age, clinical symptoms, cervical cytology, and biopsy results was further analyzed. Omp1 gene PCR-RFLP and sequencing showed that the order of prevalent CT genotypes in the female lower genital tract was D (n=38, 29.69%), followed by E (n=28, 21.88%), G (n=21, 16.41%), and F (n=16,12.50%). Genotypes J, H, and K were comparatively rare. Genotype I was not identified in our samples. Further analysis showed that patients with genotype G were more frequently co-infected with other bacteria. Genotype G was also associated with mucopurulent cervicitis (MPC) and cervical intraepithelial neoplasia (CIN). Patients with genotype E were commonly co-infected with HR-HPV. Although genotype D was the most prevalent, it was a relatively low-risk type. These results provide information on distribution of CT genotypes in infective diseases of the female lower genital tract, which is instrumental to developing a vaccine for CT.

  3. Women's empowerment and the intention to continue the practice of female genital cutting in Egypt.

    Science.gov (United States)

    Afifi, Mustafa

    2009-03-01

    The study aimed to (dis)prove the association of the level of women's empowerment with their future intention to perpetuate female genital cutting for their daughters. In a national representative community-based sample of 14,393 currently-married women in Egypt, the level of empowerment, intention to continue the practice, and other socio- demographic variables were collected in the 2000 Egypt Demographic and Health Survey. Secondary in-depth analysis was conducted on data downloaded from MEASURE Demographic Health Surveys (MEASURE DHS) website. About 14% of the women intended to discontinue the practice. Twenty-six percent of the women were empowered in all household decisions. Levels of women's empowerment adjusted for age, residence, education, interaction between empowerment and education, work status, and female genital cutting status of currently-married women were entered in six logistic regression models in a sequential way. In the last model, those of high levels of empowerment and education were 8.06 times more likely not intending to perpetuate female genital cutting for their daughters than low- empowered low-educated women.

  4. Incidental Detection of Metastatic Lobular Breast Carcinoma in the Female Internal Genital Organs 2 Years Following Modified Radical Mastectomy

    Directory of Open Access Journals (Sweden)

    Tsai-Fang Lee

    2005-12-01

    Conclusions: The present case provides evidence of breast cancer metastasis to the female internal genital organs. We suggest close gynecologic follow-up after surgical and medical management of breast cancer.

  5. Functional morphology of the tubular genital organs in the female owl monkey (Aotus spp.).

    Science.gov (United States)

    Mayor, Pedro; Takeshita, Rafaela Sayuri Cicalise; Coutinho, Leandro Nassar; Sánchez, Nofre; Gálvez, Hugo; Ique, Carlos; Ruiz, Julio Cesar; Monteiro, Frederico Ozanan Barros

    2015-06-01

    Studies on reproductive morphology are important to understand the reproductive cycle of non-human primates. This study describes the functional morphology of the adult female tubular genital organs in 41 Aotus (12.8 ± 6.8 years old, ranging from 3 to 25 years), with respect to reproductive status and number of parturitions. In females with developing embryos, endometrial glands showed a higher secretion than other females, and the embryo implantation occupied this secretive endometrium. Changes in the thickening, number of layers, and keratinization in the vaginal epithelium suggest that vaginal cytology may be an indicator of the estrous cycle. Non-pregnant multiparous females had a larger uterine body than nulliparous females. Number of parturitions and reproductive state had an impact on tubular genital organs in female owl monkeys. These results can be useful for the development of biotechnologies of reproduction and for improvement of the management of this species. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Vulvar Epidermal Inclusion Cyst as a Long-term Complication of Female Genital Mutilation

    Science.gov (United States)

    Victoria-Martínez, Ana Mercedes; Cubells-Sánchez, Laura; Martínez-Leborans, Lorena; Sánchez-Carazo, José Luis; de Miquel, Víctor Alegre

    2016-01-01

    We present a case report of a patient with epidermal inclusion cyst as a late complication of female genital mutilation (FGM). We describe the management of the patient, and a review of the literature. We report the clinical and pathological findings in a 37-year-old female patient from Nigeria, with a clitoral mass of 1 year duration. She declared to have an FGM since she was 5 years. The lesion was excised successfully with good cosmetic results. Histological examination revealed epidermal cyst with the presence of granular layer. An epidermal inclusion cyst can develop as a long-term consequence of FGM. PMID:26955127

  7. A rose by any other name? Rethinking the similarities and differences between male and female genital cutting.

    Science.gov (United States)

    Darby, Robert; Svoboda, J Steven

    2007-09-01

    In this article, we offer a critical examination of the tendency to segregate discussion of surgical alterations to the male and female genitals into separate compartments--the first known as circumcision, the second as genital mutilation. We argue that this fundamental problem of definition underlies the considerable controversy surrounding these procedures when carried out on minors, and that it hinders objective discussion of the alleged benefits, harms, and risks. We explore the variable effects of male and female genital surgeries, and we propose a scale of damage for male circumcision to complement the World Health Organization's categorization of female genital mutilation. The origins of the double standard identified are placed in historical perspective, and in a brief conclusion we make a plea for greater gender neutrality in the approach to this contentious issue.

  8. Validity and reliability of the Arabic version of the female genital self-image scale.

    Science.gov (United States)

    Mohammed, Ghada Farouk Abd El-Kaream; Hassan, Haydy

    2014-05-01

    Female genital self-image is significantly related to female sexual function. It has been inadequately investigated in Egypt. To translate the original English version of the Female Genital Self-Image Scale (FGSIS) into Arabic and validate the Arabic version (AVFGSIS). Validation was carried out for the aspects of face, content, and criterion (concurrent) validity. Studies on test-retest reliability and internal consistency were conducted using Cronbach's alpha and Pearson correlation, respectively. Main outcome measures were the validity and reliability of the AVFGSIS and its domains. Correlations between domain scores on the AVFGSIS and the Arabic version of the Female Sexual Function Index (AVFSFI) were assessed. A total of 244 married women aged 18-60 years participated in this study. There was a high test-retest correlation (r > 0.8). The AVFGSIS was found to have good face and content validity as a whole and for each domain. Significant positive correlations were observed with each domain of the AVFSFI: desire (r = 0.815), arousal (r = 0.861), lubrication (r = 0.855), orgasm (r = 0.820), satisfaction (r = 0.832), and pain (r = 0.884) (all P self-image was found to be significantly related to female sexual function. © 2014 International Society for Sexual Medicine.

  9. Sensationalising the female pudenda: an examination of public communication of aesthetic genital surgery.

    Science.gov (United States)

    Ashong, Ashong C; Batta, Herbert E

    2012-12-26

    We live in a society where beauty and sensations are important. Advances in medical technologies have brought on waves of new notions of beauty where commercial interests both in the media and the health industry spurred by fashion, advertising and celebrity promotion have tended to popularise body modifications and enhancements. In recent times, through offerings on cable television channels and glossy consumer magazines, medical procedures hitherto only in the precincts of medical schools, gyneacological clinics and medical journals have now pervaded the population. More seriously, on the Internet particularly, medical experts now offer services and graphic details of labiaplasty, clitoral hood reduction or enhancement, vaginal rejuvenation, etc. Here, we examine the public communication of the phenomenon of aesthetic genital surgery and interrogate thus; is it decent, honest, balanced and ethical? Relying on textual analysis, personal observation and literature review for data gathering, we observe that besides tending to commercialise and medicalise the female genitalia, a coalescence of medical, advertising and fashion interests as played out in the media sensationalises the benign science of plastic surgery and robs it of its truthfulness, genuineness, and purposefulness. The conclusion is that in Africa, where the effect of the development crises is telling, the hype surrounding cosmetic or aesthetic genital surgery is a damaging distraction particularly when the continent is waging a battle against female genital mutilation. The recommendations are that media and medical regulatory bodies should impress it upon media and medical industry operators that glaring commercial promotions of cosmetic genital surgery in the public media be checked, and that such communication should bear equal weight of facts related to risks, short comings, complications, and threats; in physical, social, and psychological terms.

  10. Sensationalising the Female Pudenda: An Examination of Public Communication of Aesthetic Genital Surgery

    Science.gov (United States)

    Ashong, Ashong C.; Batta, Herbert E.

    2013-01-01

    We live in a society where beauty and sensations are important. Advances in medical technologies have brought on waves of new notions of beauty where commercial interests both in the media and the health industry spurred by fashion, advertising and celebrity promotion have tended to popularise body modifications and enhancements. In recent times, through offerings on cable television channels and glossy consumer magazines, medical procedures hitherto only in the precincts of medical schools, gyneacological clinics and medical journals have now pervaded the population. More seriously, on the Internet particularly, medical experts now offer services and graphic details of labiaplasty, clitoral hood reduction or enhancement, vaginal rejuvenation, etc. Here, we examine the public communication of the phenomenon of aesthetic genital surgery and interrogate thus; is it decent, honest, balanced and ethical? Relying on textual analysis, personal observation and literature review for data gathering, we observe that besides tending to commercialise and medicalise the female genitalia, a coalescence of medical, advertising and fashion interests as played out in the media sensationalises the benign science of plastic surgery and robs it of its truthfulness, genuineness, and purposefulness. The conclusion is that in Africa, where the effect of the development crises is telling, the hype surrounding cosmetic or aesthetic genital surgery is a damaging distraction particularly when the continent is waging a battle against female genital mutilation. The recommendations are that media and medical regulatory bodies should impress it upon media and medical industry operators that glaring commercial promotions of cosmetic genital surgery in the public media be checked, and that such communication should bear equal weight of facts related to risks, short comings, complications, and threats; in physical, social, and psychological terms. PMID:23445703

  11. Cross-cultural adaptation of the Female Genital Self-Image Scale (FGSIS) in Iranian female college students.

    Science.gov (United States)

    Pakpour, Amir H; Zeidi, Isa Mohammadi; Ziaeiha, Masoumeh; Burri, Andrea

    2014-01-01

    The aim of the present study was to investigate the psychometric properties of a translated and culturally adapted Iranian version of the Female Genital Self-Image Scale (FGSIS-I) in a sample of college women. Further, the relationship between women's self-image, body appreciation, sexual functioning, and gynecological exam behavior was explored. A sample of 1,877 female students from five different universities across Qazvin and Tehran completed the Female Sexual Function Index (FSFI), the Body Appreciation Scale (BAS), the Rosenberg Self-Esteem Scale (RSES), the FGSIS-I, and a gynecological exam behavior questionnaire. Good to excellent internal consistency reliability, test-retest reliability, and convergent and construct validity were found. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) both provided a two-factor structure for the FGSIS-I. The validity of the FGSIS-I in predicting gynecological exam behavior of college women was tested using structural equation modeling (SEM). The final model accounted for 33% of the variance in gynecological exam behavior (p valid and reliable instrument to assess female genital self-image in Iranian women.

  12. Epidemiology and Natural History of Human Papillomavirus Infections in the Female Genital Tract

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available Human papillomavirus (HPV is the most common newly diagnosed sexually transmitted infection in the United States. Although the majority of sexually active adults will be infected with HPV at least once in their lives, it is sexually active women less than 25 years of age who consistently have the highest rates of infection. Besides youth and gender, common risk factors for HPV infection and clinical sequelae of infection include high number of sexual partners and coinfection with Chlamydia trachomatis or herpes simplex virus. Most HPV infections are cleared by the immune system and do not result in clinical complications. Clinical sequelae in cases of low-risk HPV infection consist of genital warts, and clinical manifestations of high-risk HPV infection include abnormal Pap test results, low-grade squamous intraepithelial lesions (LSIL, high-grade squamous intraepithelial lesions (HSIL, and cervical cancer. LSIL, HSIL, and cervical cancer carry significant morbidity and/or mortality; genital warts and abnormal Pap test results are often significant sources of psychosocial distress. Currently, there are neither effective means of preventing HPV transmission nor cures for clinical manifestations: infection can only be prevented via complete sexual abstinence, while treatment for clinical sequelae such as genital warts and cytologic abnormalities consists of removing the problematic cells and watching for recurrence; this method consumes significant health care resources and is costly. New prophylactic HPV vaccines promise to dramatically reduce the incidence of HPV infection, genital warts, and cytologic abnormalities.

  13. Body Dysmorphic Disorder: Contraindication or Ethical Justification for Female Genital Cosmetic Surgery in Adolescents.

    Science.gov (United States)

    Spriggs, Merle; Gillam, Lynn

    2016-11-01

    Is Female Genital Cosmetic Surgery for an adolescent with Body Dysmorphic Disorder ever ethically justified? Cosmetic genital surgery (specifically labioplasty) for adolescent girls is one of the most ethically controversial forms of cosmetic surgery and Body Dysmorphic Disorder is typically seen as a contraindication for cosmetic surgery. Two key ethical concerns are (1) that Body Dysmorphic Disorder undermines whatever capacity for autonomy the adolescent has; and (2) even if there is valid parental consent, the presence of Body Dysmorphic Disorder means that cosmetic surgery will fail in its aims. In this article, we challenge, in an evidence-based way, the standard view that Body Dysmorphic Disorder is a contraindication for genital cosmetic surgery in adolescents. Our argument gathers together and unifies a substantial amount of disparate research in the context of an ethical argument. We focus on empirical questions about benefit and harm, because these are ethically significant. Answers to these questions affect the answer to the ethical question. We question the claim that there would be no benefit from surgery in this situation, and we consider possible harms that might be done if treatment is refused. For an adolescent with Body Dysmorphic Disorder, the most important thing may be to avoid harm. We find ourselves arguing for the ethical justifiability of cosmetic labioplasty for an adolescent with Body Dysmorphic Disorder, even though we recognize that it is a counter intuitive position. We explain how we reached our conclusion. © 2016 John Wiley & Sons Ltd.

  14. Management of painful clitoral neuroma after female genital mutilation/cutting.

    Science.gov (United States)

    Abdulcadir, Jasmine; Tille, Jean-Christophe; Petignat, Patrick

    2017-02-08

    Traumatic neuromas are the result of regenerative disorganized proliferation of the proximal portion of lesioned nerves. They can exist in any anatomical site and are responsible for neuropathic pain. Post-traumatic neuromas of the clitoris have been described as an uncommon consequence of female genital mutilation/cutting (FGM/C). FGM/C involves partial or total removal of the female genital organs for non-therapeutic reasons. It can involve cutting of the clitoris and can cause psychological, sexual, and physical complications. We aimed to evaluate the symptoms and management of women presenting with a clitoral neuroma after female genital mutilation/cutting (FGM/C). We identified women who attended our specialized clinic for women with FGM/C who were diagnosed with a traumatic neuroma of the clitoris between April 1, 2010 and June 30, 2016. We reviewed their medical files and collected socio-demographic, clinical, surgical, and histopathological information. Seven women were diagnosed with clitoral neuroma. Six attended our clinic to undergo clitoral reconstruction, and three of these suffered from clitoral pain. The peri-clitoral fibrosis was removed during clitoral reconstruction, which revealed neuroma of the clitoris in all six subjects. Pain was ameliorated after surgery. The seventh woman presented with a visible and palpable painful clitoral mass diagnosed as a neuroma. Excision of the mass ameliorated the pain. Sexual function improved in five women. One was not sexually active, and one had not yet resumed sex. Post-traumatic clitoral neuroma can be a consequence of FGM/C. It can cause clitoral pain or be asymptomatic. In the case of pain symptoms, effective treatment is neuroma surgical excision, which can be performed during clitoral reconstruction. Surgery should be considered as part of multidisciplinary care. The efficacy of neuroma excision alone or during clitoral reconstruction to treat clitoral pain should be further assessed among symptomatic

  15. Awareness and predictors of female genital mutilation/cutting among young health advocates

    OpenAIRE

    Abolfotouh, Sherif M; Ebrahim, Ahmed Z; Abolfotouh, Mostafa A

    2015-01-01

    Sherif M Abolfotouh,1,2 Ahmed Z Ebrahim,1,3 Mostafa A Abolfotouh4 On Behalf of IFMSA-Egypt 1IFMSA-Egypt, Alexandria, Egypt; 2Oulu University Hospital, Oulu, Finland; 3Alexandria Faculty of Medicine, Alexandria, Egypt; 4King Abdullah International Medical Research Center (KAIMRC), King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia Abstract: The act of female genital mutilation/cutting (FGM/C) is considered internationally as a violent act against girls and women and...

  16. Female Genital Mutilation Is a Violation of Reproductive Rights of Women: Implications for Health Workers.

    Science.gov (United States)

    Jungari, Suresh Banayya

    2016-02-01

    Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia or other injury to the female genital organs for nonmedical reasons. This coercive practice is still prevalent in many parts of the world, in both developed and developing countries. However, FGM is more prevalent in African countries and some Asian countries. In this study, an attempt has been made to understand the prevalence and practice of FGM worldwide and its adverse effects on women's reproductive health. To fulfill the study objectives, the author collected evidence from various studies conducted by international agencies. Many studies found that FGM has no health benefits; is mostly carried out on girls before they reach the age of 15 years; can cause severe bleeding, infections, psychological illness, and infertility; and, most important, can have serious consequences during childbirth. The practice is mainly governed by the traditions and cultures of the communities without having any scientific or medical benefit. In conclusion, FGM is a practice that violates the human and reproductive rights of women.

  17. Female genital mutilation as sexual disability: perceptions of women and their spouses in Akure, Ondo State, Nigeria.

    Science.gov (United States)

    Owojuyigbe, Michael; Bolorunduro, Miracle-Eunice; Busari, Dauda

    2017-05-01

    Disability encompasses the limitations on an individual's basic physical activities, and the consequent social oppressions such individual faces in society. In this regard, the limitation on the use of some parts of the genitals in a patriarchal system is considered a form of disability. This paper describes the perceptions of and the coping mechanisms employed by affected couples dealing with the consequences of female genital mutilation (FGM) as a form of sexual disability. Cultural Libertarianism was employed as a theoretical framework. The paper presents the results of a descriptive cross-sectional study conducted in Akure, Ondo State, Nigeria, with 10 male and 12 female respondents purposively selected through a snowball sampling for in-depth interviews. The findings present the justifications provided for the practice of FGM, and victims' perceptions of how it affects their sexual relations. Furthermore, it highlights coping strategies employed by affected women and their spouses. The study shows that the disabling consequence of FGM is largely sexual in nature, leading to traumatic experiences and negative beliefs about sex, and requiring a myriad of coping strategies employed by the disabled women, and their spouses, which may have its own implications for marital and sexual bliss.

  18. Female genital mutilation among Edo people: the complications and pattern of presentation at a pediatric surgery unit, Benin City.

    Science.gov (United States)

    Osifo, David Osarumwese; Evbuomwan, Iyekoretin

    2009-03-01

    This prospective study on female genital mutilation among Edo people was based on female children and parents who presented on account of it at the University of Benin Teaching Hospital, Benin City, Nigeria, between January 2002 and December 2007. During the period, 51 female children aged 10 days and 18 years presented with complications following genital mutilation. Twenty-nine were brought by their parents for mutilation while 67 parents interviewed believed strongly on female genital mutilation with 47 mothers mutilated. Religio-cultural and superstitious beliefs were the main indications and the type of mutilation ranged from excision of clitoridal tip in 10 (19.6%) children to complete excision of the clitoris, labia minora and inner layer of majora in 7 (13.7%). Complications ranged from clitoridal cyst formation in 21 (41.2%) to life threatening infections with one mortality due to tetanus infection.

  19. Functional anatomy of the female genital organs of the wild black agouti (Dasyprocta fuliginosa) female in the Peruvian Amazon.

    Science.gov (United States)

    Mayor, P; Bodmer, R E; Lopez-Bejar, M

    2011-02-01

    This study examined anatomical and histological characteristics of genital organs of 38 black agouti females in the wild in different reproductive stages, collected by rural hunters in the North-eastern Peruvian Amazon. Females in the follicular phase of the estrous cycle had greater antral follicle sizes than other females, the largest antral follicle measuring 2.34mm. Antral follicles in pregnant females and females in luteal phase of the estrous cycle had an average maximum diameter smaller than 1mm. In black agouti females in follicular phase, some antral follicles are selected to continue to growth, reaching a pre-ovulatory diameter of 2mm. Mean ovulation rate was 2.5 follicles and litter size was 2.1 embryos or fetuses per pregnant female, resulting in a rate of ovum mortality of 20.8%. Many follicles from which ovulation did not occur of 1-mm maximum diameter luteinize forming accessory CL. The constituent active luteal tissues of the ovary are functional and accessory CL. Although all females had accessory CL, transformation of follicles into accessory CL occurred especially in pregnant females, resulting in a contribution from 9% to 23% of the total luteal volume as pregnancy advances. The persistence of functional CL throughout pregnancy might reflect the importance for the maintenance of gestation and may be essential for the continuous hormonal production. The duplex uterus of the agouti female is composed by two completely independent uterine horns with correspondent separate cervices opening into the vagina. In pregnant females, most remarkable observed uterine adaptations were induced by the progressive enlargement caused by the normal pregnancy evolution. The wild black agouti showed different vaginal epithelium features in accordance with the reproductive state of the female. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. Female genital mutilation and infections: a systematic review of the clinical evidence.

    Science.gov (United States)

    Iavazzo, Christos; Sardi, Thalia A; Gkegkes, Ioannis D

    2013-06-01

    Female genital mutilation (FGM) is a common practice especially performed in women with no anaesthesia or antibiotics and in absence of aseptic conditions. The aim of this systematic review is to explore and analyze for first time in the current literature, the clinical evidence related to the presence of infections in the practice of FGM. A systematic search of PubMed and Scopus was performed. A combination of the terms "female circumcision", "genital mutilation", "genital cutting" and "infection" were used. Studies reporting data on the infections related to patients with FGM were included. A total of 22,052 patients included, in the study, from African countries. The age ranged from 10 days to 20 years. The procedure was done by physicians, paramedical staff, and other specialties. Type I FGM was performed in 3,115 women while 5,894, 4,049 and 93 women underwent Type II, Type III and unknown type of FGM, respectively. Different types of infections were identified including UTIs, genitourinary tract infections, abscess formation and septicemia or even HIV infection. Moreover, most infections were identified in Type III FGM. The isolated pathogens in the different type of infections, were HIV, Clostridium tetani, Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Candida albicans, Trichomonas vaginalis, HSV-2, Pseudomonas pyocyanea, Staphylococcus aureus. The univariate risk of infection ranged from 0.47 to 5.2. A variety of infections can occur after FGM. The management of these complications in a low-income economy can be a great burden for the families.

  1. Perception of primary health professionals about Female Genital Mutilation: from healthcare to intercultural competence

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    Fàbregas Ma Jose

    2009-01-01

    Full Text Available Abstract Background The practice of Female Genital Mutilation (FGM, a deeply-rooted tradition in 28 countries in Sub-Saharan Africa, carries important negative consequences for the health and quality of life of women and children. Migratory movements have brought this harmful traditional practice to our medical offices, with the subsequent conflicts related to how to approach this healthcare problem, involving not only a purely healthcare-related event but also questions of an ethical, cultural identity and human rights nature. Methods The aim of this study was to analyse the perceptions, degree of knowledge, attitudes and practices of the primary healthcare professionals in relation to FGM. A transversal, descriptive study was performed with a self-administered questionnaire to family physicians, paediatricians, nurses, midwives and gynaecologists. Trends towards changes in the two periods studied (2001 and 2004 were analysed. Results A total of 225 (80% professionals answered the questionnaire in 2001 and 184 (62% in 2004. Sixteen percent declared detection of some case in 2004, rising three-fold from the number reported in 2001. Eighteen percent stated that they had no interest in FGM. Less than 40% correctly identified the typology, while less than 30% knew the countries in which the practice is carried out and 82% normally attended patients from these countries. Conclusion Female genital mutilations are present in primary healthcare medical offices with paediatricians and gynaecologists having the closest contact with the problem. Preventive measures should be designed as should sensitization to promote stands against these practices.

  2. Meaning-making of female genital cutting: children's perception and acquired knowledge of the ritual.

    Science.gov (United States)

    Schultz, Jon-Håkon; Lien, Inger-Lise

    2013-01-01

    How do girls who have undergone female genital cutting understand the ritual? This study provides an analysis of the learning process and knowledge acquired in their meaning-making process. Eighteen participants were interviewed in qualitative indepth interviews. Women in Norway, mostly with Somali or Gambian backgrounds, were asked about their experiences of circumcision. Two different strategies were used to prepare girls for circumcision, ie, one involving giving some information and the other keeping the ritual a secret. Findings indicate that these two approaches affected the girls' meaning-making differently, but both strategies seemed to lead to the same educational outcome. The learning process is carefully monitored and regulated but is brought to a halt, stopping short of critical reflexive thinking. The knowledge tends to be deeply internalized, embodied, and morally embraced. The meaning-making process is discussed by analyzing the use of metaphors and narratives. Given that the educational outcome is characterized by limited knowledge without critical reflection, behavior change programs to end female genital cutting should identify and implement educational stimuli that are likely to promote critical reflexive thinking.

  3. Defibulation during vaginal delivery for women with type III female genital mutilation.

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    Rouzi, Abdulrahim A; Al-Sibiani, Sharifa A; Al-Mansouri, Nisma M; Al-Sinani, Nawal S; Al-Jahdali, Eetedal A; Darhouse, Khalid

    2012-07-01

    To assess the routine practice of defibulation during vaginal delivery for women who have undergone female genital mutilation or cutting. A case-control study was conducted on women from Sudan, Somalia, Ethiopia, Egypt, and Yemen who delivered at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from January 1, 2000, to November 30, 2011. Women who had defibulation were identified, and their records were examined. For each woman who had defibulation, a woman from the same nationality who delivered without defibulation on the same day or the next days was chosen as a control. Data collected included demographics, mode of delivery, blood loss, intraoperative and postoperative complications, and labor outcome. During the study period, 388 women underwent defibulation during vaginal delivery. Women who did not have defibulation were chosen as a control group (n=388). In the defibulation group, 300 (77.3%) women were registered during pregnancy; 88 (22.7%) women were unregistered. Defibulation during vaginal delivery was successfully performed by residents and senior residents under the care of the attending on call. No cesarean delivery was performed because of female genital mutilation or cutting, and no spontaneous rupture of the scar occurred. There were no statistically significant differences between women who had defibulation with those who did not or between infibulated registered and unregistered women in the duration of labor, episiotomy rates, blood loss, Apgar score, or fetal birth weight. Defibulation during vaginal delivery is a valid management option. Labor attendants should be trained to perform it.

  4. Providing information about the consequences of female genital mutilation to healthcare providers caring for women and girls living with female genital mutilation: A systematic review.

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    Oringanje, Chioma M; Okoro, Anthony; Nwankwo, Ogonna N; Meremikwu, Martin M

    2017-02-01

    The persistence of female genital mutilation (FGM) in some countries, despite an overall decline in the prevalence of the practice, calls for improvement in the capacity of healthcare workers and institutions to provide optimal care for this population. To determine the impact of providing information on FGM and its consequences to healthcare providers on their attitudes toward FGM, and quality of care and patient satisfaction. The following major databases were searched from inception to August 2015: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, SCOPUS, Web of Science, and ClinicalTrials.gov, without language restrictions. Controlled studies were included based on use of objective measures. Two team members independently screened and collected data. Relative risks and proportions were calculated and evidence assessed using the GRADE (Grade of Recommendation, Assessment, Development and Evaluation) approach. One study was identified. Based on this study there was no evidence to suggest change in healthcare provider outcomes after the intervention. Despite a comprehensive search, only one study of low methodological quality was included. This precludes a definitive conclusion regarding the impact of providing information on FGM to healthcare providers. More research is needed. CRD42015024570. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  5. Morphology and Ultrastructure of the Accessory Glands in the Female Genital Tract of the House Cricket, Acheta domesticus

    Science.gov (United States)

    Sturm, Robert

    2012-01-01

    The accessory glands in the genital tract of female Acheta domesticus L. (Orthoptera: Gryllidae) were investigated in detail. The glands are situated within the 7th and 8th abdominal segment and lead to the genital chamber lateral to the terminal papilla of the ductus receptaculi. The shape of the gland is characterized by a complex system of tubules, including numerous ramifications. The gland's size ranges from 2 to 4 mm. The epithelium is constructed according to a simple scheme and consists of a cuticular intima at the luminal side, one layer of gland cells, and a basallamina at the outermost side. The observed morphology of the accessory glands widely corresponds with that in other cricket species (e.g., Teleogryllus commodus). This is also true for the structure of a single gland cell, which can be subdivided into a basal part with nucleus and intracellular cisternae, as well as an apical part with all those compartments responsible for the production of the secretion. The secretion itself may be classified as lipophilic and is produced for the first time 4 to 6 days after the imaginai moult. Several endogenic functions of the secretion are discussed (lubricant for oviposition, support for introducing the tube of the spermatophore into the ductus receptaculi, etc.). PMID:23425229

  6. Morphology and ultrastructure of the accessory glands in the female genital tract of the house cricket, Acheta domesticus.

    Science.gov (United States)

    Sturm, Robert

    2012-01-01

    The accessory glands in the genital tract of female Acheta domesticus L. (Orthoptera: Gryllidae) were investigated in detail. The glands are situated within the 7(th) and 8(th) abdominal segment and lead to the genital chamber lateral to the terminal papilla of the ductus receptaculi. The shape of the gland is characterized by a complex system of tubules, including numerous ramifications. The gland's size ranges from 2 to 4 mm. The epithelium is constructed according to a simple scheme and consists of a cuticular intima at the luminal side, one layer of gland cells, and a basallamina at the outermost side. The observed morphology of the accessory glands widely corresponds with that in other cricket species (e.g., Teleogryllus commodus). This is also true for the structure of a single gland cell, which can be subdivided into a basal part with nucleus and intracellular cisternae, as well as an apical part with all those compartments responsible for the production of the secretion. The secretion itself may be classified as lipophilic and is produced for the first time 4 to 6 days after the imaginai moult. Several endogenic functions of the secretion are discussed (lubricant for oviposition, support for introducing the tube of the spermatophore into the ductus receptaculi, etc.).

  7. The timing of female genital mutilation and the role of contralateral palpal insertions in the spiderCyclosa argenteoalba.

    Science.gov (United States)

    Nakata, Kensuke

    2017-11-01

    Some male spiders exhibit female genital mutilation behaviour (FGM) by removing the female genital appendage (scape) to control the mating frequency of females. Female spiders have two, i.e. right and left, genital openings connected with separate spermathecae into which males transfer sperm successively using one pedipalp (secondary genitalia) at a time. Thus, males must complete at least two palpal insertions to fill both spermathecae, before FGM. The present study examined whether (i) scape removal is only associated with the second palpal insertion (one-action hypothesis) or (ii) two contralateral palpal insertions facilitate FGM, with each insertion cutting the basal part of the scape halfway (two-actions hypothesis). Experiments in which females were replaced after a male had made the first insertion did not support the one-action hypothesis, because scapes remained intact after the newly introduced virgin females received their first palpal insertion, which was the second insertion by the males. In comparison, mating experiments using two half-eunuchs (i.e. one of the palps of each male had been manually removed, forcing them to fill female spermatheca on one side only) supported the two-actions hypothesis. FGM was more frequent in females that received two contralateral palpal insertions than in females that received ipsilateral insertions.

  8. "The first cut is the deepest": a psychological, sexological and gynecological perspective on female genital cosmetic surgery.

    Science.gov (United States)

    Barbara, Giussy; Facchin, Federica; Meschia, Michele; Vercellini, Paolo

    2015-09-01

    In recent years increased numbers of healthy women and girls have been seeking female genital cosmetic surgery for esthetic reasons and/or to enhance sexual functioning. This phenomenon is associated with the development of a new vulvovaginal standard due to Internet pornography and the increased exposure of female genitalia. This strict standard may negatively affect women's psychological health and cause increased insecurity, which may drive even teenagers to seek female genital cosmetic surgery. Psychological counseling is recommended to inform women that surgery is not a definitive solution to treat psychologically based pain or dysfunction. Moreover, there is no robust evidence supporting the effectiveness of female genital cosmetic surgery, especially regarding sexual enhancement, as underlined by major scientific societies. The importance of a definite regulation of female genital cosmetic surgery should be emphasized and be based on an ethically oriented, multidisciplinary model aimed at providing exhaustive information on all gynecological, sexological, and psychological concerns raised by this type of surgery. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  9. Attitudes to female genital mutilation/cutting among male adolescents in Ilorin, Nigeria.

    Science.gov (United States)

    Adeniran, Abiodun S; Ijaiya, Munirdeen A; Fawole, Adegboyega A; Balogun, Olayinka R; Adesina, Kikelomo T; Olatinwo, Abdul Waheed O; Olarinoye, Adebunmi O; Adeniran, Peace I

    2016-07-04

    The central role of males in female reproductive health issues in patriarchal societies makes them an important group in the eradication of female genital mutilation/cutting (FGM/C). To determine knowledge about and attitudes to FGM/C among male adolescents, and their preparedness to protect their future daughters from it. A cross-sectional survey among male adolescent students in Ilorin, Nigeria. Participants completed a self-administered questionnaire after consent had been obtained from them or their parents. Statistical analysis was with SPSS version 20.0 (IBM, USA). A p-value of <0.05 was taken as significant. Of 1 536 male adolescents (mean age 15.09 (standard deviation 1.84) years, range 14 - 19), 1 184 (77.1%) were aware of FGM/C, 514 (33.5%) supported female circumcision, 362 (23.6%) would circumcise their future daughters, 420 (27.3%) were of the opinion that FGM/C had benefits, mostly as a necessity for womanhood (109, 7.1%), and 627 (40.8%) perceived it as wickedness against females; 546 (35.5%) were aware of efforts to eradicate FGM/C, and 42.2% recommended education as the most important intervention to achieve this. Education and involvement in advocacy may transform male adolescents into agents for eradication of FGM/C.

  10. Daughters at Risk of Female Genital Mutilation: Examining the Determinants of Mothers' Intentions to Allow Their Daughters to Undergo Female Genital Mutilation.

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    Tahereh Pashaei

    Full Text Available Female genital mutilation (FGM is still a common practice in many countries in Africa and the Middle East. Understanding the determinants of FGM can lead to more active interventions to prevent this harmful practice. The goal of this study is to explore factors associated with FGM behavior among Iranian mothers and their daughters. Based on Ajzen's theory of planned behavior, we examined the predictive value of attitudes, subjective norms, perceived behavioral control and several socio-demographic variables in relation to mothers' intentions to mutilate their daughters. A paper-and-pencil survey was conducted among 300 mothers (mean age = 33.20, SD = 9.09 who had at least one daughter and who lived in Ravansar, a county in Kermanshah Province in Iran. Structural equation modeling was used to investigate the relationships among the study variables. Our results indicate that attitude is the strongest predictor of mothers' intentions to allow their daughters to undergo FGM, followed by subjective norms. Compared to younger mothers, older mothers have more positive attitudes toward FGM, perceive themselves as having more control over their behavior and demonstrate a greater intention to allow their daughter to undergo FGM. Furthermore, we found that less educated mothers and mothers living in rural areas had more positive attitudes toward FGM and feel more social pressure to allow FGM. The model accounts for 93 percent of the variance in the mothers' intentions to allow their daughters to undergo FGM. Intervention programs that want to decrease FGM might focus primarily on converting mothers' neutral or positive feelings toward FGM into negative attitudes and on alleviating the perceived social pressure to mutilate one's daughter. Based on our findings, we provide recommendations about how to curtail mothers' intentions to allow their daughters to undergo FGM.

  11. Daughters at Risk of Female Genital Mutilation: Examining the Determinants of Mothers’ Intentions to Allow Their Daughters to Undergo Female Genital Mutilation

    Science.gov (United States)

    Pashaei, Tahereh; Ponnet, Koen; Moeeni, Maryam; Khazaee-pool, Maryam; Majlessi, Fereshteh

    2016-01-01

    Female genital mutilation (FGM) is still a common practice in many countries in Africa and the Middle East. Understanding the determinants of FGM can lead to more active interventions to prevent this harmful practice. The goal of this study is to explore factors associated with FGM behavior among Iranian mothers and their daughters. Based on Ajzen’s theory of planned behavior, we examined the predictive value of attitudes, subjective norms, perceived behavioral control and several socio-demographic variables in relation to mothers’ intentions to mutilate their daughters. A paper-and-pencil survey was conducted among 300 mothers (mean age = 33.20, SD = 9.09) who had at least one daughter and who lived in Ravansar, a county in Kermanshah Province in Iran. Structural equation modeling was used to investigate the relationships among the study variables. Our results indicate that attitude is the strongest predictor of mothers’ intentions to allow their daughters to undergo FGM, followed by subjective norms. Compared to younger mothers, older mothers have more positive attitudes toward FGM, perceive themselves as having more control over their behavior and demonstrate a greater intention to allow their daughter to undergo FGM. Furthermore, we found that less educated mothers and mothers living in rural areas had more positive attitudes toward FGM and feel more social pressure to allow FGM. The model accounts for 93 percent of the variance in the mothers’ intentions to allow their daughters to undergo FGM. Intervention programs that want to decrease FGM might focus primarily on converting mothers’ neutral or positive feelings toward FGM into negative attitudes and on alleviating the perceived social pressure to mutilate one’s daughter. Based on our findings, we provide recommendations about how to curtail mothers’ intentions to allow their daughters to undergo FGM. PMID:27031613

  12. Lactobacillus Proteins Are Associated with the Bactericidal Activity against E. coli of Female Genital Tract Secretions

    Science.gov (United States)

    Kalyoussef, Sabah; Nieves, Edward; Dinerman, Ellen; Carpenter, Colleen; Shankar, Viswanathan; Oh, Jamie; Burd, Berta; Angeletti, Ruth H.; Buckheit, Karen W.; Fredricks, David N.; Madan, Rebecca P.; Keller, Marla J.; Herold, Betsy C.

    2012-01-01

    Background Female genital tract secretions are bactericidal for Escherichia (E.) coli ex vivo. However, the intersubject variability and molecules that contribute to this activity have not been defined. Methods The bactericidal activity and concentration of immune mediators in cervicovaginal lavage (CVL) collected from 99 healthy women were determined. Results CVL reduced the number of E. coli colonies by 68% [−26, 100] (median [range]). CVL were active against laboratory and clinical isolates of E. coli, but were inactive against Lactobacillus species. Bactericidal activity correlated with the concentration of protein recovered (p90% inhibitory activity (active) and two withbactericidal for E. coli. Conclusion Both host and commensal microbiota proteins contribute to mucosal defense. Identification of these proteins will facilitate the development of strategies to maintain a healthy vaginal microbiome and prevent colonization with pathogenic bacteria such as E. coli that increase the risk for urinary tract infections, preterm labor and perinatal infection. PMID:23185346

  13. The struggle for abandonment of Female Genital Mutilation/Cutting (FGM/C) in Egypt.

    Science.gov (United States)

    Molleman, Gerard; Franse, Lilian

    2009-03-01

    This commentary describes a visit to the Female Genital Mutilation/Cutting project in Cairo. FGM/C is a very serious problem in Egypt and other countries in the North of Africa. Among girls between the age of 15-17, 77% have been cut, with very serious health consequences. In Egypt, there is a comprehensive strategy led by very enthusiastic employees of the National Council for Childhood and Motherhood with support of UNICEF. At a national level a broad coalition is being built that tries to mobilise the legal, medical and media communities to overcome the practice of FGM/C and realising adequate laws that criminalise FGM/C.At a local level two community projects were started in 160 villages in Upper and Lower Egypt for raising community awareness and dialogue on FGM/C. That is the only way to create a growing social movement that can collectively abandon the practice of FGM/C.

  14. Female genital mutilation/cutting: risk management and strategies for social workers and health care professionals.

    Science.gov (United States)

    Costello, Susan

    2015-01-01

    Female genital mutilation/cutting (FGM/C) is a traditional practice originating in Africa. Its worst forms cause irreparable harm to girls and women and have no medical justification. Based on a literature review of global responses to FGM/C and conversations with Australian women who migrated from FGM/C practicing countries, this paper provides some background on FGM/C and its epidemiology, outlining its prevalence, types, and health risks and complications for women and girls. It discusses risk-prevention strategies, first, for health practitioners in identifying, screening, and supporting women affected by FGM/C and, second, for welfare and social workers and health care professionals to identify, work with, and prevent girls from being cut. Consistent with international trends in addressing the risks of FGM/C, the paper suggests practice responses for coordinated responses between professionals, communities from practicing countries, and governments of different countries.

  15. Internalizing Knowledge and Changing Attitudes to Female Genital Cutting/Mutilation

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    Inger-Lise Lien

    2013-01-01

    Full Text Available The process of paradigmatic attitudinal change has been analyzed by the use of multimethods and multileveled internalization theories. Forty-six informants (a network of activists and a group of Gambian women have described their change of attitude to female genital cutting. This study shows that internalizing a packet of information as adults, that contradicts an old schema of knowledge internalized as children, can be experienced as epistemologically very painful. Activists in Norway who have changed their attitude to FGC have got information from different educational institutions, from seminars and conferences, from work as interpreters in hospitals, and from discussions among families and friends. Information can be received, listened to and subsequently discarded. In order to design FGC-abandonment campaigns, the importance of the internalization process in order for the individual to make an attitudinal change must be understood.

  16. Type I female genital mutilation: a cause of completely closed vagina.

    Science.gov (United States)

    Rouzi, Abdulrahim A; Sahly, Nora; Alhachim, Estabraq; Abduljabbar, Hassan

    2014-09-01

    Female genital mutilation (FGM) ranges in severity from a nick of the clitoris to partial or total removal of the external genitalia. Sexual complications after FGM include sexual dysfunction, difficult intercourse, and dyspareunia. We report a case of Type I FGM presenting as complete vaginal closure and urinary retention. A 16-year-old adolescent was referred for obliterated vagina and urinary retention. She had recurrent urinary tract infections, difficulty in voiding, and cyclic hematuria. At the age of 1 year she had been taken by her mother to a pediatric surgeon to have a Type I FGM procedure. On examination, the urethral meatus and vaginal orifices were completely closed by the FGM scar. She underwent uneventful surgical opening of the vagina. A normal vaginal orifice was created and normal flow of urine and menses occurred. Type I FGM can present as complete vaginal closure and urinary retention. Proper diagnosis and treatment are of paramount importance. © 2014 International Society for Sexual Medicine.

  17. Gross morphology and morphometry of squirrel monkey (Saimiri sciureus Linnaeus, 1758 female genital organs

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    Erika Branco

    2010-03-01

    Full Text Available The gross anatomy of the genital organs of four specimens of young female of Saimiri sciureus was investigated. The animals were bred in captivity at the Centro Nacional de Primatas and had died from natural causes. The vulva was limited by the labium minus and presented a well-developed clitoris which seemed to represent a rudimentary penis. The vaginal vestibule was the first cavity and was very short, presenting a thick muscular wall which extended from the vulva comissure to the vaginal ostium. The vagina was constituted by an elongated and dorsally flattened muscular tube with a thin wall between the vaginal vestibule and cervix. The cervix was short with well-developed musculature. The uterus was simple, presenting a global fundus located in the caudal portion of the abdominal cavity. The uterine tubes were elongated and rectilinear, connected to the ovaries which were large, ellipsoid in shape, and presented a smooth surface.

  18. Female genital interventions: Between the plastic surgeon’s scalpel and the ritual knife

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    La Barbera, MariaCaterina

    2010-12-01

    Full Text Available While enormous and growing sums of money are spent each year in genital cosmetic surgeries, ritual female genital interventions increasingly meet strong political and social opposition. Which interpretative models have been adopted to define some interventions as “cosmetic” and the others as “criminal”? Is there a colonialist attitude implicit in banning ritual female genital interventions? This appear to be the case after a joint examination of the health risks associated with the breast implant, the symbolic meanings of the ritual interventions, the strategic reinvention of traditional practices, and the use of the binomy health/pathology as a “controlling process”. This paper challenges the assumption that who is exposed to the plastic surgeon’s scalpel enjoys freedom and autonomy in an oppression-free society, while who is subjected to the ritual knife is a passive victim of traditional patriarchal societies.

    Mientras se gastan cifras enormes y cada año crecientes en intervenciones quirúrgicas que modifican los órganos sexuales, las intervenciones rituales sobre los genitales femeninos encuentran una oposición política y social cada vez más fuerte. ¿Cuáles son los modelos interpretativos adoptados para definir como estéticas a unas y criminales a las otras? ¿Existe una actitud colonialista implícita en la condena de las intervenciones rituales sobre los genitales femeninos? Este parece ser el caso cuando se examinan conjuntamente los daños para la salud derivados del implante mamario, los significados simbólicos de las intervenciones rituales, la reinvención estratégica de las prácticas tradicionales y el uso del binomio salud/patología como “proceso de control”. Este artículo propone cuestionar la idea de que quien se somete al bisturí del cirujano plástico disfruta de libertad y autonomía en una sociedad libre de opresión, mientras que quien se expone al cuchillo ritual es víctima pasiva de

  19. The Dutch approach to female genital mutilation in view of the ECHR The time for change has come

    NARCIS (Netherlands)

    Kool, Renée

    2010-01-01

    Worldwide female genital mutilation (FGM) is acknowledged as a serious violation of human rights which needs to be actively combated. However, in Europe France has been the only state to have prosecuted cases of FGM: until 2007 37 cases were tried. As for the Netherlands, (assumingly) FGM is

  20. The lower prevalence of female genital mutilation in the Netherlands: a nationwide study in Dutch midwifery practices

    NARCIS (Netherlands)

    Korfker, D.G.; Reis, R.; Rijnders, M.E.B.; Meijer-van Asperen, S.; Read, L.; Sanjuan, M.; Herschderfer, K.; Buitendijk, S.E.

    2012-01-01

    Objectives To determine the prevalence of female genital mutilation (FGM) in women giving birth in 2008 in the Netherlands. Method A retrospective questionnaire study was conducted. The study covered all 513 midwifery practices in the Netherlands. The data were analysed with SPSS 17.0. Results The

  1. Female genital mutilation/cutting and issues of sexuality in Egypt.

    Science.gov (United States)

    Fahmy, Amel; El-Mouelhy, Mawaheb T; Ragab, Ahmed R

    2010-11-01

    Female genital mutilation/cutting (FGM/C), officially referred to as female circumcision and at community level as tahara (cleanliness), is still prevalent in Egypt. This study was designed to examine the role of female sexuality in women's and men's continued support for FGM/C, and their perceptions of its sexual consequences. The study was conducted in 2008-09 in two rural communities in Upper Egypt and a large slum area in Cairo. Qualitative data were collected from 102 women and 99 men through focus group discussions and interviews. The clitoris was perceived to be important to, and a source of, sexual desire rather than sexual pleasure. FGM/C was intended to reduce women's sexual appetite and increase women's chastity, but was generally not believed to reduce women's sexual pleasure. Men and women framed sexual pleasure differently, however. While men, especially younger men, considered sexual satisfaction as a cornerstone of marital happiness, women considered themselves sexually satisfied if there was marital harmony and their socio-economic situation was satisfactory. However, sexual problems, including lack of pleasure in sex and sexual dissatisfaction, for whatever reasons, were widespread. We conclude that political commitment is necessary to combat FGM/C and that legal measures must be combined with comprehensive sexuality education, including on misconceptions about FGM/C. Copyright © 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  2. Changing practices and shifting meanings of female genital cutting among the Maasai of Arusha and Manyara regions of Tanzania.

    Science.gov (United States)

    Van Bavel, Hannelore; Coene, Gily; Leye, Els

    2017-12-01

    Using mixed methods that combined participant observation and semi-structured in-depth interviews, this study looked at changing practices and shifting meanings of female genital cutting among the Maasai people in Tanzania. The findings suggest that an increasing social pressure to abandon female genital cutting has inspired the hiding of the practice, causing the actual cutting to become detached from its traditional ceremonial connotations. This detaching of cutting from ceremony has created a shift in meanings: the ceremony still carries the meaning of passage into adulthood, while the cutting seems to function as a way of inscribing Maasai identity into the body. The detaching of genital cutting from ceremony offers those willing to continue the practice the opportunity to do so without being prosecuted, and those unwilling to undergo or perform the practice the opportunity to evade it by faking the cutting without being socially sanctioned for it. Findings also suggest changing attitudes towards the practice among the younger generation as the result of education. Maasai culture and the practice of female genital cutting are not static but actively challenged and reinterpreted from within the community, with formally schooled and women taking up leading roles in reshaping gender norms.

  3. Assailants' sexual dysfunction during rape: prevalence and relationship to genital trauma in female victims.

    Science.gov (United States)

    Jones, Jeffrey S; Rossman, Linda; Wynn, Barbara N; Ostovar, Herald

    2010-05-01

    Partial or complete failure to maintain an erection sufficient for coitus is known to occur in a proportion of sexual assailants during the rape episode. The purpose of this study was to determine whether the presence of coercion, physical violence, and genital injury associated with sexual assaults is influenced by the assailant's erectile impotence. This prospective, observational study evaluated consecutive female patients presenting to a free-standing urban sexual assault clinic during a 3-year study period. Sexual assault victims presenting directly to four downtown emergency departments (EDs) are routinely referred to the clinic for evaluation after triage and initial assessment. The clinic is associated with a university-affiliated emergency medicine residency program and is staffed by forensic nurses trained to perform medical-legal examinations. The primary outcome was to compare the frequency of anogenital findings documented in women whose assailant experienced no erectile dysfunction vs. those victims who reported erectile impotence in the assailant. During the study period, 569 sexual assault victims were eligible to participate in the study; 47 (8.3%) reported that their assailants had experienced erectile impotence. Except for assailant age, the two victim groups were comparable in terms of marital status, alcohol and drug use, known assailant, and time to physical examination. In attacks where erectile dysfunction occurred, there was a higher incidence of physical coercion (60% vs. 32% without physical coercion, p rape episode. Despite this erectile dysfunction, the majority of sexual assault victims sustained anogenital trauma. In the attacks with erectile impotence, there was a higher incidence of intra-rape violence and subsequent non-genital injuries. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  4. Attitude toward female genital mutilation among Somali and Harari people, Eastern Ethiopia

    Directory of Open Access Journals (Sweden)

    Abathun AD

    2016-10-01

    Full Text Available Asresash Demissie Abathun,1 Johanne Sundby,2 Abdi A Gele3 1Faculty of Medicine, Institute of Health and Society, 2Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, 3Department of Nursing and Health Promotion, Oslo and Akershus University College, Oslo, Norway Background: Female genital mutilation (FGM is a worldwide problem, and it is practiced by many communities in Africa and Asia as well as immigrants from those areas. This practice results in short- and long-term health consequences on women’s health. Like many other developing countries, FGM is widely practiced in Ethiopia, especially among Somali and Harari ethnic groups. Despite intensive campaigns against FGM in Ethiopia, since 2011, it has been practiced in the aforementioned communities. There is no recent information as to whether these campaigns have an impact on the attitude and practice of the community regarding FGM. This qualitative research was aimed at exploring the attitudes of Somali and Harari people between 18 and 65 years toward FGM.Methods: A purposive sampling technique was used to recruit 64 (32 in each region participants. Data were collected from October to December 2015 in Somali and Harari Regions.Results: The findings showed that there was a strong support for the continuation of the practice among female discussants in Somali region, whereas male discussants from the same region and the majority of the participants from Harari region had a positive attitude toward the discontinuation of the practice. Marriageability was the major reason for practicing FGM in Somali region, whereas making girls calm, sexually inactive, and faithful for their husbands were mentioned in Harari region. Although young men in both the regions prefer to marry uncircumcised girls, the study showed that there are some differences in the attitude toward the FGM practice between the people in the two regions.Conclusion: The findings

  5. The Evolution of a Female Genital Trait Widely Distributed in the Lepidoptera: Comparative Evidence for an Effect of Sexual Coevolution

    Science.gov (United States)

    Sánchez, Víctor; Hernández-Baños, Blanca Estela; Cordero, Carlos

    2011-01-01

    Background Sexual coevolution is considered responsible for the evolution of many male genital traits, but its effect on female genital morphology is poorly understood. In many lepidopterans, females become temporarily unreceptive after mating and the length of this refractory period is inversely related to the amount of spermatophore remaining in their genital tracts. Sperm competition can select for males that delay female remating by transferring spermatophores with thick spermatophore envelopes that take more time to be broken. These envelopes could select for signa, sclerotized sharp structures located within the female genital tract, that are used for breaking spermatophores. Thus, this hypothesis predicts that thick spermatophore envelopes and signa evolve in polyandrous species, and that these adaptations are lost when monandry evolves subsequently. Here we test the expected associations between female mating pattern and presence/absence of signa, and review the scant information available on the thickness of spermatophore envelopes. Methodology/Principal Findings We made a literature review and found information on female mating pattern (monandry/polyandry), presence/absence of signa and phylogenetic position for 37 taxa. We built a phylogenetic supertree for these taxa, mapped both traits on it, and tested for the predicted association by using Pagel's test for correlated evolution. We found that, as predicted by our hypothesis, monandry evolved eight times and in five of them signa were lost; preliminary evidence suggests that at least in two of the three exceptions males imposed monandry on females by means of specially thick spermatophore envelopes. Previously published data on six genera of Papilionidae is in agreement with the predicted associations between mating pattern and the characteristics of spermatophore envelopes and signa. Conclusions/Significance Our results support the hypothesis that signa are a product of sexually antagonistic

  6. The evolution of a female genital trait widely distributed in the Lepidoptera: comparative evidence for an effect of sexual coevolution.

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    Víctor Sánchez

    Full Text Available BACKGROUND: Sexual coevolution is considered responsible for the evolution of many male genital traits, but its effect on female genital morphology is poorly understood. In many lepidopterans, females become temporarily unreceptive after mating and the length of this refractory period is inversely related to the amount of spermatophore remaining in their genital tracts. Sperm competition can select for males that delay female remating by transferring spermatophores with thick spermatophore envelopes that take more time to be broken. These envelopes could select for signa, sclerotized sharp structures located within the female genital tract, that are used for breaking spermatophores. Thus, this hypothesis predicts that thick spermatophore envelopes and signa evolve in polyandrous species, and that these adaptations are lost when monandry evolves subsequently. Here we test the expected associations between female mating pattern and presence/absence of signa, and review the scant information available on the thickness of spermatophore envelopes. METHODOLOGY/PRINCIPAL FINDINGS: We made a literature review and found information on female mating pattern (monandry/polyandry, presence/absence of signa and phylogenetic position for 37 taxa. We built a phylogenetic supertree for these taxa, mapped both traits on it, and tested for the predicted association by using Pagel's test for correlated evolution. We found that, as predicted by our hypothesis, monandry evolved eight times and in five of them signa were lost; preliminary evidence suggests that at least in two of the three exceptions males imposed monandry on females by means of specially thick spermatophore envelopes. Previously published data on six genera of Papilionidae is in agreement with the predicted associations between mating pattern and the characteristics of spermatophore envelopes and signa. CONCLUSIONS/SIGNIFICANCE: Our results support the hypothesis that signa are a product of sexually

  7. Psychosexual Complications of Female Genital Mutilation for Couples: A Comparative Study

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    Osman Mahmoudi

    2017-03-01

    Full Text Available Introduction: Female genital mutilation (FGM comprises of various procedures that damage female genitalia for non-therapeutic intentions, and it offers multidimensional and interdependent effects. Objectives: The aim of this study was to determine whether FGM versus non-FGM couples in Kermanshah in Iran vary in relationship characteristics, such as relationship satisfaction, sexual satisfaction, and mental health. Methods: To achieve this goal of research, a sample of 414 couples (206 FGM couples and 208 normal couples of Uramanat area in Kermanshah Province, were selected by non-randomized sampling. Enrich Marital Inventory, 25-SCL Mental Health Inventory and the Arizona Sexual Experience Scale were used for data collection. Data were analyzed between the two groups by utilizing independent t-test. The significance level was P < 0.05. Results: The findings indicated that there was a significant difference between FGM couples and normal couples. Besides, the results revealed that the two groups of participants had significant differences in mental health, marital satisfaction, and sexual function. Overall, FGM couples compared with normal couples had lower levels of mental health, marital satisfaction, and sexual function. Conclusion: FGM is associated with frequent psychosexual difficulties in Uramanat couples; notably orgasm difficulties, sense of incomplete sexual-needs fulfillment, and neurotic symptoms. Awareness of the psychosexual effects of this operation could help women cope with psychological and psychosexual problems, and could prevent the performing of this inhuman action on others.

  8. Punishment of Minor Female Genital Ritual Procedures: Is the Perfect the Enemy of the Good?

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    Jacobs, Allan J; Arora, Kavita Shah

    2017-08-01

    Female genital alteration (FGA) is any cutting, removal or destruction of any part of the external female genitalia. Various FGA practices are common throughout the world. While most frequent in Africa and Asia, transglobal migration has brought ritual FGA to Western nations. All forms of FGA are generally considered undesirable for medical and ethical reasons when performed on minors. One ritual FGA procedure is the vulvar nick (VN). This is a small laceration to the vulva that does not cause morphological changes. Besides being performed as a primary ritual procedure it has been proposed as a substitute for more extensive forms of FGA. Measures advocated or taken to reduce the burden of FGA can be punitive or non-punitive. Even if it is unethical to perform VN, we argue that it also is unethical to attempt to suppress it through punishment. First, punishment of VN is likely to cause more harm than good overall, even to those ostensibly being protected. Second, punishment is likely to exceed legitimate retributive ends. We do not argue in favor of performing VN. Rather, we argue that non-punitive strategies such as education and harm reduction should be employed. © 2016 John Wiley & Sons Ltd.

  9. Health consequences of female genital mutilation/cutting in the Gambia, evidence into action

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    Hechavarría Suiberto

    2011-10-01

    Full Text Available Abstract Background Female Genital Mutilation/Cutting (FGM/C is a harmful traditional practice with severe health complications, deeply rooted in many Sub-Saharan African countries. In The Gambia, the prevalence of FGM/C is 78.3% in women aged between 15 and 49 years. The objective of this study is to perform a first evaluation of the magnitude of the health consequences of FGM/C in The Gambia. Methods Data were collected on types of FGM/C and health consequences of each type of FGM/C from 871 female patients who consulted for any problem requiring a medical gynaecologic examination and who had undergone FGM/C in The Gambia. Results The prevalence of patients with different types of FGM/C were: type I, 66.2%; type II, 26.3%; and type III, 7.5%. Complications due to FGM/C were found in 299 of the 871 patients (34.3%. Even type I, the form of FGM/C of least anatomical extent, presented complications in 1 of 5 girls and women examined. Conclusion This study shows that FGM/C is still practiced in all the six regions of The Gambia, the most common form being type I, followed by type II. All forms of FGM/C, including type I, produce significantly high percentages of complications, especially infections.

  10. Body enhancement through female genital cosmetic surgery creates ethical and rights dilemmas.

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    Cain, Joanna M; Iglesia, Cheryl B; Dickens, Bernard; Montgomery, Owen

    2013-08-01

    Female genital cosmetic surgery is surgery performed on a woman within a normal range of variation of human anatomy. The issues are heightened by a lack of long-term and substantive evidence-based literature, conflict of interest from personal financial gain through performing these procedures, and confusion around macroethical and microethical domains. It is a source of conflict and controversy globally because the benefit and harm of offering these procedures raise concerns about harmful cultural views, education, and social vulnerability of women with regard to both ethics and human rights. The rights issues of who is defining normal female anatomy and function, as well as the economic vulnerability of women globally, bequeath the profession a greater responsibility to ensure that there is adequate health and general education-not just among patients but broadly in society-that there is neither limitation nor interference in the decision being made, and that there are no psychological disorders that could be influencing such choices. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  11. The effects of female genital mutilation on the onset of sexual activity and marriage in Guinea.

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    Van Rossem, Ronan; Gage, Anastasia J

    2009-04-01

    Female genital mutilation (FGM) is almost universal in Guinea and practiced by all ethnic and religious groups and social classes, although the prevalence of the various types of FGM varies by socioeconomic group. A common explanation for FGM practices is that they contribute to the social control over female sexuality and enhance the marriageability of women. These claims were tested using the 1999 Guinea Demographic and Health Survey (DHS) (N = 6753). Event history techniques were used to examine the effect of type of FGM on the age at first sex and the age at first marriage and logistic regression for the effect of FGM on premarital sex. The results showed that the type of FGM had a significant zero-order effect on the age at first marriage and the prevalence of premarital sex, but not on the age at first sex. However, these effects became non-significant once controls for age, religion, ethnicity, education, residence, and wealth were added to the model. Variations in sexual behavior, therefore, were unrelated to type of FGM, but reflected differences in the social characteristics of the participants.

  12. The Applicability of Behaviour Change in Intervention Programmes Targeted at Ending Female Genital Mutilation in the EU: Integrating Social Cognitive and Community Level Approaches

    OpenAIRE

    Brown, Katherine; Beecham, David; Barrett, Hazel

    2013-01-01

    With increased migration, female genital mutilation (FGM) also referred to as female circumcision or female genital cutting is no longer restricted to Africa, the Middle East, and Asia. The European Parliament estimates that up to half a million women living in the EU have been subjected to FGM, with a further 180,000 at risk. Aware of the limited success of campaigns addressing FGM, the World Health Organization recommended a behavioural change approach be implemented in order to end FGM. T...

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

    OpenAIRE

    Adinew, Yohannes Mehretie; Mekete, Beza Tamirat

    2017-01-01

    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. Me...

  14. Information ranks highest: Expectations of female adolescents with a rare genital malformation towards health care services.

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    Elisabeth Simoes

    Full Text Available Access to highly specialized health care services and support to meet the patient's specific needs is critical for health outcome, especially during age-related transitions within the health care system such as with adolescents entering adult medicine. Being affected by an orphan disease complicates the situation in several important respects. Long distances to dedicated institutions and scarcity of knowledge, even among medical doctors, may present major obstacles for proper access to health care services and health chances. This study is part of the BMBF funded TransCareO project examining in a mixed-method design health care provisional deficits, preferences, and barriers in health care access as perceived by female adolescents affected by the Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS, a rare (orphan genital malformation.Prior to a communicative validation workshop, critical elements of MRKHS related care and support (items were identified in interviews with MRKHS patients. During the subsequent workshop, 87 persons involved in health care and support for MRKHS were asked to rate the items using a 7-point Likert scale (7, strongly agree; 1, strongly disagree as to 1 the elements' potential importance (i.e., health care expected to be "best practice", or priority and 2 the presently experienced care. A gap score between the two was computed highlighting fields of action. Items were arranged into ten separate questionnaires representing domains of care and support (e.g., online-portal, patient participation. Within each domain, several items addressed various aspects of "information" and "access". Here, we present the outcome of items' evaluation by patients (attended, NPAT = 35; respondents, NRESP = 19.Highest priority scores occurred for domains "Online-Portal", "Patient participation", and "Tailored informational offers", characterizing them as extremely important for the perception as best practice. Highest gap scores yielded domains

  15. Effects of female genital cutting on physical health outcomes: a systematic review and meta-analysis.

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    Berg, Rigmor C; Underland, Vigdis; Odgaard-Jensen, Jan; Fretheim, Atle; Vist, Gunn E

    2014-11-21

    Worldwide, an estimated 125 million girls and women live with female genital mutilation/cutting (FGM/C). We aimed to systematically review the evidence for physical health risks associated with FGM/C. We searched 15 databases to identify studies (up to January 2012). Selection criteria were empirical studies reporting physical health outcomes from FGM/C, affecting females with any type of FGM/C, irrespective of ethnicity, nationality and age. Two review authors independently screened titles and abstracts, applied eligibility criteria, assessed methodological study quality and extracted full-text data. To derive overall risk estimates, we combined data from included studies using the Mantel-Haenszel method for unadjusted dichotomous data and the generic inverse-variance method for adjusted data. Outcomes that were sufficiently similar across studies and reasonably resistant to biases were aggregated in meta-analyses. We applied the instrument Grading of Recommendations Assessment, Development and Evaluation to assess the extent to which we have confidence in the effect estimates. Our search returned 5109 results, of which 185 studies (3.17 million women) satisfied the inclusion criteria. The risks of systematic and random errors were variable and we focused on key outcomes from the 57 studies with the best available evidence. The most common immediate complications were excessive bleeding, urine retention and genital tissue swelling. The most valid and statistically significant associations for the physical health sequelae of FGM/C were seen on urinary tract infections (unadjusted RR=3.01), bacterial vaginosis (adjusted OR (AOR)=1.68), dyspareunia (RR=1.53), prolonged labour (AOR=1.49), caesarean section (AOR=1.60), and difficult delivery (AOR=1.88). While the precise estimation of the frequency and risk of immediate, gynaecological, sexual and obstetric complications is not possible, the results weigh against the continuation of FGM/C and support the diagnosis and

  16. Effects of female genital cutting on physical health outcomes: a systematic review and meta-analysis

    Science.gov (United States)

    Berg, Rigmor C; Underland, Vigdis; Odgaard-Jensen, Jan; Fretheim, Atle; Vist, Gunn E

    2014-01-01

    Objective Worldwide, an estimated 125 million girls and women live with female genital mutilation/cutting (FGM/C). We aimed to systematically review the evidence for physical health risks associated with FGM/C. Design We searched 15 databases to identify studies (up to January 2012). Selection criteria were empirical studies reporting physical health outcomes from FGM/C, affecting females with any type of FGM/C, irrespective of ethnicity, nationality and age. Two review authors independently screened titles and abstracts, applied eligibility criteria, assessed methodological study quality and extracted full-text data. To derive overall risk estimates, we combined data from included studies using the Mantel-Haenszel method for unadjusted dichotomous data and the generic inverse-variance method for adjusted data. Outcomes that were sufficiently similar across studies and reasonably resistant to biases were aggregated in meta-analyses. We applied the instrument Grading of Recommendations Assessment, Development and Evaluation to assess the extent to which we have confidence in the effect estimates. Results Our search returned 5109 results, of which 185 studies (3.17 million women) satisfied the inclusion criteria. The risks of systematic and random errors were variable and we focused on key outcomes from the 57 studies with the best available evidence. The most common immediate complications were excessive bleeding, urine retention and genital tissue swelling. The most valid and statistically significant associations for the physical health sequelae of FGM/C were seen on urinary tract infections (unadjusted RR=3.01), bacterial vaginosis (adjusted OR (AOR)=1.68), dyspareunia (RR=1.53), prolonged labour (AOR=1.49), caesarean section (AOR=1.60), and difficult delivery (AOR=1.88). Conclusions While the precise estimation of the frequency and risk of immediate, gynaecological, sexual and obstetric complications is not possible, the results weigh against the continuation of

  17. Transfer of IgG in the female genital tract by MHC class I-related neonatal Fc receptor (FcRn) confers protective immunity to vaginal infection

    Science.gov (United States)

    IgG is a major immunoglobulin subclass in mucosal secretions of human female genital tract, where it predominates over the IgA isotype. Despite the abundance of IgG, surprisingly little is known about whether and how IgG enters the lumen of the genital tract and the exact role of local IgG may play ...

  18. The risk of female genital cutting in Europe: Comparing immigrant attitudes toward uncut girls with attitudes in a practicing country.

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    Vogt, Sonja; Efferson, Charles; Fehr, Ernst

    2017-12-01

    Worldwide, an estimated 200 million girls and women have been subjected to female genital cutting. Female genital cutting is defined as an intentional injury to the female genitalia without medical justification. The practice occurs in at least 29 countries in Africa, the Middle East, and Asia. In addition, globalization and migration have brought immigrants from countries where cutting is commonly practiced to countries where cutting is not traditionally practiced and may even be illegal. In countries receiving immigrants, governments and development agencies would like to know if girls with parents who immigrated from practicing countries are at risk of being cut. Risk assessments, for example, could help governments identify the need for programs promoting the abandonment of cutting among immigrants. Extrapolating from the prevalence and incidence rates in practicing countries, however, is generally not sufficient to guarantee a valid estimate of risk in immigrant populations. In particular, immigrants might differ from their counterparts in the country of origin in terms of attitudes toward female genital cutting. Attitudes can differ because migrants represent a special sample of people from the country of origin or because immigrants acculturate after arriving in a new country. To examine these possibilities, we used a fully anonymous, computerized task to elicit implicit attitudes toward female genital cutting among Sudanese immigrants living in Switzerland and Sudanese people in Sudan. Results show that Sudanese immigrants in Switzerland were significantly more positive about uncut girls than Sudanese in Sudan, and that selective migration out of Sudan likely contributed substantially to this difference. We conclude by suggesting how our method could potentially be coupled with recent efforts to refine extrapolation methods for estimating cutting risk among immigrant populations. More broadly, our results highlight the need to better understand how

  19. Improving estimates of the prevalence of Female Genital Mutilation/Cutting among migrants in Western countries

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    Livia Elisa Ortensi

    2015-02-01

    Full Text Available Background: Female Genital Mutilation/Cutting (FGM/C is an emerging topic in immigrant countries as a consequence of the increasing proportion of African women in overseas communities. Objective: While the prevalence of FGM/C is routinely measured in practicing countries, the prevalence of the phenomenon in western countries is substantially unknown, as no standardized methods exist yet for immigrant countries. The aim of this paper is to present an improved method of indirect estimation of the prevalence of FGM/C among first generation migrants based on a migrant selection hypothesis. A criterion to assess reliability of indirect estimates is also provided. Methods: The method is based on data from Demographic Health Surveys (DHS and Multiple Indicator Cluster Surveys (MICS. Migrants' Selection Hypothesis is used to correct national prevalence estimates and obtain an improved estimation of prevalence among overseas communities. Results: The application of the selection hypothesis modifies national estimates, usually predicting a lower occurrence of FGM/C among immigrants than in their respective practicing countries. A comparison of direct and indirect estimations confirms that the method correctly predicts the direction of the variation in the expected prevalence and satisfactorily approximates direct estimates. Conclusions: Given its wide applicability, this method would be a useful instrument to estimate FGM/C occurrence among first generation immigrants and provide corresponding support for policies in countries where information from ad hoc surveys is unavailable.

  20. Counselling for deinfibulation among women with type III female genital mutilation: A systematic review.

    Science.gov (United States)

    Bello, Segun; Ogugbue, Miriam; Chibuzor, Moriam; Okomo, Uduak; Meremikwu, Martin M

    2017-02-01

    Counselling is a routine practice done before deinfibulation in women with type III female genital mutilation (FGM). However, cultural and social pressures, in addition to maladaptation to the changes in the body post deinfibulation, cause some women to choose to be reinfibulated after being deinfibulated. To conduct a systematic review of the impact of counselling prior to deinfibulation on patient satisfaction, marital satisfaction, and rate of requests for reinfibulation among women living with type III FGM. The secondary aim was to assess the impact of male partner involvement in counselling on patient satisfaction, marital satisfaction, and rate of requests for reinfibulation. Major databases including Cochrane Central Register of Controlled Trials, Medline, SCOPUS, and ClinicalTrials.gov were searched until August 2015. Studies comparing women with type III FGM who received counselling before deinfibulation versus no counselling were included. Two team members independently screened and collected data. No eligible studies were identified. There is no evidence to conclude that counselling before deinfibulation influences patients' satisfaction with overall quality of care or rates of request for reinfibulation. CRD42015024675. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  1. Female genital mutilation of minors in Italy: is a harmless and symbolic alternative justified?

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    Maria Luisa Di Pietro

    2012-09-01

    Full Text Available

    In 2004, Omar Abdulcadir - a gynecologist of the Centre for the prevention and therapy of female genital mutilation (FMG at the Careggi Hospital (Florence - proposed a “harmless and symbolic” alternative to FMG, which consists in the puncture of the clitoris under local anesthesia, in order to allow the outflow of some drops of blood (1.

    The intention behind the symbolic alternative is to avoid more severe forms of FGM while respecting cultural heritage. The proposal of this alternative procedure, which was sustained by the leaders of 10 local African immigrant communities, has encountered ample criticism (1.

    However, the question is: is the puncture of the clitoris prohibited by the Italian Law n. 7/2006? If it is not, could it be considered a method of reducing health risks caused by the more invasive forms of FGM (2? Or could it culturally legitimize FGM, causing a greater difficulty in the attempts to prevent and eradicate FGM in Italy?

  2. Female Genital Mutilation/Cutting: The Secret World of Women as Seen by Men

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    Adriana Kaplan

    2013-01-01

    Full Text Available Efforts aimed at the abandonment of Female Genital Mutilation/Cutting (FGM/C in the communities where it is deeply rooted have extensively considered and addressed women’s perceptions on the issue, leaving those of men barely acknowledged. Although the practice is generally confined to the secret world of women, it does not mean that men cannot be influential. Indeed, men can play an important role in prevention. In order to address this gap, and having as background an extensive ethnographic field work, a transversal descriptive study was designed to explore Gambian men’s knowledge and attitudes towards FGM/C, as well as related practices in their family/household. Results show ethnic identity, more than religion, as the decisive shaping factor on how men conceive and value FGM/C. The greater support towards the practice is found among traditionally practicing groups. A substantial proportion of men intend to have it performed on their daughters, although reporting a low involvement in the decision making process, with very few taking alone the final decision. Only a minority is aware of FGM/C health consequences, but those who understand its negative impact on the health and well-being of girls and women are quite willing to play a role in its prevention.

  3. Obstetric care of women with female genital mutilation attending a specialized clinic in a tertiary center.

    Science.gov (United States)

    Abdulcadir, Jasmine; Dugerdil, Adeline; Yaron, Michal; Irion, Olivier; Boulvain, Michel

    2016-02-01

    To study the obstetric outcomes of women attending a specialized clinic for women with female genital mutilation (FGM). The medical charts of women with FGM who consecutively attended a specialized clinic between 2010 and 2012 were reviewed retrospectively. The present study focused on women attending for obstetric reasons. The outcome measures were type of delivery, reason for cesarean delivery or assisted delivery, blood loss, episiotomy, perineal tear, duration of the second stage of labor, postpartum complications, weight of the neonate, and Apgar score. Outcomes were compared between women with FGM type III who underwent defibulation, and patients with FGM type I and II. The clinic was attended by 129 women, 84 perinatally. Obstetric outcomes were similar to average outcomes for women without FGM presenting at the same department and in Switzerland generally. Specifically, 20 women had a cesarean delivery. An assisted delivery was performed for 18 patients; among these, only eight had experienced obstructed labor. No statistically significant differences were found for the outcome measures when women with FGM type III were compared to FGM type I and II. Routine obstetric follow-up combined with specialized care for women with FGM, including defibulation, can avoid inappropriate obstetric practices and reduce obstetric complications known to be associated with FGM. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  4. A multidisciplinary approach to clitoral reconstruction after female genital mutilation: the crucial role of counselling.

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    De Schrijver, Lotte; Leye, Els; Merckx, Mireille

    2016-08-01

    Female genital mutilation (FGM) is becoming more widely seen in the West, due to immigration and population movement. Health services are being confronted with the need to provide care for women with FGM. One of the more recent trends is the provision of clitoral reconstruction. It remains unclear, however, what constitutes good practice with regard to this type of surgery. Based on a keynote presentation about reconstructive clitoral surgery, we briefly discuss the possible consequences of FGM and the findings from recent publications on clitoral reconstruction. Recognising individual differences in women, we suggest a multidisciplinary counselling model to provide appropriate care for women requesting clitoral reconstruction. The literature shows that FGM influences physical, mental and sexual health. Clitoral reconstructive surgery can lead to an increase in sexual satisfaction and orgasm in some, but not all, women. A multidisciplinary approach would enable a more satisfactory and individually tailored approach to care. The multidisciplinary team should consist of a midwife, a gynaecological surgeon, a psychologist-psychotherapist, a sexologist and a social worker. Comprehensive health counselling should be the common thread in this model of care. Our proposed care pathway starts with taking a thorough history, followed by medical, psychological and sexological consultations. Women with FGM requesting clitoral reconstruction might primarily be looking to improve their sexual life, to recover their identity and to reduce pain. Surgery may not always be the right answer. Thorough counselling that includes medical, psychological and sexual advice is therefore necessary as part of a multidisciplinary approach.

  5. Interventions for healthcare providers to improve treatment and prevention of female genital mutilation: a systematic review.

    Science.gov (United States)

    Balfour, Julie; Abdulcadir, Jasmine; Say, Lale; Hindin, Michelle J

    2016-08-19

    Studies on healthcare providers' awareness, knowledge and attitudes regarding female genital mutilation (FGM) have shown a lack of awareness of the prevalence, diagnosis, and management of FGM. Our objective was to systematically review the literature on interventions improving healthcare providers' capacities of prevention and treatment of FGM. Systematic review of the published and grey literature on interventions aimed at improving healthcare providers' capacities of prevention and treatment of FGM (1995-2015). Outcomes observed were knowledge and attitudes about FGM, medicalization, and prevention. Only two studies met our inclusion criteria. They reported on educational interventions aimed at increasing caregivers' knowledge on FGM. One was conducted with 59 providers, in Mali; the other one with 11 certified nurse-midwives in the United States. The studies report basic statistics regarding the improvement of healthcare professionals' knowledge, attitude on FGM and medicalization of the practice. Neither conducted multivariable analysis nor evaluated the training effects on the quality of the care offered, the clinical outcomes and the satisfaction of women attended, and prevention. As health care providers are essential in prevention and treatment of FGM, developing effective interventions is crucial.

  6. A systematic review of the evidence on clitoral reconstruction after female genital mutilation/cutting.

    Science.gov (United States)

    Abdulcadir, Jasmine; Rodriguez, Maria I; Say, Lale

    2015-05-01

    Clitoral reconstruction is a new surgical technique for women who have undergone female genital mutilation/cutting (FGM/C). To review evidence on the safety and efficacy of clitoral reconstruction. PubMed and Cochrane databases were searched for articles published in any language from database inception until May 2014. Search terms related to FGM/C and clitoral reconstruction were used in various combinations. Studies of any design that reported on safety or clinical outcomes (e.g. appearance, pain, sexual response, or patient satisfaction) associated with clitoral reconstruction after FGM/C were included. Evidence was summarized and systematically assessed via a standard data abstraction form. Four of 269 identified articles were included. They were fair to poor in quality. Summary measures could not be computed owing to heterogeneity. The studies reported on immediate surgical complications, clitoral appearance, dyspareunia or chronic pain, and clitoral function postoperatively via non-standardized scales. Women who request clitoral reconstruction should be informed about the scarcity of evidence available. Additional research is needed on the safety and efficacy of the procedure to identify both long-term outcomes and which women might benefit. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Deinfibulation for treating urologic complications of type III female genital mutilation: A systematic review.

    Science.gov (United States)

    Effa, Emmanuel; Ojo, Olumuyiwa; Ihesie, Austin; Meremikwu, Martin M

    2017-02-01

    Women and girls who have undergone type III female genital mutilation (FGM) may suffer urologic complications such as recurrent urinary tract infections, obstruction, stones, and incontinence. To assess the effectiveness of deinfibulation for preventing and treating urologic complications in women and girls living with FGM. The following major databases were searched from inception to August 2015: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, SCOPUS, Web of Science, and ClinicalTrials.gov without language restrictions. Randomized controlled studies (RCTs) or observational studies with controls were considered. We screened the results of the search independently for potentially relevant studies and applied inclusion and exclusion criteria for the full texts of the relevant studies. No RCTs were found. We found three case reports and a retrospective case review, all of which were excluded. There is no evidence on the use of deinfibulation to improve urologic complications among women with type III FGM. Current clinical practice may be informed by anecdotal evidence from case reports. Appropriate RCTs and observational studies with comparison groups in countries where FGM is common are needed. PROSPERO registration: CRD42015024901. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  8. Female Genital Cutting: shattering the debate yet still violating human rights

    Directory of Open Access Journals (Sweden)

    Celine Jacquemin

    2010-04-01

    Full Text Available

    Summary: The international fight against the various forms of female circumcision, or the mutilation of the genitals of women and children, has many different aspects. Although no religious text from any religion suggests the practice, still in many countries the torture of young girls and women continue. Even though there is an assumption that the phenomenon is exclusive to the developing world, many practices in the West, such as vaginal and vulvar surgeries, as well as changes to the face and body of women can be included in the same tendency to portray women as impure, incomplete, and in need of improvement so that she can be accepted by prospective husbands.

  9. Microbiome Composition and Function Drives Wound-Healing Impairment in the Female Genital Tract.

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    Alexander S Zevin

    2016-09-01

    Full Text Available The mechanism(s by which bacterial communities impact susceptibility to infectious diseases, such as HIV, and maintain female genital tract (FGT health are poorly understood. Evaluation of FGT bacteria has predominantly been limited to studies of species abundance, but not bacterial function. We therefore sought to examine the relationship of bacterial community composition and function with mucosal epithelial barrier health in the context of bacterial vaginosis (BV using metaproteomic, metagenomic, and in vitro approaches. We found highly diverse bacterial communities dominated by Gardnerella vaginalis associated with host epithelial barrier disruption and enhanced immune activation, and low diversity communities dominated by Lactobacillus species that associated with lower Nugent scores, reduced pH, and expression of host mucosal proteins important for maintaining epithelial integrity. Importantly, proteomic signatures of disrupted epithelial integrity associated with G. vaginalis-dominated communities in the absence of clinical BV diagnosis. Because traditional clinical assessments did not capture this, it likely represents a larger underrepresented phenomenon in populations with high prevalence of G. vaginalis. We finally demonstrated that soluble products derived from G. vaginalis inhibited wound healing, while those derived from L. iners did not, providing insight into functional mechanisms by which FGT bacterial communities affect epithelial barrier integrity.

  10. Disappearance of female genital mutilation from the Bedouin population of Southern Israel.

    Science.gov (United States)

    Halila, Suhil; Belmaker, R H; Abu Rabia, Yunis; Froimovici, Miron; Applebaum, Julia

    2009-01-01

    Recently, clinicians in Southern Israel perceived that the practice of female genital mutilation had disappeared entirely in the Bedouin population. We previously studied the prevalence of this practice in 1995. We decided to survey again the Bedouin population focusing on those tribes previously reported to perform this practice. Eighty percent of the interviews were done by an Arabic-speaking psychiatrist and 20% were done by an Arabic speaking nurse in the gynecologic clinic of a large Bedouin township or the gynecologic clinic of a smaller Bedouin township. Women were asked if they would be willing to answer a few questions about their past and if they were willing to have the gynecologist, with no additional procedure, note whether any operation had been performed on their genitalia. Physical examination by gynecologist and an oral questionnaire. One hundred and thirty two women were examined. No cases of any scarring of the kind reported in the previous study were found on physical examination. FGM has apparently disappeared over 15 years in a population in which it was once prevalent.

  11. The Association between Female Genital Cutting and Spousal HCV Infection in Egypt

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    Chris R. Kenyon

    2014-01-01

    Full Text Available Objective. To identify the risk factors for HCV infection within married couples in Egypt. Methods. In 2008 Egypt conducted its first nationally representative survey of HCV prevalence. 11126 of the 12780 individuals aged 15–59 year who were sampled agreed to participate and provided information via a questionnaire about demographic and behavioural characteristics and blood for HCV antibody and RNA analysis. We assessed the risk factors for HCV infection in a subsample of 5182 married individuals via multivariate logistic regression. Results. Overall HCV antibody prevalence in the married couples was 18.2% (95% CI, 16.8–19.6. HCV antibody prevalence was higher in the husbands (23.7% than the wives (12.1%; P<0.001. Having a spouse who was infected with HCV was an independent risk factor for HCV infection with odds ratios of 2.1 (95% CI, 1.6–2.9 and 2.2 (95% CI, 1.6–3.1 for women and men, respectively. Husbands whose wives had experienced female genital cutting (FGC had a higher prevalence of HCV and this relationship was driven by a strong association in urban areas. Amongst the women there was no association between FGC and HCV overall but in urban areas only women who had experienced FGC were HCV infected. Conclusions. This study provides additional evidence of the importance of intrafamilial transmission of HCV in Egypt.

  12. The Obstetric Consequences of Female Genital Mutilation/Cutting: A Systematic Review and Meta-Analysis

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    Rigmor C. Berg

    2013-01-01

    Full Text Available Various forms of female genital mutilation/cutting (FGM/C have been performed for millennia and continue to be prevalent in parts of Africa. Although the health consequences following FGM/C have been broadly investigated, divergent study results have called into question whether FGM/C is associated with obstetric consequences. To clarify the present state of empirical research, we conducted a systematic review of the scientific literature and quantitative meta-analyses of the obstetric consequences of FGM/C. We included 44 primary studies, of which 28 were comparative, involving almost 3 million participants. The methodological study quality was generally low, but several studies reported the same outcome and were sufficiently similar to warrant pooling of effect sizes in meta-analyses. The meta-analyses results showed that prolonged labor, obstetric lacerations, instrumental delivery, obstetric hemorrhage, and difficult delivery are markedly associated with FGM/C, indicating that FGM/C is a factor in their occurrence and significantly increases the risk of delivery complications. There was no significant difference in risk with respect to cesarean section and episiotomy. These results can make up the background documentation for health promotion and health care decisions that inform work to reduce the prevalence of FGM/C and improve the quality of services related to the consequences of FGM/C.

  13. Female genital mutilation: prevalence, perceptions and effect on women’s health in Kersa district of Ethiopia

    Science.gov (United States)

    Yirga, Wondimu Shanko; Kassa, Nega Assefa; Gebremichael, Mengistu Welday; Aro, Arja R

    2012-01-01

    Background Female genital mutilation (FGM) is nontherapeutic surgical modification of the female genitalia. It is an ancient tradition in large parts of Africa, including Ethiopia, especially in the eastern part of the country. This study aimed to identify the prevalence, perceptions, perpetuators, reasons for conducting FGM, and factors associated with this practice with regard to women’s health. Methods Community-based cross-sectional house-to-house interviews were conducted during 2008 among 858 females of reproductive age (15–49 years), in Kersa district, East Hararge, Oromia region, Ethiopia. Proportions and Chi-square tests were used to describe the data and logistic regression was used to describe statistical associations. Statistical significance was set at P female sexual hyperactivity (reported by 198 women [60.3%]). Circumcision of daughters was reported by 288 (88.1%) respondents, and this showed a statistically significant association with the Christian religion (P = 0.003), illiteracy (P = 0.01), and Amhara ethnicity (P = 0.012). The majority of the respondents (792, 92.3%) were themselves circumcised and 68.8% did not know of any health-related problems associated with FGM. Conclusion In spite of FGM being a common practice in the study area, only one third of the respondents stated that they knew about it. Local healers were the main performers of FGM. Some of the women knew about the negative reproductive health effects of FGM and some had also experienced these themselves. However, only a few had tried to stop the practice and the majority had taken no steps to do so. This may be attributable to the fear of becoming alienated from the cultural system and fear of isolation. PMID:22371659

  14. The increasing number of surgical procedures for female genital fistula in England: analysis of Hospital Episode Statistics (HES) data.

    Science.gov (United States)

    Ismail, S I M F

    2015-01-01

    The aim of this study was to describe the number and trend of surgical procedures for female genital fistula in England. An online search of Hospital Episode Statistics (HES) data was carried out. Data were available for the 4-year period from 2002-03 until 2005-06. The total number of surgical procedures carried out for female genital fistula steadily increased by 28.7% from 616 in 2002-03 to 793 in 2005-06. The number of surgical procedures performed for rectovaginal fistula exceeded the total number of surgical procedures carried out for vesicovaginal and urethrovaginal fistula in each year of the study period. This pattern needs to be monitored and investigated further.

  15. Intention toward the continuation of female genital mutilation in Bale Zone, Ethiopia

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    Bogale D

    2015-01-01

    Full Text Available Daniel Bogale,1 Desalegn Markos,2 Muhammedawel Kaso1 1Department of Public Health, 2Department of Nursing, College of Medicine and Health Sciences, Madawalabu University, Bale Goba, Ethiopia Background: Female genital mutilation (FGM is a harmful traditional practice that is deeply rooted in Africa. It is associated with health complications and human rights violations. Research on intention for the continuation of FGM and the social determinants underpinning this practice are scarce. Therefore, this study intended to assess the intention of women toward the continuation of FGM among Bale Zone reproductive-age women.Methods: A community-based cross-sectional study design supplemented by qualitative methods was conducted in 2014. A total of 634 reproductive-age women were involved in the quantitative part of the study. The respondents were drawn from five randomly selected districts of Bale Zone. The total sample was allocated proportionally to each district based on the number of reproductive-age women it has. Purposive sampling method was used for qualitative study. Then, data were collected using a pretested and structured questionnaire. The collected data were analyzed by Statistical Package for Social Sciences for Windows version 16.0. Multiple logistic regressions were carried out to examine the existence of a relationship between intentions for the continuation of FGM and selected determinant factors.Results: This study revealed that 26.7% of the respondents had intention for the continuation of FGM. Religion, safeguarding virginity, tradition, and social values were the major reasons for the perpetuation of this practice. Circumcised respondents and those who were not able to read and write were ~3 (adjusted odds ratio = 2.89, 95% confidence interval = [1.33, 6.20] and 7.58 (adjusted odds ratio = 7.58, 95% confidence interval = [3.47, 16.54] times more likely intending the continuation of FGM than uncircumcised and those who

  16. Female genital cutting (FGC) and the ethics of care: community engagement and cultural sensitivity at the interface of migration experiences

    OpenAIRE

    Vissandjée, Bilkis; Denetto, Shereen; Migliardi, Paula; Proctor, Jodi

    2014-01-01

    Background Female Genital Cutting (FGC) anchored in a complex socio-cultural context becomes significant at the interface of access of health and social services in host countries. The practice of FGC at times, understood as a form of gender-based violence, may result in unjustifiable consequences among girls and women; yet, these practices are culturally engrained traditions with complex meanings calling for ethically and culturally sensitive health and social service provision. Intents and ...

  17. Effects of female genital cutting on the sexual function of Egyptian women. A cross-sectional study.

    Science.gov (United States)

    Anis, Tarek H; Aboul Gheit, Samah; Awad, Hossam H; Saied, Hanan S

    2012-10-01

    The existing literature is conflicting regarding effects of female genital cutting (FGC) on sexual functions. Several studies from Africa over the past 20 years have challenged the negative effect of genital cutting on sexual function as defined by performance on the following domains: desire, arousal, lubrication, orgasm, satisfaction, and sexual pain. Other studies however indicated that sexual function of genitally cut women is adversely altered. The aim of the study was to investigate the effects of FGC on the female sexual function of Egyptian women. This is a cross-sectional study conducted between February and May 2011 at the outpatient clinic of Cairo University Hospitals. The study included 650 Egyptian females between 16 and 55 years of age (333 genitally cut women and 317 uncut women). Participants were requested to complete the Arabic Female Sexual Function Index (ArFSFI) and were then subjected to clinical examination where the cutting status was confirmed. The total score of the ArFSFI and its individual domains. The mean age of cutting was 8.59 (±1.07) years. Of the cut participants, 84.98% showed signs of type I genital cutting, while 15.02% showed signs of type II genital cutting. After adjusting for age, residential area, and education level, uncut participants had significantly higher ArFSFI total score (23.99±2.21) compared with cut participants (26.81±2.26). The desire, arousal, lubrication, orgasm, and satisfaction domains were significantly higher in the uncut participants (4.02±0.78, 4.86±0.72, 4.86±0.75, 4.86±0.68, 5.04±0.71, respectively) compared with those of the cut participants (3.37±0.89, 4.13±0.71, 4.16±0.84, 4.50±0.79, 4.69±0.92, respectively). No significant difference between the two groups was found regarding the sexual pain domain. In Egyptian women, FGC is associated with reduced scores of ArFSFI on all domain scores except the sexual pain domain. © 2012 International Society for Sexual Medicine.

  18. Mothers' factors associated with female genital mutilation in daughters in the Iraqi Kurdistan Region.

    Science.gov (United States)

    Shabila, Nazar P

    2017-03-01

    An important proactive factor for the continuation of female genital mutilation (FGM) is tradition and customs inherited in the family from mothers to daughters. Therefore, the aim of this study was to determine mothers' factors associated with the occurrence of FGM among their daughters. The datasets from the Iraq Multiple Indicator Cluster Survey 2011, on 5,184 women aged 15 to 49 years having at least one daughter, was used. Multivariate analysis based on a binary logistic regression model was applied. Mothers' age (adjusted odds ratio [aOR] = 8.18 at ages 25-34 years, aOR = 22.64 at ages 35-44 years, and aOR = 29.78 at ages 45-49 years, compared to the age group 15-24 years), educational level (aOR = 0.52 for primary education, aOR = 0.26 for secondary education, and aOR = 0.03 for higher education compared to uneducated), employment status (aOR = 0.55 for women having office work compared with unemployed), FGM status (aOR = 27.44 for circumcised mothers compared to uncircumcised), the governorate of residence (aOR = 18.73 for Suleimaniya and aOR = 33.23 for Erbil compared with Dohuk), and the wealth index of the household (aOR = 0.55 for richest group compared to the poorest) were significantly associated with the occurrence of FGM in daughters. Strategies aimed at preventing this harmful practice in the Iraqi Kurdistan Region should include female education and empowerment.

  19. Awareness and predictors of female genital mutilation/cutting among young health advocates.

    Science.gov (United States)

    Abolfotouh, Sherif M; Ebrahim, Ahmed Z; Abolfotouh, Mostafa A

    2015-01-01

    The act of female genital mutilation/cutting (FGM/C) is considered internationally as a violent act against girls and women and a violation of their human rights. This study sought to assess the awareness and predictors of FGM/C in young Egyptian health advocates. A cross-sectional study of 600 medical students from a total of 2,500 members of the International Federation of Medical Students' Associations (IFMSA)-Egypt, across all Egyptian medical schools, was conducted using a previously validated online Google survey. The overall prevalence of circumcision was 14.7/100 female students, with a significantly higher prevalence in students from rural areas (25%) than in non-rural areas (10.8%, P=0.001), and in those residing in Upper (southern) Egypt (20.6%) than in Lower (northern) Egypt (8.7%, P=0.003). The students' mean percentage score for knowledge about the negative health consequences of FGM/C was 53.50±29.07, reflecting a modest level of knowledge; only 30.5% had a good level of knowledge. The mean percentage score for the overall attitude toward discontinuation of the practice of FGM/C was 76.29±17.93, reflecting a neutral attitude; 58.7% had a favorable attitude/norms toward discontinuation of the practice. Of circumcised students, approximately one-half (46.8%) were unwilling to have their daughters circumcised, and 60% reported no harm from being circumcised. After controlling for confounders, a negative attitude toward FGM/C was significantly (Pdrive a change in attitude toward discontinuation of this harmful practice.

  20. Coping and chronic psychosocial consequences of female genital mutilation in The Netherlands.

    Science.gov (United States)

    Vloeberghs, Erick; van der Kwaak, Anke; Knipscheer, Jeroen; van den Muijsenbergh, Maria

    2012-01-01

    The study presented in this article explored psychosocial and relational problems of African immigrant women in The Netherlands who underwent female genital mutilation/cutting (FGM/C), the causes they attribute to these problems--in particular, their opinions about the relationship between these problems and their circumcision--and the way they cope with these health complaints. This mixed-methods study used standardised questionnaires as well as in-depth interviews among a purposive sample of 66 women who had migrated from Somalia, Sudan, Eritrea, Ethiopia or Sierra Leone to The Netherlands. Data were collected by ethnically similar female interviewers; interviews were coded and analysed by two independent researchers. One in six respondents suffered from post-traumatic stress disorder (PTSD), and one-third reported symptoms related to depression or anxiety. The negative feelings caused by FGM/C became more prominent during childbirth or when suffering from physical problems. Migration to the Netherlands led to a shift in how women perceive FGM, making them more aware of the negative consequences of FGM. Many women felt ashamed to be examined by a physician and avoided visiting doctors who did not conceal their astonishment about the FGM. FGM/C had a lifelong impact on the majority of the women participating in the study, causing chronic mental and psychosocial problems. Migration made women who underwent FGM/C more aware of their condition. Three types of women could be distinguished according to their coping style: the adaptives, the disempowered and the traumatised. Health care providers should become more aware of their problems and more sensitive in addressing them.

  1. Attitude toward female genital mutilation among Somali and Harari people, Eastern Ethiopia

    Science.gov (United States)

    Abathun, Asresash Demissie; Sundby, Johanne; Gele, Abdi A

    2016-01-01

    Background Female genital mutilation (FGM) is a worldwide problem, and it is practiced by many communities in Africa and Asia as well as immigrants from those areas. This practice results in short- and long-term health consequences on women’s health. Like many other developing countries, FGM is widely practiced in Ethiopia, especially among Somali and Harari ethnic groups. Despite intensive campaigns against FGM in Ethiopia, since 2011, it has been practiced in the aforementioned communities. There is no recent information as to whether these campaigns have an impact on the attitude and practice of the community regarding FGM. This qualitative research was aimed at exploring the attitudes of Somali and Harari people between 18 and 65 years toward FGM. Methods A purposive sampling technique was used to recruit 64 (32 in each region) participants. Data were collected from October to December 2015 in Somali and Harari Regions. Results The findings showed that there was a strong support for the continuation of the practice among female discussants in Somali region, whereas male discussants from the same region and the majority of the participants from Harari region had a positive attitude toward the discontinuation of the practice. Marriageability was the major reason for practicing FGM in Somali region, whereas making girls calm, sexually inactive, and faithful for their husbands were mentioned in Harari region. Although young men in both the regions prefer to marry uncircumcised girls, the study showed that there are some differences in the attitude toward the FGM practice between the people in the two regions. Conclusion The findings show that there is an attitudinal difference between the people in the two regions, which calls for behavioral change communication using women-centered approach and culturally appropriate strategies. As young people in both the regions had the intention to marry uncircumcised girls, there has to be a strong advocacy and multisectoral

  2. A survey of Australian midwives' knowledge, experience, and training needs in relation to female genital mutilation.

    Science.gov (United States)

    Turkmani, Sabera; Homer, Caroline; Varol, Nesrin; Dawson, Angela

    2018-02-01

    Female genital mutilation (FGM) involves partial or total removal of the external female genitalia or any other injury for non-medical reasons. Due to international migration patterns, health professionals in high income countries are increasingly caring for women with FGM. Few studies explored the knowledge and skills of midwives in high income countries. To explore the knowledge, experience and needs of midwives in relation to the care of women with FGM. An online self-administered descriptive survey was designed and advertised through the Australian College of Midwives' website. Of the 198 midwives (24%) did not know the correct classification of FGM. Almost half of the respondents (48%) reported they had not received FGM training during their midwifery education. Midwives (8%) had been asked, or knew of others who had been asked to perform FGM in Australia. Many midwives were not clear about the law or health data related to FGM and were not aware of referral paths for affected women. As frontline providers, midwives must have appropriate up-to-date clinical skills and knowledge to ensure they are able to provide women with FGM the care they need and deserve. Midwives have a critical role to play in the collection of FGM related data to assist with health service planning and to prevent FGM by working closely with women and communities they serve to educate and advocate for its abandonment. Therefore, addressing educational gaps and training needs are key strategies to deliver optimal quality of care. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  3. Females with paired occurrence of cancers in the UADT and genital region have a higher frequency of either Glutathione S-transferase M1/T1 null genotype

    Directory of Open Access Journals (Sweden)

    Jhavar Sameer G

    2005-03-01

    Full Text Available Abstract Upper Aero digestive Tract (UADT is the commonest site for the development of second cancer in females after primary cervical cancer. Glutathione S-transferase (GSTM1 and / or T1 null genotype modulates the risk of developing UADT cancer (primary as well as second cancer. The aim of this study was to evaluate the difference in GST null genotype frequencies in females with paired cancers in the UADT and genital region as compared to females with paired cancers in the UADT and non-genital region. Forty-nine females with a cancer in the UADT and another cancer (at all sites-genital and non-genital were identified from a database of patients with multiple primary neoplasms and were analyzed for the GSTM1 and T1 genotype in addition to known factors such as age, tobacco habits, alcohol habits and family history of cancer. Frequencies of GSTM1 null, GSTT1 null, and either GSTM1/T1 null were higher in females with paired occurrence of cancer in the UADT and genital site (54%, 33% and 75% respectively in comparison to females with paired occurrence of cancer in the UADT and non-genital sites (22%, 6% and 24% respectively. The significantly higher inherited frequency of either GSTM1/T1 null genotype in females with a paired occurrence of cancers in UADT and genital region (p = 0.01, suggests that these females are more susceptible to damage by carcinogens as compared to females who have UADT cancers in association with cancers at non-genital sites.

  4. Female genital mutilation/cutting in Italy: an enhanced estimation for first generation migrant women based on 2016 survey data.

    Science.gov (United States)

    Ortensi, Livia Elisa; Farina, Patrizia; Leye, Els

    2018-01-12

    Migration flows of women from Female Genital Mutilation/Cutting practicing countries have generated a need for data on women potentially affected by Female Genital Mutilation/Cutting. This paper presents enhanced estimates for foreign-born women and asylum seekers in Italy in 2016, with the aim of supporting resource planning and policy making, and advancing the methodological debate on estimation methods. The estimates build on the most recent methodological development in Female Genital Mutilation/Cutting direct and indirect estimation for Female Genital Mutilation/Cutting non-practicing countries. Direct estimation of prevalence was performed for 9 communities using the results of the survey FGM-Prev, held in Italy in 2016. Prevalence for communities not involved in the FGM-Prev survey was estimated using to the 'extrapolation-of-FGM/C countries prevalence data method' with corrections according to the selection hypothesis. It is estimated that 60 to 80 thousand foreign-born women aged 15 and over with Female Genital Mutilation/Cutting are present in Italy in 2016. We also estimated the presence of around 11 to 13 thousand cut women aged 15 and over among asylum seekers to Italy in 2014-2016. Due to the long established presence of female migrants from some practicing communities Female Genital Mutilation/Cutting is emerging as an issue also among women aged 60 and over from selected communities. Female Genital Mutilation/Cutting is an additional source of concern for slightly more than 60% of women seeking asylum. Reliable estimates on Female Genital Mutilation/Cutting at country level are important for evidence-based policy making and service planning. This study suggests that indirect estimations cannot fully replace direct estimations, even if corrections for migrant socioeconomic selection can be implemented to reduce the bias.

  5. Gender equality and human rights approaches to female genital mutilation: a review of international human rights norms and standards.

    Science.gov (United States)

    Khosla, Rajat; Banerjee, Joya; Chou, Doris; Say, Lale; Fried, Susana T

    2017-05-12

    Two hundred million girls and women in the world are estimated to have undergone female genital mutilation (FGM), and another 15 million girls are at risk of experiencing it by 2020 in high prevalence countries (UNICEF, 2016. Female genital mutilation/cutting: a global concern. 2016). Despite decades of concerted efforts to eradicate or abandon the practice, and the increased need for clear guidance on the treatment and care of women who have undergone FGM, present efforts have not yet been able to effectively curb the number of women and girls subjected to this practice (UNICEF. Female genital mutilation/cutting: a statistical overview and exploration of the dynamics of change. 2013), nor are they sufficient to respond to health needs of millions of women and girls living with FGM. International efforts to address FGM have thus far focused primarily on preventing the practice, with less attention to treating associated health complications, caring for survivors, and engaging health care providers as key stakeholders. Recognizing this imperative, WHO developed guidelines on management of health complications of FGM. In this paper, based on foundational research for the development of WHO's guidelines, we situate the practice of FGM as a rights violation in the context of international and national policy and efforts, and explore the role of health providers in upholding health-related human rights of women at girls who are survivors, or who are at risk. Findings are based on a literature review of relevant international human rights treaties and UN Treaty Monitoring Bodies.

  6. Meaning-making of female genital cutting: children’s perception and acquired knowledge of the ritual

    Directory of Open Access Journals (Sweden)

    Schultz JH

    2013-04-01

    Full Text Available Jon-Håkon Schultz, Inger-Lise Lien Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway Abstract: How do girls who have undergone female genital cutting understand the ritual? This study provides an analysis of the learning process and knowledge acquired in their meaning-making process. Eighteen participants were interviewed in qualitative indepth interviews. Women in Norway, mostly with Somali or Gambian backgrounds, were asked about their experiences of circumcision. Two different strategies were used to prepare girls for circumcision, ie, one involving giving some information and the other keeping the ritual a secret. Findings indicate that these two approaches affected the girls' meaning-making differently, but both strategies seemed to lead to the same educational outcome. The learning process is carefully monitored and regulated but is brought to a halt, stopping short of critical reflexive thinking. The knowledge tends to be deeply internalized, embodied, and morally embraced. The meaning-making process is discussed by analyzing the use of metaphors and narratives. Given that the educational outcome is characterized by limited knowledge without critical reflection, behavior change programs to end female genital cutting should identify and implement educational stimuli that are likely to promote critical reflexive thinking. Keywords: female genital cutting, metaphors, health education, immigrants

  7. The prevalence and genotype of human papillomavirus on cervical samples from an Irish female population with external genital warts.

    LENUS (Irish Health Repository)

    Cremin, Suzanne M

    2012-07-01

    The aim of this study was to determine the cervical genotype profile of females who presented to an STI Clinic with external genital warts (EGW); and to determine the potential vaccine coverage prior to the uptake of the HPV vaccines. Sixty-one cervical scrapings were taken from females aged 18-35 y who had external genital warts or a history of external genital warts. The resulting 50 samples that were positive for HPV-DNA were subjected to genotype identification. Forty-six of these samples had detectable genotypes by LIPA analysis and most (78%, 36\\/46) had multiple low risk (LR) and high risk (HR) genotypes on the cervix. Twenty-five of these samples (54%) had more than 1 HR genotype. Of the 36 patients who had any HR genotypes, 18 (50%) were identified to have the most oncogenic HPV genotypes, namely 16 and 18. Three of these samples had both 16 and 18 on the cervix. The presence of multiple HR genotypes on the majority of cervical samples from a self-referred population of females with EGW is presented. This study is of importance since persistent HR-HPV is the necessary risk factor in the development of precancerous and cancerous lesions of the cervix. Gardisil, the quadrivalent HPV vaccine would have been useful in the prevention of 28% (13\\/46) of these infections.

  8. The Genital Hygiene Behaviors of the Females Aged 15-49 Living at the Firat Health Clinic Neighborhood in Malatya

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    Yurdagul Yagmur

    2007-10-01

    Full Text Available It is known that wrong and inappropriate hygienic applications damage the vaginal flora and causes a lot of health problems. The aim of this study was to define the females’ behaviors on genital hygiene, who live in a health center neighborhood. This descriptive study has been based on 400 females aged 15-49 living at the Firat Health Clinic neighborhood in Malatya. The randomized sampling method was used. The females were asked questions from a questionnaire form in their houses. The data were evaluated by using the SPSS for Windows version 10.0. Of the 37% females included in this study are graduated from the primary school, 66.3% of them are married, 87.8% of females are unemployed, and 54% are in average economic situation. Of the 71% women have a shower in every two-three days, 38% of them do not shower during their menses period, 56% of them change their underwear in every 2-3 days, 23.5% of the females use wash-and-use diaper during their menses period, 46.5% of them change 1-2 pads daily, 43% have a vaginal lavage. In addition 27% of the females are being diagnosed now and were being diagnosed before having genital tract infection. As a result of the study, some inadequate and improper applications regarding hygiene habits were detected among women. Thus, taking the educational and socio-economic status of the women into consideration, they should be given some training about protecting and improving health. Also it would be beneficial if the nurses and midwives questioned and informed the women about the genital hygiene behaviors during their house visits under the health services at first stage. [TAF Prev Med Bull. 2007; 6(5: 325-330

  9. The Genital Hygiene Behaviors of the Females Aged 15-49 Living at the Firat Health Clinic Neighborhood in Malatya

    Directory of Open Access Journals (Sweden)

    Yurdagul Yagmur

    2007-10-01

    Full Text Available It is known that wrong and inappropriate hygienic applications damage the vaginal flora and causes a lot of health problems. The aim of this study was to define the females’ behaviors on genital hygiene, who live in a health center neighborhood. This descriptive study has been based on 400 females aged 15-49 living at the Firat Health Clinic neighborhood in Malatya. The randomized sampling method was used. The females were asked questions from a questionnaire form in their houses. The data were evaluated by using the SPSS for Windows version 10.0. Of the 37% females included in this study are graduated from the primary school, 66.3% of them are married, 87.8% of females are unemployed, and 54% are in average economic situation. Of the 71% women have a shower in every two-three days, 38% of them do not shower during their menses period, 56% of them change their underwear in every 2-3 days, 23.5% of the females use wash-and-use diaper during their menses period, 46.5% of them change 1-2 pads daily, 43% have a vaginal lavage. In addition 27% of the females are being diagnosed now and were being diagnosed before having genital tract infection. As a result of the study, some inadequate and improper applications regarding hygiene habits were detected among women. Thus, taking the educational and socio-economic status of the women into consideration, they should be given some training about protecting and improving health. Also it would be beneficial if the nurses and midwives questioned and informed the women about the genital hygiene behaviors during their house visits under the health services at first stage. [TAF Prev Med Bull 2007; 6(5.000: 325-330

  10. Female genital mutilation/cutting in Italy: an enhanced estimation for first generation migrant women based on 2016 survey data

    OpenAIRE

    Ortensi, Livia Elisa; Farina, Patrizia; Leye, Els

    2018-01-01

    Background Migration flows of women from Female Genital Mutilation/Cutting practicing countries have generated a need for data on women potentially affected by Female Genital Mutilation/Cutting. This paper presents enhanced estimates for foreign-born women and asylum seekers in Italy in 2016, with the aim of supporting resource planning and policy making, and advancing the methodological debate on estimation methods. Methods The estimates build on the most recent methodological development in...

  11. Epidemiology, Regional Characteristics, Knowledge, and Attitude Toward Female Genital Mutilation/Cutting in Southern Iran.

    Science.gov (United States)

    Dehghankhalili, Maryam; Fallahi, Soghra; Mahmudi, Forugh; Ghaffarpasand, Fariborz; Shahrzad, Mohammad Esmaeil; Taghavi, Mohsen; Fereydooni Asl, Marjan

    2015-07-01

    Female genital mutilation/cutting (FGM/C), also known as female circumcision, is an ancient traditional procedure that involves partial or total removal of the female external genitalia for nonmedical reasons. Although it is well described in African and some Arabic countries, data from Iran are scarce. To describe the epidemiology, regional characteristics, knowledge, and attitude toward FGM/C in Southern Iran. This cross-sectional study was conducted during a 36-month period from 2010 to 2013 in Hormozgan, a southern province of Iran near the Persian Gulf. We included 780 women in six major rural areas of the province who referred to healthcare centers for vaccination, midwifery, or family planning services. All participants underwent complete pelvic examination to determine the type of FGM. The questionnaire consisted of several sections such as demographic and baseline characteristics, and two self-report sections addressing the knowledge and attitude toward FGM/C and its complications. Baseline sociodemographic characteristics including age, educational level, marital status, religion, and nationality were the independent variables. Among the participants, 535 (68.5%) had undergone FGM/C. FGM/C was associated with higher age (P = 0.002), Afghan nationality (P = 0.003), Sunni Islam as religion (P = 0.019), illiteracy (P < 0.001), and family history of FGM/C in mother (P < 0.001), sister (P < 0.001), and grandmother (P < 0.001). Ancient traditions in the area (57.1%) were mentioned as the most important factor leading to FMG/C. Urinary tract infection was the most common reported complication (60.4%). FGM/C is a common practice in rural areas of Southern Iran. It is associated with increased age, illiteracy, Sunni Islam religion, Afghan nationality, and positive family history. Lack of knowledge toward FGM/C is the main cause of its high prevalence and continuation in the area. © 2015 International Society for Sexual Medicine.

  12. Female Genital Mutilation/Cutting v postkoloniálním a genderovém kontextu

    OpenAIRE

    Králová Ježková, Olga

    2014-01-01

    This thesis concerns subject of Female Genital Mutilation/Cutting (FGM/C), ritual commonly - but inaccurately - named female circumcision. In the thesis I analyze two autobiographical texts written by women who got through the FGM/C - Mutilated written by Senegal author Khady and Desert Flower by Somali author Waris Dirie. Aim of this thesis is to analyze view point of two women who have direct experience with FGM/C, to add more information to research of this ritual and to strengthen effort ...

  13. Diversity of cervicovaginal microbiota associated with female lower genital tract infections.

    Science.gov (United States)

    Ling, Zongxin; Liu, Xia; Chen, Xiaoyi; Zhu, Haibin; Nelson, Karen E; Xia, Yaxian; Li, Lanjuan; Xiang, Charlie

    2011-04-01

    The female genital tract (FGT) harbors very large numbers of bacterial species that are known to play an important role on vaginal health. Previous studies have focused on bacterial diversity in the vagina, but little is known about the ectocervical microbiota associated with FGT infections. In our study, vaginal swabs and ectocervical swabs were collected from 100 participants in China, including 30 women with bacterial vaginosis (BV; BV group), 22 women with cervicitis (Cer group), 18 women with BV in combination with cervicitis (BC group) and 30 healthy control women (CN group). The diversity and richness of cervicovaginal microbiota were investigated with culture-independent polymerase chain reaction (PCR)-denaturing gradient gel electrophoresis (DGGE) and quantitative PCR (qPCR) targeting 11 microorganisms that have been associated with FGT infections. Despite significant interpersonal variations, the PCR-DGGE profiles revealed that vaginal microbiota and ectocervical microbiota were clearly much more complex in the BV group, while the ectocervical microbiota showed no significant difference between healthy and diseased participants. Using species-specific qPCR, BV and cervicitis were significantly associated with a dramatic decrease in Lactobacillus species (p  0.05) in ectocervical microbiota. The total numbers of bacteria were significantly lower in the ectocervix as compared in the vagina (p microbiota from participants with BV in combination with cervicitis was quite different from that of participants with BV or cervicitis alone. Our study demonstrated that the cervicovaginal microbiota was actively involved in the process of FGT infections. The predominant bacteria of the cervicovaginal communities were clearly associated with BV; however, there was not sufficient evidence that the ectocervical microbiota is directly involved in the development of cervicitis.

  14. Female Genital Mutilation/Cutting among Women of Somali and Kurdish Origin in Finland.

    Science.gov (United States)

    Koukkula, Mimmi; Keskimäki, Ilmo; Koponen, Päivikki; Mölsä, Mulki; Klemetti, Reija

    2016-09-01

    The tradition of female genital mutilation/cutting (FGM/C) has spread in Europe as a result of immigration. Although it is known to have negative health impacts, the exact prevalence of FGM/C and its health effects in Finland are unknown. This study explores the prevalence of FGM/C, the sociodemographic characteristics associated with it, and its health effects among women of Somali and Kurdish origin in Finland. Data were obtained from the Migrant Health and Well Being Study carried out in 2010-2012. This study uses data from interviews with Somali (N = 165) and Kurdish origin (N = 224) women. The participation rate was 37 percent for Somali and 54 percent for Kurdish origin women. The prevalence of FGM/C was 69 percent among those of Somali origin and 32 percent among those of Kurdish origin. Having no education and older age were significantly associated with FGM/C, as was marriage amongst women of Somali origin, and the practice of Islam among women of Kurdish origin. Reporting good self-perceived health was more common among women without FGM/C. Outpatient visits to medical doctors were less common among women of Somali origin with FGM/C, compared with women without FGM/C. About 26 percent of Somali origin and 39 percent of Kurdish origin women with FGM/C reported reproductive or other health problems because of FGM/C. FGM/C is more common in Finland than previously assumed, particularly among women of Kurdish origin. Women with FGM/C need improved access to culturally competent health services to address the health impacts of FGM/C. Education and outreach to immigrant communities to prevent future FGM/C are also urgently needed. © 2016 Wiley Periodicals, Inc.

  15. Estimating the number of foreign women with female genital mutilation/cutting in Italy.

    Science.gov (United States)

    Farina, Patrizia; Ortensi, Livia Elisa; Menonna, Alessio

    2016-08-01

    Female genital mutilation/cutting (FGM/C), is an emerging topic in Europe as a consequence of the increasing proportion of women migrating from Africa. The prevalence of FGM/C is however unknown in Europe, as there are no country-representative surveys on this topic. The aim of this study is to provide an estimate for Italy for the year 2010. This study relies on the results of the First Survey on Women at Risk of FGM/C held in Italy in 2010. This cross-sectional survey involved 1000 migrants from the main FGM/C practicing countries aged 15-49 living in the Italian region of Lombardy. The estimate presented is based on a method combining direct estimates for the communities involved in the survey and indirect estimates for other communities. Indirect estimations were obtained using a refinement of the most general extrapolation-of-country-prevalence-data method. It is estimated that some 57 000 foreign girls and women aged 15-49 with FGM/C were living in Italy in 2010. The Nigerian community is the most affected, with around 20 000 women with FGM/C (35.5% of the total number women affected in Italy), followed by the Egyptian community (around 18 600 women with FGM/C; 32.5%). Another 15% of the women affected are from the Horn of Africa, notably from Ethiopia (3200 women; 5.5%), Eritrea (2800 women; 4.9%) and Somalia (2300 women; 4%). This study offers an additional methodological advancement by proposing a combination of direct and indirect estimation of FGM/C. The results are crucial information to plan interventions and targeted policies. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  16. Clitoral neuroma after female genital mutilation/cutting: a rare but possible event.

    Science.gov (United States)

    Abdulcadir, Jasmine; Pusztaszeri, Marc; Vilarino, Raquel; Dubuisson, Jean-Bernard; Vlastos, Anne-Thérèse

    2012-04-01

    Female genital mutilation/cutting (FGM/C), in particular, type III, also called infibulation, can cause various long-term complications. However, posttraumatic neuroma of the clitoris is extremely rare; only one case was previously reported in the literature. The aim of this study was to describe the case of a patient presenting a clitoral neuroma post-FGM/C in detail and her successful multidisciplinary treatment. We report the case of a 24-year-old woman originating from Somalia presenting a type III a-b FGM/C who attended our outpatient clinic at the Geneva University Hospitals complaining of primary dysmenorrhea and a post-mutilation painful clitoral mass. The mass was clinically diagnosed as a cyst and surgically removed. Histopathological analysis revealed that it was a posttraumatic neuroma and a foreign body granuloma around the ancient surgical thread. Our patient was also offered a multidisciplinary counseling by a specialized gynecologist on FGM/C, a sexologist, and a reproductive and sexual health counselor. One month after surgical treatment, the vulvar pain was over. This is the second case of clitoral neuroma after FGM/C reported and the first with complete clinical, as well as histopathological documentation and multidisciplinary care. Considering the high frequency of clitoral cysts in case of infibulation, clitoral neuroma should be considered in the differential diagnosis. In this case, if symptomatic, the treatment should be surgery, clinical follow-up, and counseling. If necessary, appropriate sexual therapy should be offered too. © 2011 International Society for Sexual Medicine.

  17. Clinical indications for cesarean delivery among women living with female genital mutilation.

    Science.gov (United States)

    Rodriguez, Maria I; Say, Lale; Abdulcadir, Jasmine; Hindin, Michelle J

    2017-10-01

    To compare primary indications for cesarean delivery among patients with different female genital mutilation (FGM) status. The present secondary analysis included data from women who underwent trial of labor resulting in cesarean delivery at 28 obstetric centers in six African countries between November 1, 2001, and March 31, 2003. Associations between cesarean delivery indications and FGM status were assessed using descriptive statistics and multivariable multinomial logistic regression. Data from 1659 women (480 patients with no type of FGM and 1179 patients with FGM [any type]) were included; cesarean delivery indications were collapsed into five categories (fetal indications, maternal factors, stage 1 arrest, stage 2 arrest, and other). The incidence of a clear medical indication for cesarean delivery did not differ between the groups (P=0.320). Among patients without a clear indication for cesarean delivery, women with FGM were more likely to have undergone cesarean delivery for maternal factors (adjusted relative risk ratio [aRRR] 3.92, 95% confidence interval [CI] 1.3-11.71), stage 1 arrest (aRRR 7.74, 95% CI 1.33-45.07), stage 2 arrest (aRRR 6.63, 95% CI 3.74-11.73), or other factors (aRRR 2.41, 95% CI 1.04-5.60) rather than fetal factors compared with women who had no type of FGM. Among women with unclear medical indications, FGM was associated with cesarean delivery being performed for maternal factors or arrest disorders. © 2017 World Health Organization; licensed by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

  18. On the origin of grasshopper oviposition behavior: structural homology in pregenital and genital motor systems.

    Science.gov (United States)

    Thompson, Karen J; Jones, Alaine D; Miller, Sandra A

    2014-01-01

    In female grasshoppers, oviposition is a highly specialized behavior involving a rhythm-generating neural circuit, the oviposition central pattern generator, unusual abdominal appendages, and dedicated muscles. This study of Schistocerca americana (Drury) grasshoppers was undertaken to determine whether the simpler pregenital abdominal segments, which do not contain ovipositor appendages, share common features with the genital segment, suggesting a roadmap for the genesis of oviposition behavior. Our study revealed that although 5 of the standard pregenital body wall muscles were missing in the female genital segment, homologous lateral nerves were, indeed, present and served 4 ovipositor muscles. Retrograde labeling of the corresponding pregenital nerve branches in male and female grasshoppers revealed motor neurons, dorsal unpaired median neurons, and common inhibitor neurons which appear to be structural homologues of those filled from ovipositor muscles. Some pregenital motor neurons displayed pronounced contralateral neurites; in contrast, some ovipositor motor neurons were exclusively ipsilateral. Strong evidence of structural homology was also obtained for pregenital and ovipositor skeletal muscles supplied by the identified neurons and of the pregenital and ovipositor skeletons. For example, transient embryonic segmental appendages were maintained in the female genital segments, giving rise to ovipositor valves, but were lost in pregenital abdominal segments. Significant proportional differences in sternal apodemes and plates were observed, which partially obscure the similarities between the pregenital and genital skeletons. Other changes in reorganization included genital muscles that displayed adult hypertrophy, 1 genital muscle that appeared to represent 2 fused pregenital muscles, and the insertion points of 2 ovipositor muscles that appeared to have been relocated. Together, the comparisons support the idea that the oviposition behavior of genital

  19. Female Genital Mutilation in Sierra Leone: Forms, Reliability of Reported Status, and Accuracy of Related Demographic and Health Survey Questions

    Science.gov (United States)

    Grant, Donald S.; Berggren, Vanja

    2013-01-01

    Objective. To determine forms of female genital mutilation (FGM), assess consistency between self-reported and observed FGM status, and assess the accuracy of Demographic and Health Surveys (DHS) FGM questions in Sierra Leone. Methods. This cross-sectional study, conducted between October 2010 and April 2012, enrolled 558 females aged 12–47 from eleven antenatal clinics in northeast Sierra Leone. Data on demography, FGM status, and self-reported anatomical descriptions were collected. Genital inspection confirmed the occurrence and extent of cutting. Results. All participants reported FGM status; 4 refused genital inspection. Using the WHO classification of FGM, 31.7% had type Ib; 64.1% type IIb; and 4.2% type IIc. There was a high level of agreement between reported and observed FGM prevalence (81.2% and 81.4%, resp.). There was no correlation between DHS FGM responses and anatomic extent of cutting, as 2.7% reported pricking; 87.1% flesh removal; and 1.1% that genitalia was sewn closed. Conclusion. Types I and II are the main forms of FGM, with labia majora alterations in almost 5% of cases. Self-reports on FGM status could serve as a proxy measurement for FGM prevalence but not for FGM type. The DHS FGM questions are inaccurate for determining cutting extent. PMID:24204384

  20. Female Genital Mutilation in Sierra Leone: Forms, Reliability of Reported Status, and Accuracy of Related Demographic and Health Survey Questions

    Directory of Open Access Journals (Sweden)

    Owolabi Bjälkander

    2013-01-01

    Full Text Available Objective. To determine forms of female genital mutilation (FGM, assess consistency between self-reported and observed FGM status, and assess the accuracy of Demographic and Health Surveys (DHS FGM questions in Sierra Leone. Methods. This cross-sectional study, conducted between October 2010 and April 2012, enrolled 558 females aged 12–47 from eleven antenatal clinics in northeast Sierra Leone. Data on demography, FGM status, and self-reported anatomical descriptions were collected. Genital inspection confirmed the occurrence and extent of cutting. Results. All participants reported FGM status; 4 refused genital inspection. Using the WHO classification of FGM, 31.7% had type Ib; 64.1% type IIb; and 4.2% type IIc. There was a high level of agreement between reported and observed FGM prevalence (81.2% and 81.4%, resp.. There was no correlation between DHS FGM responses and anatomic extent of cutting, as 2.7% reported pricking; 87.1% flesh removal; and 1.1% that genitalia was sewn closed. Conclusion. Types I and II are the main forms of FGM, with labia majora alterations in almost 5% of cases. Self-reports on FGM status could serve as a proxy measurement for FGM prevalence but not for FGM type. The DHS FGM questions are inaccurate for determining cutting extent.

  1. Short communication: expression of transporters and metabolizing enzymes in the female lower genital tract: implications for microbicide research.

    Science.gov (United States)

    Zhou, Tian; Hu, Minlu; Cost, Marilyn; Poloyac, Samuel; Rohan, Lisa

    2013-11-01

    Topical vaginal microbicides have been considered a promising option for preventing the male-to-female sexual transmission of HIV; however, clinical trials to date have not clearly demonstrated robust and reproducible effectiveness results. While multiple approaches may help enhance product effectiveness observed in clinical trials, increasing the drug exposure in lower genital tract tissues is a compelling option, given the difficulty in achieving sufficient drug exposure and positive correlation between tissue exposure and microbicide efficacy. Since many microbicide drug candidates are substrates of transporters and/or metabolizing enzymes, there is emerging interest in improving microbicide exposure and efficacy through local modulation of transporters and enzymes in the female lower genital tract. However, no systematic information on transporter/enzyme expression is available for ectocervical and vaginal tissues of premenopausal women, the genital sites most relevant to microbicide drug delivery. The current study utilized reverse transcriptase polymerase chain reaction (RT-PCR) to examine the mRNA expression profile of 22 transporters and 19 metabolizing enzymes in premenopausal normal human ectocervix and vagina. Efflux and uptake transporters important for antiretroviral drugs, such as P-gp, BCRP, OCT2, and ENT1, were found to be moderately or highly expressed in the lower genital tract as compared to liver. Among the metabolizing enzymes examined, most CYP isoforms were not detected while a number of UGTs such as UGT1A1 were highly expressed. Moderate to high expression of select transporters and enzymes was also observed in mouse cervix and vagina. The implications of this information on microbicide research is also discussed, including microbicide pharmacokinetics, the utilization of the mouse model in microbicide screening, as well as the in vivo functional studies of cervicovaginal transporters and enzymes.

  2. Awareness and predictors of female genital mutilation/cutting among young health advocates

    Directory of Open Access Journals (Sweden)

    Abolfotouh SM

    2015-02-01

    Full Text Available Sherif M Abolfotouh,1,2 Ahmed Z Ebrahim,1,3 Mostafa A Abolfotouh4 On Behalf of IFMSA-Egypt 1IFMSA-Egypt, Alexandria, Egypt; 2Oulu University Hospital, Oulu, Finland; 3Alexandria Faculty of Medicine, Alexandria, Egypt; 4King Abdullah International Medical Research Center (KAIMRC, King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia Abstract: The act of female genital mutilation/cutting (FGM/C is considered internationally as a violent act against girls and women and a violation of their human rights. This study sought to assess the awareness and predictors of FGM/C in young Egyptian health advocates. A cross-sectional study of 600 medical students from a total of 2,500 members of the International Federation of Medical Students’ Associations (IFMSA-Egypt, across all Egyptian medical schools, was conducted using a previously validated online Google survey. The overall prevalence of circumcision was 14.7/100 female students, with a significantly higher prevalence in students from rural areas (25% than in non-rural areas (10.8%, P=0.001, and in those residing in Upper (southern Egypt (20.6% than in Lower (northern Egypt (8.7%, P=0.003. The students’ mean percentage score for knowledge about the negative health consequences of FGM/C was 53.50±29.07, reflecting a modest level of knowledge; only 30.5% had a good level of knowledge. The mean percentage score for the overall attitude toward discontinuation of the practice of FGM/C was 76.29±17.93, reflecting a neutral attitude; 58.7% had a favorable attitude/norms toward discontinuation of the practice. Of circumcised students, approximately one-half (46.8% were unwilling to have their daughters circumcised, and 60% reported no harm from being circumcised. After controlling for confounders, a negative attitude toward FGM/C was significantly (P<0.001 in all cases associated with male sex, residency in Upper Egypt, rural origin, previous circumcision, and the preclinical

  3. Awareness and predictors of female genital mutilation/cutting among young health advocates

    Science.gov (United States)

    Abolfotouh, Sherif M; Ebrahim, Ahmed Z; Abolfotouh, Mostafa A

    2015-01-01

    The act of female genital mutilation/cutting (FGM/C) is considered internationally as a violent act against girls and women and a violation of their human rights. This study sought to assess the awareness and predictors of FGM/C in young Egyptian health advocates. A cross-sectional study of 600 medical students from a total of 2,500 members of the International Federation of Medical Students’ Associations (IFMSA)-Egypt, across all Egyptian medical schools, was conducted using a previously validated online Google survey. The overall prevalence of circumcision was 14.7/100 female students, with a significantly higher prevalence in students from rural areas (25%) than in non-rural areas (10.8%, P=0.001), and in those residing in Upper (southern) Egypt (20.6%) than in Lower (northern) Egypt (8.7%, P=0.003). The students’ mean percentage score for knowledge about the negative health consequences of FGM/C was 53.50±29.07, reflecting a modest level of knowledge; only 30.5% had a good level of knowledge. The mean percentage score for the overall attitude toward discontinuation of the practice of FGM/C was 76.29±17.93, reflecting a neutral attitude; 58.7% had a favorable attitude/norms toward discontinuation of the practice. Of circumcised students, approximately one-half (46.8%) were unwilling to have their daughters circumcised, and 60% reported no harm from being circumcised. After controlling for confounders, a negative attitude toward FGM/C was significantly (P<0.001 in all cases) associated with male sex, residency in Upper Egypt, rural origin, previous circumcision, and the preclinical medical phase of education. The low level of knowledge among even future health professions in our study suggests that communication, rather than passive learning, is needed to convey the potentially negative consequences of FGM/C and to drive a change in attitude toward discontinuation of this harmful practice. PMID:25759602

  4. Female genital mutilation – why does it still exist in Africa?

    Directory of Open Access Journals (Sweden)

    Annika Schmöker

    2015-05-01

    Full Text Available Female genital mutilation (FGM includes all procedures that involve partial or total removal of the external female genitalia for non-medical reasons. FGM is practised in many parts of the world – including 28 African countries, some countries in the Middle East and Asia, and some population groups in Central and South America. Its prevalence rates range from 0.6% up to 97.9%, and it has been classified as a violation of human and children’s rights. Consequently, several countries have passed laws against the practice and many international programmes have been implemented to abandon it. Yet, FGM still prevails in many countries. This literature review aimed at identifying the underlying reasons for the perpetuation of FGM, ascertaining forces that foster its promotion and persistence and who is responsible for pushing its continuation. The main goal was to try to understand the underlying causes that make FGM resistant against initiatives and campaigns targeting its elimination. A literature search was carried out using several databases. All sources that approached the topic of FGM were incorporated including literature reviews, systematic reviews, qualitative and quantitative as well as mixed-method studies that described attitudes towards FGM and factors associated with its practice. Different factors that were interlinked could be identified at the individual, interpersonal, organisational/institutional as well as the community/societal level as the underlying causes of the perpetuation for FGM. These factors varied within and between different settings, and include individual characteristics such as parents’ level of education, place of residence, personal beliefs (aesthetics, health benefits, hygiene about FGM as well as the medicalisation of FGM and the involvement of health care professionals at the institutional level. Cultural factors like gender inequality, social norms and pressure also played an important role. Surprisingly

  5. Activism on the medicalization of sex and female genital cosmetic surgery by the New View Campaign in the United States.

    Science.gov (United States)

    Tiefer, Leonore

    2010-05-01

    The New View Campaign is a grassroots initiative begun in 1999 to challenge the over-medicalization of sex in the wake of publicity following the release of Viagra. This paper describes the history of the campaign and its activities, which started with analysing the construction of female sexual dysfunction, and moved on to develop a critical understanding of sexuality as a market for the pharmaceutical industry to exploit. The campaign has also had much to say about a positive model for sexuality, sex education, treatment of sex problems, and sex research. From 2006, we began to look at the new female cosmetic genital surgery industry. In 2008, we wrote letters to many government and medical professional groups expressing our concerns about female cosmetic genital surgery and asking for support. We also organised a demonstration outside the office of a New York surgeon who was doing this surgery and developed a webpage as a resource for students, scholars, journalists and activists. In 2009, we held an event in an art gallery that celebrated artists who support and encourage female sexual diversity. Supporters and colleagues of the campaign have published books and articles, and created visual and training materials, including a project called Vulvagraphics. Copyright 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  6. The Colposcopic Atlas of Schistosomiasis in the Lower Female Genital Tract Based on Studies in Malawi, Zimbabwe, Madagascar and South Africa

    Science.gov (United States)

    Norseth, Hanne M.; Ndhlovu, Patricia D.; Kleppa, Elisabeth; Randrianasolo, Bodo S.; Jourdan, Peter M.; Roald, Borghild; Holmen, Sigve D.; Gundersen, Svein G.; Bagratee, Jayanthilall; Onsrud, Mathias; Kjetland, Eyrun F.

    2014-01-01

    Background Schistosoma (S.) haematobium is a neglected tropical disease which may affect any part of the genital tract in women. Female genital schistosomiasis (FGS) may cause abnormal vaginal discharge, contact bleeding, genital tumours, ectopic pregnancies and increased susceptibility to HIV. Symptoms may mimic those typical of sexually transmitted infections (STIs) and women with genital schistosomiasis may be incorrectly diagnosed. An expert consensus meeting suggested that the following findings by visual inspection should serve as proxy indicators for the diagnosis of schistosomiasis of the lower genital tract in women from S. haematobium endemic areas: sandy patches appearing as (1) single or clustered grains or (2) sandy patches appearing as homogenous, yellow areas, or (3) rubbery papules. In this atlas we aim to provide an overview of the genital mucosal manifestations of schistosomiasis in women. Methodology/Principal findings Photocolposcopic images were captured from women, between 1994 and 2012 in four different study sites endemic for S. haematobium in Malawi, Zimbabwe, South Africa and Madagascar. Images and specimens were sampled from sexually active women between 15 and 49 years of age. Colposcopic images of other diseases are included for differential diagnostic purposes. Significance This is the first atlas to present the clinical manifestations of schistosomiasis in the lower female genital tract. It will be freely available for online use, downloadable as a presentation and for print. It could be used for training purposes, further research, and in clinical practice. PMID:25412334

  7. The colposcopic atlas of schistosomiasis in the lower female genital tract based on studies in Malawi, Zimbabwe, Madagascar and South Africa.

    Directory of Open Access Journals (Sweden)

    Hanne M Norseth

    Full Text Available Schistosoma (S. haematobium is a neglected tropical disease which may affect any part of the genital tract in women. Female genital schistosomiasis (FGS may cause abnormal vaginal discharge, contact bleeding, genital tumours, ectopic pregnancies and increased susceptibility to HIV. Symptoms may mimic those typical of sexually transmitted infections (STIs and women with genital schistosomiasis may be incorrectly diagnosed. An expert consensus meeting suggested that the following findings by visual inspection should serve as proxy indicators for the diagnosis of schistosomiasis of the lower genital tract in women from S. haematobium endemic areas: sandy patches appearing as (1 single or clustered grains or (2 sandy patches appearing as homogenous, yellow areas, or (3 rubbery papules. In this atlas we aim to provide an overview of the genital mucosal manifestations of schistosomiasis in women.Photocolposcopic images were captured from women, between 1994 and 2012 in four different study sites endemic for S. haematobium in Malawi, Zimbabwe, South Africa and Madagascar. Images and specimens were sampled from sexually active women between 15 and 49 years of age. Colposcopic images of other diseases are included for differential diagnostic purposes.This is the first atlas to present the clinical manifestations of schistosomiasis in the lower female genital tract. It will be freely available for online use, downloadable as a presentation and for print. It could be used for training purposes, further research, and in clinical practice.

  8. Gross anatomy of the female genital organs of the domestic donkey (Equus asinus Linné, 1758).

    Science.gov (United States)

    Renner-Martin, T F P; Forstenpointner, G; Weissengruber, G E; Eberhardt, L

    2009-04-01

    Although donkeys play an important role as companion or pack and draught animals, theriogenological studies and anatomical data on the genital organs of the jenny are sparse. To provide anatomical descriptions and morphometric data, the organa genitalia feminina, their arteries and the ligamentum latum uteri of 10 adult but maiden jennies were examined by means of gross anatomical and morphometric techniques. In comparison with anatomical data of horses obtained from literature the genital organs of jennies appear to be more voluminous in relation to the body mass and the position of the ovaries is slightly further cranial than in mares. In asses, the ovaries contain large follicles reaching a diameter of up to 40 mm. The mesosalpinx is much wider than in the horse forming a considerably spacious bursa ovarica. The asinine ligamentum teres uteri reveals a very prominent cranial end, the 'appendix'. Tortuous mucosal folds occur in the wall of the jenny's cervical channel. The vascularization of the female genital organs of asses is very similar to that of horses. One of the examined specimens reveals a large mucosal fold dividing the cranial part of the vagina into a left and right compartment.

  9. Female Genital Mutilation/Cutting: Innovative Training Approach for Nurse-Midwives in High Prevalent Settings

    Directory of Open Access Journals (Sweden)

    Samuel Kimani

    2018-01-01

    Full Text Available Background. Female genital mutilation/cutting (FGM/C has no medical benefits and is associated with serious health complications. FGM/C including medicalization is illegal in Kenya. Capacity building for nurse-midwives to manage and prevent FGM/C is therefore critical. Objective. Determine the current FGM/C knowledge and effect of training among nurse-midwives using an electronic tool derived from a paper-based quiz on FGM/C among nurse-midwives. Methods. Nurse-midwives n=26 were assessed pre- and post-FGM/C training using a quiz comprising 12 questions. The quiz assessed the following factors: definition, classification, determining factors, epidemiology, medicalization, prevention, health consequences, and nurse-midwives’ roles in FGM/C prevention themes. The scores for individuals and all the questions were computed and compared using SPSS V22. Results. The mean scores for the quiz were 64.8%, improving to 96.2% p<0.05 after training. Before the training, the following proportions of participants correctly answered questions demonstrating their knowledge of types of cutting (84.6%, link with health problems (96.2%, FGM/C-related complications (96.2%, communities that practice FGM/C (61.5%, medicalization (43.6%, reinfibulation (46.2%, dissociation from religion (46.2%, and the law as it relates to FGM/C (46.2%. The participants demonstrated knowledge of FGM/C-related complications with the proportion of nurse-midwives correctly answering questions relating to physical impact (69.2%, psychological impact (69.2%, sexual impact (57.7%, and social impact (38.5%. Additionally, participant awareness of NM roles in managing FGM/C included the following: knowledge of the nurse-midwife as counselor (69.2%, advocate (80.8%, leader (26.9%, role model (42.3%, and caregiver (34.6%. These scores improved significantly after training. Conclusion. Substantial FGM/C-related knowledge was demonstrated by nurse-midwives. They, however, showed challenges in

  10. Knowledge and attitudes of female genital mutilation among midwives in Eastern Sudan

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    Ali Abdel Aziem A

    2012-09-01

    Full Text Available Abstract Background Female Genital Mutilation (FGM or cutting caries legal and bioethical debates and it is practiced in many developing countries. Methods Random selection of 154 midwives was used for the study during June 2012 and through July 2012 aiming to assess knowledge and attitudes of the midwives towards FGM in Eastern Sudan. Results A total of 157 midwives enrolled in this study. They had been practicing for 3 – 44 years (mean SD 19.2 ± 10.3. More than two third of them experienced practicing FGM sometime in their life (127/157, 80.9%. There was low level of awareness of types of FGM practice since only 7% (11/157 identified the four types correctly. 53.5% (84/157 identified type 1 correctly while 18.5% (29/157, 17.8% (28/157 and 15.9% (25/157 identified type 2, 3 and 4 as correct respectively. While 30 (19.1% of the midwives claimed that all types of FGM are harmful, 76.4% (120/157 were of the opinion that some forms are not harmful and 7 (4.5% reported that all types of FGM are not harmful. Likewise while 74.5% (117/157 of the interviewed midwives mentioned that the FGM is a legal practice only 25.5% (40/117 were of the opinion that FGM is illegal practice. The vast majority of the respondents (64.3%, 101/157 have an opinion that FGM decreases the sexual pleasure. More than half (53.5%, 84/157 of the participants affirmed that FGM does not increase the risk of HIV transmission. High proportion of the respondents (71.3%, 112/157 did not know whether or not infertility could complicate FGM. Conclusions Thus a substantial effort should be made to discourage the continuation of FGM practice among midwives in Sudan. This might be achieved by improving knowledge and awareness among the midwives and the community

  11. Factors associated with female genital mutilation in Burkina Faso and its policy implications

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    Chung Donna

    2011-05-01

    Full Text Available Abstract Background Female genital mutilation (FGM usually undertaken between the ages of 1-9 years and is widely practised in some part of Africa and by migrants from African countries in other parts of the world. Laws prohibit FGM in almost every country. FGM can cause immediate complications (pain, bleeding and infection and delayed complications (sexual, obstetric, psychological problems. Several factors have been associated with an increased likelihood of FGM. In Burkina Faso, the prevalence of FGM appears to have increased in recent years. Methods We investigated social, demographic and economic factors associated with FGM in Burkina Faso using the 2003 Demographic Health Survey (DHS. The DHS is a nationally representative cross-sectional survey (multistage stratified random sampling of households of women of reproductive age (15-49 years. Associations between potential risk factors and the prevalence of FGM were explored using χ2 and t-tests and Mann Whitney U-test as appropriate. Logistic regression modelling was used to investigate social, demographic and economic risk factors associated with FGM. Main outcome measures i whether a woman herself had had FGM; ii whether she had one or more daughters with FGM. Results Data were available on 12,049 women. Response rates by region were at least 90%. Women interviewed were representative of the underlying populations of the different regions of Burkina Faso. Seventy seven percent (9267 of the women interviewed had had FGM. 7336 women had a daughter of whom 2216 (30.2% had a daughter with FGM and 334 (4.5% said that they intended that their daughter should have it. Univariate analysis showed that age, religion, wealth, ethnicity, literacy, years of education, household affluence, region and who had responsibility for health care decisions in the household had (RHCD were all significantly related to the two outcomes (p Conclusions and Policy implications Factors associated with FGM are varied

  12. Episiotomy and obstetric outcomes among women living with type 3 female genital mutilation: a secondary analysis.

    Science.gov (United States)

    Rodriguez, Maria I; Seuc, Armando; Say, Lale; Hindin, Michelle J

    2016-10-10

    To investigate the association between type of episiotomy and obstetric outcomes among 6,187 women with type 3 Female Genital Mutilation (FGM). We conducted a secondary analysis of women presenting in labor to 28 obstetric centres in Burkina Faso, Ghana, Kenya, Nigeria, Senegal and Sudan between November 2001 and March 2003. Data were analysed using cross tabulations and multivariable logistic regression to determine if type of episiotomy by FGM classification had a significant impact on key maternal outcomes. Our main outcome measures were anal sphincter tears, intrapartum blood loss requiring an intervention, and postpartum haemorrhage. Type of episiotomy performed varied significantly by FGM status. Among women without FGM, the most common type of episiotomy performed was posterior lateral (25.4 %). The prevalence of the most extensive type of episiotomy, anterior and posterior lateral episiotomy increased with type of FGM. Among women without FGM, 0.4 % had this type of episiotomy. This increased to 0.6 % for women with FGM Types 1, 2 or 4 and to 54.6 % of all women delivering vaginally with FGM Type 3. After adjustment, women with an anterior episiotomy, (AOR = 0.15 95 %; CI 0.06-0.40); posterior lateral episiotomy (AOR = 0.68 95 %; CI 0.50-0.94) or both anterior and posterior lateral episiotomies performed concurrently (AOR = 0.21 95 % CI 0.12-0.36) were all significantly less likely to have anal sphincter tears compared to women without episiotomies. Women with anterior episiotomy (AOR = 0.08; 95%CI 0.02-0.24), posterior lateral episiotomy (AOR = 0.17 95 %; CI 0.05-0.52) and the combination of the two (AOR = 0.04 95 % CI 0.01-0.11) were significantly less likely to have postpartum haemorrhage compared with women who had no episiotomy. Among women living with FGM Type 3, episiotomies were protective against anal sphincter tears and postpartum haemorrhage. Further clinical and research is needed to guide clinical practice of

  13. Effect of antitubercular treatment on ovarian function in female genital tuberculosis with infertility

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    Jai Bhagwan Sharma

    2016-01-01

    Full Text Available AIM: To evaluate the effect of antitubercular therapy (ATT on an ovarian function such as ovarian reserve, ovarian dimensions, and ovarian stromal blood flow. SETTINGS AND DESIGN: Prospective study design. MATERIALS AND METHODS: Fifty infertile women with female genital tuberculosis (FGTB without tubo-ovarian masses diagnosed by positive acid-fast bacilli culture or epithelioid granuloma on endometrial aspirate or positive polymerase chain reaction with positive findings on laparoscopy or hysteroscopy were recruited. The ovarian function tests were performed on day 2/3 as follicle-stimulating hormone (FSH levels and anti-Mullerian hormone (AMH levels. Ovarian dimensions (length, width, and depth were measured using a transvaginal ultrasound. Mean antral follicle count (AFC and ovarian stromal blood flow (peak systolic velocity [PSV], pulsatility index (PI, and resistive index [RI] were measured using a transvaginal ultrasound. All women were started on ATT for 6 months by directly observed treatment strategy. After completion of ATT, all the parameters were repeated. RESULTS: There was a significant increase in AMH (2.68 ± 0.97 ng/ml to 2.8 ± 1.03 ng/ml pre- to post-ATT, nonsignificant increase in FSH (7.16 ± 2.34 mIU/ml to 7.26 ± 2.33 mIU/ml post-ATT, significant increase in mean AFC (7.40 ± 2.12-8.14 ± 2.17, PSV in the right ovary (6.015-6.11 cm/s and left ovary (6.05-6.08 cm/s, PI in the right ovary (0.935-0.951 cm/s and left ovary (0.936-0.957 cm/s, and RI in the right ovary (0.62 ± 0.01-0.79 ± 0.02 and left ovary (0.65 ± 0.02-0.84 ± 0.01 with ATT. There was no significant change in mean ovarian dimensions (ovarian length, breadth, and width and summed ovarian volume with ATT. On laparoscopy, tubercles were seen in 27 (54% women. Caseous nodules and encysted ascites were seen in 8% cases each. CONCLUSION: ATT improves the ovarian function (AMH and AFC and ovarian blood flow in women with FGTB.

  14. Qualitative evaluation of the Saleema campaign to eliminate female genital mutilation and cutting in Sudan.

    Science.gov (United States)

    Johnson, Andrea C; Douglas Evans, W; Barrett, Nicole; Badri, Howida; Abdalla, Tamador; Donahue, Cody

    2018-02-17

    Female genital mutilation and cutting (FGM/C, herein FGM) is a widespread and harmful practice. The Government developed a national campaign in Sudan, called Saleema, to change social norms discouraging FGM. Saleema translates to being "whole", healthy in body and mind, unharmed, intact, pristine, and untouched, in a God-given condition. An interim evaluation was conducted using focus groups among Sudanese adults. The primary aim was to explore perceptions of the Saleema poster exemplars and to assess if the desired themes were being communicated. Secondary aims were to understand more about participants' information sources, values, and suggestions for the campaign broadly. The Saleema campaign evaluation included four focus groups from each of the 18 states in Sudan (72 total). Participants were presented with three poster stimuli from the Saleema campaign and asked about the content and their reactions. Themes were coded inductively by concepts that arose through content in the transcripts. Codes were also reviewed in conjunction with themes from the broader Saleema evaluation framework. Participants reported the most common source of information or admiration was from local leaders who are responsive to a community, media-based outlets, and discussions among community members. Participants held high value for education, community solidarity, and/or religious devotion. Participants had positive opinions of Saleema and responded positively to the branding elements in the posters and the campaign as a whole. The most common suggestion was continued awareness. Advocacy, training, and posters were suggested to highlight the harms of FGM through leaders or in community settings. Individuals suggested that these activities target older women and individuals in rural villages. There was also a burgeoning theme of targeting youth for support of the campaign. The results of this focus group analysis demonstrate support for future Saleema campaign efforts promoting

  15. Female Genital Mutilation: perceptions of healthcare professionals and the perspective of the migrant families

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    Kaplan-Marcusán Adriana

    2010-04-01

    Full Text Available Abstract Background Female Genital Mutilation (FGM is a traditional practice which is harmful to health and is profoundly rooted in many Sub-Saharan African countries. It is estimated that between 100 and 140 million women around the world have been victims of some form of FGM and that each year 3 million girls are at risk of being submitted to these practices. As a consequence of the migratory phenomena, the problems associated with FGM have extended to the Western countries receiving the immigrants. The practice of FGM has repercussions on the physical, psychic, sexual and reproductive health of women, severely deteriorating their current and future quality of life. Primary healthcare professionals are in a privileged position to detect and prevent these situations of risk which will be increasingly more present in Spain. Methods/Design The objective of the study is to describe the knowledge, attitudes and practices of the primary healthcare professionals, working in 25 health care centres in Barcelona and Girona regions, regarding FGM, as well as to investigate the perception of this subject among the migrant communities from countries with strong roots in these practices. A transversal descriptive study will be performed with a questionnaire to primary healthcare professionals and migrant healthcare users. Using a questionnaire specifically designed for this study, we will evaluate the knowledge, attitudes and skills of the healthcare professionals to approach this problem. In a sub-study, performed with a similar methodology but with the participation of cultural mediators, the perceptions of the migrant families in relation to their position and expectancies in view of the result of preventive interventions will be determined. Variables related to the socio-demographic aspects, knowledge of FGM (types, cultural origin, geographic distribution and ethnicity, evaluation of attitudes and beliefs towards FGM and previous contact or experience

  16. Female genital mutilation: perceptions of healthcare professionals and the perspective of the migrant families.

    Science.gov (United States)

    Kaplan-Marcusán, Adriana; Del Rio, Natividad Fernández; Moreno-Navarro, Juana; Castany-Fàbregas, Ma José; Nogueras, Marta Ruiz; Muñoz-Ortiz, Laura; Monguí-Avila, Eliana; Torán-Monserrat, Pere

    2010-04-13

    Female Genital Mutilation (FGM) is a traditional practice which is harmful to health and is profoundly rooted in many Sub-Saharan African countries. It is estimated that between 100 and 140 million women around the world have been victims of some form of FGM and that each year 3 million girls are at risk of being submitted to these practices. As a consequence of the migratory phenomena, the problems associated with FGM have extended to the Western countries receiving the immigrants. The practice of FGM has repercussions on the physical, psychic, sexual and reproductive health of women, severely deteriorating their current and future quality of life. Primary healthcare professionals are in a privileged position to detect and prevent these situations of risk which will be increasingly more present in Spain. The objective of the study is to describe the knowledge, attitudes and practices of the primary healthcare professionals, working in 25 health care centres in Barcelona and Girona regions, regarding FGM, as well as to investigate the perception of this subject among the migrant communities from countries with strong roots in these practices. A transversal descriptive study will be performed with a questionnaire to primary healthcare professionals and migrant healthcare users.Using a questionnaire specifically designed for this study, we will evaluate the knowledge, attitudes and skills of the healthcare professionals to approach this problem. In a sub-study, performed with a similar methodology but with the participation of cultural mediators, the perceptions of the migrant families in relation to their position and expectancies in view of the result of preventive interventions will be determined.Variables related to the socio-demographic aspects, knowledge of FGM (types, cultural origin, geographic distribution and ethnicity), evaluation of attitudes and beliefs towards FGM and previous contact or experience with cases or risk situations will be obtained

  17. Thirty-year trends in the prevalence and severity of female genital mutilation: a comparison of 22 countries

    Science.gov (United States)

    Heymann, Jody

    2017-01-01

    Introduction Female genital mutilation (FGM) harms women’s health and well-being and is widely considered a violation of human rights. The United Nations has called for elimination of the practice by 2030. Methods We used household survey data to measure trends in the prevalence of FGM in 22 countries. We also examined trends in the severity of the practice by measuring changes in the prevalence of flesh removal, infibulation and symbolic ‘nicking’ of the genitals. We evaluated the extent to which measurement error may have influenced our estimates by observing the consistency of reports for the same birth cohorts over successive survey waves. Results The prevalence of all types of FGM fell in 17 of 22 countries we examined. The vast majority of women who undergo FGM have flesh removed from their genitals, likely corresponding to the partial or total removal of the clitoris and labia. Infibulation is still practised throughout much of sub-Saharan Africa. Its prevalence has declined in most countries, but in Chad, Mali and Sierra Leone the prevalence has increased by 2–8 percentage points over 30 years. Symbolic nicking of the genitals is relatively rare but becoming more common in Burkina Faso, Chad, Guinea and Mali. Conclusion FGM is becoming less common over time, but it remains a pervasive practice in some countries: more than half of women in 7 of the 22 countries we examined still experience FGM. The severity of the procedures has not changed substantially over time. Rigorous evaluation of interventions aimed at eliminating or reducing the harms associated with the practice is needed. PMID:29225952

  18. Susceptibilities of Chlamydia trachomatis isolates causing uncomplicated female genital tract infections and pelvic inflammatory disease.

    OpenAIRE

    Rice, R J; Bhullar, V; Mitchell, S H; Bullard, J; Knapp, J S

    1995-01-01

    The in vitro susceptibilities of 45 recent clinical isolates of Chlamydia trachomatis obtained from women with asymptomatic genital tract infection, mucopurulent cervicitis, or pelvic inflammatory disease to doxycycline, azithromycin, ofloxacin, and clindamycin were determined. In addition, susceptibilities of 12 isolates to amoxicillin and trimethoprim-sulfamethoxazole were also determined. Isolates also were serotyped with a panel of monoclonal antibodies specific for chlamydial major outer...

  19. Knowledge, attitude, and experience of health professionals of female genital mutilation (FGM): A qualitative study in Iraqi Kurdistan Region.

    Science.gov (United States)

    Shabila, Nazar P; Ahmed, Hamdia M; Safari, Kolsoom

    2017-11-01

    We aimed to assess the knowledge, attitude, and experience of health professionals of female genital mutilation (FGM). The study involved content analysis of semistructured interviews with 21 health professionals. The participants had poor knowledge regarding different aspects of FGM including its types, prevalence, and complications as well as the existing legislation that prohibits FGM. They believed that FGM is mainly practiced for religious reasons and to reduce sexual desire/arousal. Health professionals are apparently not involved in performing FGM, and they do not support its continuation. Health professionals can take a leading role in raising the awareness of women and combating FGM.

  20. A systematic review of doctors' experiences and needs to support the care of women with female genital mutilation.

    Science.gov (United States)

    Dawson, Angela; Homer, Caroline S E; Turkmani, Sabera; Black, Kirsten; Varol, Nesrin

    2015-10-01

    Female genital mutilation (FGM) involves partial or complete removal of the external female genitalia or other injury for non-therapeutic reasons. Little is known about the knowledge and skills of doctors who care for affected women and their practice in relation to FGM. To examine the FGM experiences and educational needs of doctors. A structured search of five bibliographic databases was undertaken to identify peer-reviewed research literature published in English between 2004 and 2014 using the keywords "female genital mutilation," "medical," "doctors," "education," and "training." Observational, quasi-experimental, and non-experimental descriptive studies were suitable for inclusion. A narrative synthesis of the study findings was undertaken and themes were identified. Ten papers were included in the review, three of which were from low-income countries. The analysis identified three themes: knowledge and attitudes, FGM-related medical practices, and education and training. There is a need for improved education and training to build knowledge and skills, and to change attitudes concerning the medicalization of FGM and reinfibulation. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  1. Female genital cosmetic surgery: a cross-sectional survey exploring knowledge, attitude and practice of general practitioners.

    Science.gov (United States)

    Simonis, M; Manocha, R; Ong, J J

    2016-09-26

    To explore general practitioner's (GP) knowledge, attitudes and practice regarding female genital cosmetic surgery (FGCS) in Australia. Cross-sectional survey. Australia. GPs who attended a women's health seminar and GPs who subscribed to a non-governmental, national health professional organisation database that provides education to primary care professionals. A national online survey of GPs was conducted for the 10-week period, starting 1 week prior and 2 months after a Women's Health seminar was held in Perth on 8 August 2015. 31 questions prompted GPs' knowledge, attitudes and practice in managing patients asking about FGCS. The survey was fully completed by 443 GPs; 54% had seen patients requesting FGCS. Overall, 75% (95% CI 71% to 79%) of GPs rated their knowledge of FGCS as inadequate and 97% (95% CI 94% to 99%) had been asked by women of all ages about genital normality. Of those who had seen patients requesting FGCS, nearly half (44%, 95% CI 38% to 51%) reported they had insufficient knowledge of risks of FGCS procedures and 35% (95% CI 29% to 41%) reported seeing females younger than 18 years of age requesting FGCS. Just over half (56%, 95% CI 51% to 60%) of the GPs felt that women should be counselled before making a referral for FGCS. More than half the GPs suspected psychological disturbances in their patients requesting FGCS such as depression, anxiety, relationship difficulties and body dysmorphic disorder. GPs see women of all ages presenting with genital anatomy concerns and in those who request FGCS, GPs often suspected a range of mental health difficulties. GPs require greater education to support their patients who request FGCS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Female genital mutilation/cutting: changes and trends in knowledge, attitudes, and practices among health care professionals in The Gambia.

    Science.gov (United States)

    Kaplan Marcusán, Adriana; Riba Singla, Laura; Laye, Mass; Secka, Dodou M; Utzet, Mireia; Le Charles, Marie-Alix

    2016-01-01

    Female genital mutilation/cutting (FGM/C) is a harmful traditional practice that affects two out of three girls in The Gambia, seriously threatening their life and well-being with severe health consequences. By tracking the reference values established in former research conducted between 2009 and 2011, the objectives of this study are to explore trends and to measure and assess changes in knowledge, attitudes, and practices regarding FGM/C among health care professionals (HCPs) in The Gambia. A cross-sectional descriptive study was designed to collect and analyze data from an overall stratified sample consisting of 1,288 HCPs including health professionals and students throughout the six regions of The Gambia. Data were collected by the implementation of a self-administered written knowledge, attitudes, and practices questionnaire between 2012 and 2014. The results of this study showed that 76.4% of HCPs are eager to abandon FGM/C, and 71.6% of them regard it as a harmful practice with negative consequences on life and health. HCPs reported more knowledge and favorable attitudes towards FGM/C abandonment, being better able to identify the practice, more aware of its health complications, and more concerned in their essential role as social agents of change. However, 25.4% of HCPs still embraced the continuation of the practice, 24.4% expressed intention of subjecting their own daughters to it, and 10.5% declared to have performed it within their professional praxis. Findings confirm progress in knowledge and attitudes regarding FGM/C among HCPs, who are better skilled to understand and manage the consequences. Nevertheless, discrepancies between information, intention, and behavior unveil resistance in practice and proves that FGM/C medicalization is increasing. Thus, there is an urgent need to support HCPs in the integration of FGM/C preventive interventions within the public health system, to address arguments favoring medicalization, and to use data to design

  3. Prevalence and determinants of genital infection with papillomavirus, in female and male university students in Busan, South Korea.

    Science.gov (United States)

    Shin, Hai-Rim; Franceschi, Silvia; Vaccarella, Salvatore; Roh, Ju-Won; Ju, Young-Hee; Oh, Jin-Kyoung; Kong, Hyun-Joo; Rha, Seo-Hee; Jung, Se-Il; Kim, Jung-Il; Jung, Kap-Yeol; van Doorn, Leen-Jan; Quint, Wim

    2004-08-01

    Little is known about the prevalence of human papillomavirus (HPV) infection in young adults in Asia. We invited female and male students in Busan, South Korea, to participate in a survey that included, for females, self-collection of vaginal cells and, for males, physician-performed collection of exfoliated genital cells. The prevalences of 25 HPV types were evaluated, by a polymerase chain reaction-based assay, in 672 female students (median age, 19 years) and in 381 male students (median age, 22 years). HPV DNA was detected more frequently in female students (15.2%) than in male students (8.7%); in both sexes, high-risk HPV types were predominant. Among sexually active students, HPV prevalence was 38.8% in females and 10.6% in males. In female students, currently smoking cigarettes and having multiple lifetime sex partners were the strongest risk factors for HPV infection; in male students, associations between HPV prevalence and sexual habits were similar to those in female students but never attained statistical significance. Young women in South Korea start having penetrative sexual intercourse relatively late (median age, 18 years), but, once they begin, HPV prevalence quickly rises to levels comparable with those found in university students in the United States and in northern Europe. The high rate of participation in our study suggests that trials of new vaccines against HPV may be feasible among university students in South Korea.

  4. Anatomicohistological characteristics of the tubular genital organs of the female red brocket deer (Mazama americana) in the Peruvian Amazon.

    Science.gov (United States)

    Mayor, P; López-Plana, C; López-Béjar, M

    2012-12-01

    This study examined the anatomical and histological characteristics of tubular genital organs of 51 adult female red brocket deer in the wild in different reproductive stages, collected by rural hunters in the north-eastern Peruvian Amazon. The infundibulum was characterized by a large diameter and the presence of a highly folded and ciliated epithelium, and the isthmus has a growing secretor epithelium and a thicker muscular layer. Whereas ciliated cells are more frequent in the infundibulum, epithelial secretory cells showing abundant apical secretory blebs are more frequent in the isthmus. In non-pregnant females in luteal phase, the endometrium transforms from a proliferative to a secretory type, showing a significant proliferation of endometrial uterine glands. The red brocket deer has four large circular folds in the cervix. The epithelium of the cervix is composed primarily of secretory cells. In pregnant females, the lumen of the endocervical canal is occupied by abundant mucous secretion. All pregnant females had one embryo or fetus, with a fetal sex ratio of 54.0% females to 46.0% males. This species has a cotyledonary, syndesmochorial and partially deciduate placenta, with 6-7 dome-shaped caruncles per female. The red brocket deer does not present a true cornification of the vaginal epithelial cells, and no vaginal epithelial pattern was determined according the reproductive state of the female. © 2012 Blackwell Verlag GmbH.

  5. Complex Genital Malformation in a Female with Congenital Adrenal Hyperplasia: Evaluation with Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    Klessen, C.; Asbach, P.; Hein, P. A.; Beyersdorff, D.; Hamm, B.; Taupitz, M.

    2005-01-01

    This is a case of complex genital malformation in a young patient with congenital adrenal hyperplasia. The magnetic resonance imaging (MRI) findings included ostium of the vagina into the urethra (common urogenital opening), prostate-like tissue surrounding the urethra, and hyperplasia of the left adrenal gland. The report provides information on the clinical findings, the MRI examination, including the applied sequences and the MR findings, and gives an overview of the disease pattern and its frequency of occurrence

  6. Persistence of mucosal T-cell responses to herpes simplex virus type 2 in the female genital tract.

    Science.gov (United States)

    Posavad, C M; Zhao, L; Mueller, D E; Stevens, C E; Huang, M L; Wald, A; Corey, L

    2015-01-01

    Relatively little is known about the human T-cell response to herpes simplex virus type 2 (HSV-2) in the female genital tract, a major site of heterosexual HSV-2 acquisition, transmission, and reactivation. In order to understand the role of local mucosal immunity in HSV-2 infection, T-cell lines were expanded from serial cervical cytobrush samples from 30 HSV-2-infected women and examined for reactivity to HSV-2. Approximately 3% of the CD3+ T cells isolated from the cervix were HSV-2 specific and of these, a median of 91.3% were CD4+, whereas a median of 3.9% were CD8+. HSV-2-specific CD4+ T cells expanded from the cervix were not only more frequent than CD8+ T cells but also exhibited greater breadth in terms of antigenic reactivity. T cells directed at the same HSV-2 protein were often detected in serial cervical cytobrush samples and in blood. Thus, broad and persistent mucosal T-cell responses to HSV-2 were detected in the female genital tract of HSV-2+ women suggesting that these cells are resident at the site of HSV-2 infection. Understanding the role of these T cells at this biologically relevant site will be central to the elucidation of adaptive immune mechanisms involved in controlling HSV-2 disease.

  7. The spider Harpactea sadistica: co-evolution of traumatic insemination and complex female genital morphology in spiders

    Science.gov (United States)

    Řezáč, Milan

    2009-01-01

    The males of invertebrates from a few phyla, including arthropods, have been reported to practise traumatic insemination (TI; i.e. injecting sperm by using the copulatory organ to penetrate the female's body wall). As all previously reported arthropod examples have been insects, there is considerable interest in whether TI might have evolved independently in other arthropods. The research reported here demonstrates the first case of TI in the arthropod subphylum Chelicerata, in particular how the genital morphology and mating behaviour of Harpactea sadistica (Řezáč 2008), a spider from Israel, has become adapted specifically for reproduction based on TI. Males have needle-like intromittent organs and females have atrophied spermathecae. In other spiders, eggs are fertilized simultaneously with oviposition, but the eggs of H. sadistica are fertilized in the ovaries (internal fertilization) and develop as embryos before being laid. Sperm-storage organs of phylogenetically basal groups to H. sadistica provide males with last male sperm priority and allow removal of sperm by males that mate later, suggesting that TI might have evolved as an adaptive strategy to circumvent an unfavourable structure of the sperm-storage organs, allowing the first male to mate with paternity advantage. Understanding the functional significance of TI gives us insight into factors underlying the evolution of the genital and sperm-storage morphology in spiders. PMID:19403531

  8. Meaning-making of female genital cutting: children’s perception and acquired knowledge of the ritual

    Science.gov (United States)

    Schultz, Jon-Håkon; Lien, Inger-Lise

    2013-01-01

    How do girls who have undergone female genital cutting understand the ritual? This study provides an analysis of the learning process and knowledge acquired in their meaning-making process. Eighteen participants were interviewed in qualitative indepth interviews. Women in Norway, mostly with Somali or Gambian backgrounds, were asked about their experiences of circumcision. Two different strategies were used to prepare girls for circumcision, ie, one involving giving some information and the other keeping the ritual a secret. Findings indicate that these two approaches affected the girls’ meaning-making differently, but both strategies seemed to lead to the same educational outcome. The learning process is carefully monitored and regulated but is brought to a halt, stopping short of critical reflexive thinking. The knowledge tends to be deeply internalized, embodied, and morally embraced. The meaning-making process is discussed by analyzing the use of metaphors and narratives. Given that the educational outcome is characterized by limited knowledge without critical reflection, behavior change programs to end female genital cutting should identify and implement educational stimuli that are likely to promote critical reflexive thinking. PMID:23637562

  9. Sexual counselling for treating or preventing sexual dysfunction in women living with female genital mutilation: A systematic review.

    Science.gov (United States)

    Okomo, Uduak; Ogugbue, Miriam; Inyang, Elizabeth; Meremikwu, Martin M

    2017-02-01

    Female sexual dysfunction is the persistent or recurring decrease in sexual desire or arousal, the difficulty or inability to achieve an orgasm, and/or the feeling of pain during sexual intercourse. Impaired sexual function can occur with all types of female genital mutilation (FGM) owing to the structural changes, pain, or traumatic memories associated with the procedure. To conduct a systematic review of randomized and nonrandomized studies into the effects of sexual counseling with or without genital lubricants on the sexual function of women living with FGM. Cochrane Central Register of Controlled Trials, MEDLINE, African Index Medicus, SCOPUS, LILACS, CINAHL, ClinicalTrials.gov, Pan African Clinical Trials Registry, and other databases were searched to August 2015. The reference lists of retrieved studies were checked for reports of additional studies, and lead authors contacted for additional data. Studies of girls and women living with any type of FGM who received counselling interventions for sexual dysfunction were included. No relevant studies that addressed the objective of the review were identified. Despite a comprehensive search, the authors could not find evidence of the effects of sexual counseling on the sexual function of women living with FGM. Studies assessing this intervention are needed. CRD42015024593. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  10. PBX1 intracellular localization is independent of MEIS1 in epithelial cells of the developing female genital tract.

    Science.gov (United States)

    Dintilhac, Agnès; Bihan, Réjane; Guerrier, Daniel; Deschamps, Stéphane; Bougerie, Héloise; Watrin, Tanguy; Bonnec, Georgette; Pellerin, Isabelle

    2005-01-01

    While studies have highlighted the role of HOXA9-13 and PBX1 homeobox genes during the development of the female genital tract, the molecular mechanisms triggered by these genes are incompletely elucidated. In several developmental pathways, PBX1 binds to MEINOX family members in the cytoplasm to be imported into the nucleus where they associate with HOX proteins to form a higher complex that modulates gene expression. This concept has been challenged by a recent report showing that in some cell cultures, PBX1 nuclear localization might be regulated independently of MEINOX proteins (Kilstrup-Nielsen et al., 2003). Our work gives the first illustration of this alternative mechanism in an organogenesis process. Indeed, we show that PBX1 is mostly cytoplasmic in epithelial endometrial cells of the developing female genital tract despite the nuclear localization of MEIS1. We thus provide evidence for a control of PBX1 intracellular distribution which is independent of MEINOX proteins, but is cell cycle correlated.

  11. Female genital mutilation/cutting: changes and trends in knowledge, attitudes, and practices among health care professionals in The Gambia

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    Kaplan Marcusán A

    2016-04-01

    practice, 24.4% expressed intention of subjecting their own daughters to it, and 10.5% declared to have performed it within their professional praxis.Conclusion: Findings confirm progress in knowledge and attitudes regarding FGM/C among HCPs, who are better skilled to understand and manage the consequences. Nevertheless, discrepancies between information, intention, and behavior unveil resistance in practice and proves that FGM/C medicalization is increasing. Thus, there is an urgent need to support HCPs in the integration of FGM/C preventive interventions within the public health system, to address arguments favoring medicalization, and to use data to design appropriate strategies. Keywords: female genital mutilation/cutting, The Gambia, health care professionals, knowledge, attitudes, practices, changes, trends, sexual and reproductive health

  12. Genital warts

    Science.gov (United States)

    ... in the genital area near the warts Increased vaginal discharge Genital itching Vaginal bleeding during or after sex ... have visible warts on your external genitals, itching, discharge, or abnormal vaginal bleeding. Keep in mind that genital warts may ...

  13. The Female Genital Self-Image Scale (FGSIS): results from a nationally representative probability sample of women in the United States.

    Science.gov (United States)

    Herbenick, Debra; Schick, Vanessa; Reece, Michael; Sanders, Stephanie; Dodge, Brian; Fortenberry, J Dennis

    2011-01-01

    Over the past two decades, an expanding body of research has examined women's and men's genital self-image. Support for the reliability and validity of the 7-item Female Genital Self-Image Scale (FGSIS) has been found in a convenience sample of women. The purpose of this study was to assess the reliability and validity of the FGSIS, its model of fit, and its association with women's scores on the Female Sexual Function Index (FSFI) in a nationally representative probability sample of women in the United States ages 18 to 60. A second purpose was to assess the temporal stability of the scale in a subset of this sample. A nationally representative sample of 3,800 women ages 18 to 60 were invited to participate in a cross-sectional Internet-based survey; 2,056 (54.1%) participated. Demographic items (e.g., age, race/ethnicity, marital status, sexual orientation, geographic region), having had a gynecological examination in the past year, having performed a genital self-examination in the past month, frequency of masturbation in the past month, vibrator use in the past month, the FGSIS, and the FSFI. An abbreviated 4-item version of the scale, the FGSIS-4, was a better fit to the data than the original 7-item scale. Women's scores on the FGSIS-4 were significantly related to vibrator use, frequency of masturbation, having had a gynecological exam in the past year, having performed genital self examination in the past month, and all FSFI subscales. Most of the participants felt generally positively about their genitals and female genital self-image was significantly related to female sexual function, women's sexual behavior and their sexual and genital healthcare behaviors. In addition, the FGSIS-4 has evidence of reliability, validity, and temporal stability in a nationally representative probability sample of women in the United States. © 2010 International Society for Sexual Medicine.

  14. Effect of female genital mutilation/cutting; types I and II on sexual function: case-controlled study.

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    Ismail, Sahar A; Abbas, Ahmad M; Habib, Dina; Morsy, Hanan; Saleh, Medhat A; Bahloul, Mustafa

    2017-08-30

    The existing literature is contradictory regarding effects of female genital mutilation/cutting (FGM/C) on sexual functions. The aim of this study was to explore the impact of type I and II FGM/C on sexual function of Egyptian women. We recruited 197 cut women and 197 control women from those visiting Assiut University hospitals for different reasons. We asked each woman to fill the Arabic female sexual function index (FSFI) (a self reported 19-item questionnaire assessing the main domains of female sexual function). Genital Examination was done to confirm the type of FGM. Female sexual dysfunction (FSD) was found in 83.8% of FGM/C cases in contrast to 64.5% of the control. The total FSFI score in the FGM/C group (19.82 ± 7.1) was significantly lower than in the control group (23.34 ± 8.1). Concerning the types of FGM/C, type 73.6% of cases had type I and 26.4% had type II. Type I FGM/C was performed mainly by physicians (62.1%) while type II was performed mainly by midwives (44.4%). FSD was found in 83.4% of FGM/C I cases and in 84.6% of FGM/C II cases. There was no statistically significant difference between the two types of FGM/C as regards total and individual domain scores except for the pain domain. There were significantly lower total and individual domain scores in both FGM/C types except for the desire domain compared to control. In this study, FGM/C was associated with reduced scores of FSFI on all domains scores, and among both types I and II, both were associated with sexual dysfunction.

  15. A qualitative study exploring how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England.

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    Moxey, Jordan M; Jones, Laura L

    2016-01-07

    To explore how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England. We explored women's perceptions of deinfibulation, caesarean section and vaginal delivery; their experiences of care during pregnancy and labour; and factors that affect ability to access these services, in order to make recommendations about future practice. A descriptive, exploratory qualitative study using face-to-face semistructured interviews. Interviews were audio-recorded, transcribed and data were analysed using a thematic approach. An interpreter was used when required (n=3). Participants recruited from 2 community centres in Birmingham, England. Convenience and snowball sample of 10 Somali women resident in Birmingham, who had accessed antenatal care services in England within the past 5 years. 3 core themes were interpreted: (1) Experiences of female genital mutilation during life, pregnancy and labour: Female genital mutilation had a significant physical and psychological impact, influencing decisions to undergo deinfibulation or caesarean section. Women delayed deinfibulation until labour to avoid undergoing multiple operations if an episiotomy was anticipated. (2) Experience of care from midwives: Awareness of female genital mutilation from midwives led to open communication and stronger relationships with women, resulting in more positive experiences. (3) Adaptation to English life: Good language skills and social support networks enabled women to access these services, while unfavourable social factors (eg, inability to drive) impeded. Female genital mutilation impacts Somali women's experiences of antenatal and intrapartum care. This study suggests that midwives should routinely ask Somali women about female genital mutilation to encourage open communication and facilitate more positive experiences. As antenatal deinfibulation is unpopular, we should consider developing strategies to promote deinfibulation to non

  16. The relationship between female genital cutting and sexual problems experienced in the first two months of marriage.

    Science.gov (United States)

    Abdel-Aleem, Mahmoud A; Elkady, Magdy M; Hilmy, Yaser A

    2016-03-01

    To examine the relationship between female genital cutting (FGC) and sexual problems experienced by couples in the first 2 months of marriage ("honeymoon distress"). A multicenter cross-sectional study was conducted at centers in Assiut and Sohag, Egypt, between March 1, 2011, and March 31, 2014. Eligible couples presented with sexual problems during the first 2 months of marriage. Couples were interviewed and asked to complete a pre-designed questionnaire, and a genital examination was performed. The primary outcomes of the study were the contribution of FGC to honeymoon distress and the effect of FGC on quality of life. Overall, 430 couples enrolled in the study. FGC was present in 376 (87.4%) women. The main presenting feature of honeymoon distress was superficial dyspareunia, which affected 291 (77.4%) women with FGC versus 16 (29.6%) of 54 without FGC (hazard ratio 8.13, 95% confidence interval 4.32-15.30). Women with FGC were more likely to have a poor quality of life during the first 2 months of marriage than were those without FGC (279 [74.2%] vs 13 [24.1%]; odds ratio 9.07, 95% confidence interval 4.66-17.64). FGC was found to be a contributing factor to honeymoon distress. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  17. Prevalence and associated factors of female genital cutting among young adult females in Jigjiga district, eastern Ethiopia: a cross-sectional mixed study

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    Gebremariam K

    2016-08-01

    Full Text Available Kidanu Gebremariam,1 Demeke Assefa,2 Fitsum Weldegebreal3 1Department of Epidemiology, School of Public Health, Mekelle University, Mekelle, 2Reproductive Health and Health Service Management, School of Public Health, Addis Ababa University, Addis Ababa, 3Medical Laboratory Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia Purpose: The aim of this study was to assess the prevalence and associated factors of female genital cutting (FGC among young adult (10–24 years of age females in Jigjiga district, eastern Ethiopia. Methods: A school-based cross-sectional mixed method combining both quantitative and qualitative research methods was employed among 679 randomly selected young adult female students from Jigjiga district, Somali regional state, eastern Ethiopia, from February to March 2014 to assess the prevalence and associated factors with FGC. A pretested structured questionnaire was used to collect data. The qualitative data were collected using focus group discussion. Results: This study depicted that the prevalence of FGC among the respondents was found to be 82.6%. The dominant form of FGC in this study was type I FGC, 265 (49.3%. The majority of the respondents, 575 (88.3%, had good knowledge toward the bad effects of FGC. Four hundred and seven (62.7% study participants had positive attitude toward FGC discontinuation. Religion, residence, respondents’ educational level, maternal education, attitude, and belief in religious requirement were the most significant predictors of FGC. The possible reasons for FGC practice were to keep virginity, improve social acceptance, have better marriage prospects, religious approval, and have hygiene. Conclusion: Despite girls’ knowledge and attitude toward the bad effects of FGC, the prevalence of FGC was still high. There should be a concerted effort among women, men, religious leaders, and other concerned bodies in understanding and clarifying the wrong

  18. The Dutch approach to female genital mutilation in view of the ECHR
    The time for change has come

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    Renée Kool

    2010-01-01

    Full Text Available Worldwide female genital mutilation (FGM is acknowledged as a serious violation of human rights which needs to be actively combated. However, in Europe France has been the only state to have prosecuted cases of FGM: until 2007 37 cases were tried. As for the Netherlands, (assumingly FGM is practised on a relatively small, but regular basis. Nevertheless, no cases have been prosecuted; moreover, there have few reports of (alleged FGM to the Centre for Advising and Reporting on Child Abuse. For the past decade the Dutch Parliament has urged the Dutch government to develop a more robust policy towards FGM, including intervention by the criminal justice system. However, to date the Dutch government has opted for a policy focusing on prevention and medical/social assistance, including a preference for a (non-statutory reporting code. Recommendations to introduce mandatory reporting, in order to enable the transfer of information needed to enable the criminal justice authorities to intervene, have been turned down. In doing so the Dutch government is neglecting the positive obligations embedded within the case law of the European Court of Human Rights (ECtHR, prescribing that states should offer adequate and effective protection against serious forms of ill-treatment (article 3 ECHR and/or serious violations of physical integrity (article 8 ECHR, especially to vulnerable persons. Moreover, according to the ECtHR in cases of serious violations, intervention by the criminal justice system is indicated. Thus, retaining a policy which provides no guarantees for the transfer of information needed to provide for effective and adequate protection results in a potential violation of the ECHR by the Dutch government. There is an urgent need for a change of policy. Moreover, as a result of the consistent political pressure by Parliament, the Dutch government has taken a recent interest in the way in which the French handle FGM. However, as legal and cultural

  19. Catachresis in Côte d’Ivoire: Female Genital Power in Religious Ritual and Political Resistance

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    Laura S. Grillo

    2013-05-01

    Full Text Available Ivoirian women vehemently protest the violence and calamity of civil war by deploying an embodied rhetoric of ritual, appealing to the traditional religious concept of “Female Genital Power”. I propose that their imagistic resistance to the postcolonial state represents a catachresis, with a few interesting twists. Most salient is that what women reinscribe onto the political scene is not as a feature of the imperial culture but the concept-metaphors of indigenous religion, and especially the image of Woman as the source of moral and spiritual power from which proceeds all political, religious, and juridical authority. Whereas the logocentrism of the academy, and postcolonial theory in particular, leads to aporia, ritual remands scholars into the situation of the actual world, where women are actively engaged in self-representation that both defies projected depictions of them and rejects their absence from state conceptions of power.

  20. Antimicrobial agents of plant origin for the treatment of phlogistic-infectious diseases of the lower female genital tract

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    Francesco Gon

    2012-12-01

    Full Text Available The phlogistic-infectious diseases of the lower female genital tract are one of the most widespread obstetricgynecologic issues, due to treatment failures that cause frequent relapses and to the adverse effects of some commonly used drugs.The most common vaginal syndromes are due to uncontrolled growth of bacteria or fungi which replace the normal vaginal flora, causing phlogistic and infectious based diseases. These infections are treated with anti-inflammatory and antibiotic therapy; however, the emergence of resistant strains and the ability of many microorganisms to grow inside biofilms severely reduce the repertoire of useful agents.Thus, in the last years increasing interest has been focused toward compounds of plant origin with anti-microbial properties. In the present work, we studied the antimicrobial activity of fractions obtained from endemic plants of Sardinia towards microorganisms that frequently are involved in vaginal infectious diseases: Streptococcus agalactiae, Gardnerella vaginalis and Candida albicans.

  1. Cloning and characterization of a female genital complex cDNA from the liver fluke Fasciola hepatica.

    Science.gov (United States)

    Zurita, M; Bieber, D; Ringold, G; Mansour, T E

    1987-01-01

    A cDNA clone whose RNA is abundant in the female genital complex of the liver fluke Fasciola hepatica has been isolated from a cDNA library in lambda gt10 by differential screening. The pattern of expression in different fluke tissues and at different stages of miracidium formation suggests that this gene is expressed in the F. hepatica vitelleria. The nucleotide sequence of the cloned cDNA was determined and the primary structure of the putative protein was deduced. The proposed protein is rich in glycine, lysine, and tyrosine and its overall amino acid composition agrees with that reported for the F. hepatica egg shell. The clone has homology with DNA from other trematodes; this homology is higher in organisms in which egg development is similar to that of F. hepatica and suggests that the protein is conserved in organisms in which miracidium formation occurs in fresh water. Images PMID:3470798

  2. The evolution of civil society and the rule of law regarding female genital mutilation in Iraqi Kurdistan.

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    R. Cardone

    2015-04-01

    Full Text Available International human rights law relies on state sovereignty to localize suggested policy with codification and enforcement in an attempt to reconcile universalism with particularity. However, amidst domestic governance developments from post-conflict state building and self-determination, governmental instability complicates and often overlooks priorities of international human rights for more tangible domestic infrastructure, such as basic human needs rather than seemingly suggested rights ideals. This does not diminish the significance of human rights, though, pertaining to the rights of the child in addressing gender-based violence through the elimination of female genital mutilation, for example. While state-centric localization is currently prioritized for implementing international law, the rule of law is more integrated throughout the realms of societal structure, culture, and institutions in addition to the legal realm. If the legal realm is disrupted with instability, violence, and discontinuity, how does society internalize and integrate international human rights law over time, and can it be sustainable despite instability? This research evaluates the development of the rule of law, and its effectiveness, regarding female genital mutilation (FGM as a case study in Iraqi Kurdistan from the end of the Iran-Iraq War in 1988 until 2013, the early years of the Kurdistan Regional Government’s parliament. Comprehensive rule of law evolution can be measured through comparing domestic legal developments through state-centric policy and enforcement, or lack thereof, with cultural internalization and non-governmental engagements. By studying the legal and cultural realms’ interaction with the anti-FGM discourse over Iraqi Kurdistan’s past two decades, this research will determine the role of a continuous society overlaid by intermittent legal structures in the sustainability of negotiating cultural relativity with universal human rights.

  3. Laparoscopic Vaginal-Assisted Hysterectomy With Complete Vaginectomy for Female-To-Male Genital Reassignment Surgery.

    Science.gov (United States)

    Gomes da Costa, Ana; Valentim-Lourenço, Alexandre; Santos-Ribeiro, Samuel; Carvalho Afonso, Maria; Henriques, Alexandra; Ribeirinho, Ana Luísa; Décio Ferreira, João

    2016-01-01

    Total hysterectomy with bilateral salpingo-oophorectomy and vaginectomy for genital reassignment surgery is a complex procedure that is usually performed with a combined vaginal and abdominal approach. The aim of this study was to describe the feasibility of laparoscopic vaginectomy in sex reassignment surgery. We reviewed the relevant medical history, intra/postoperative complications, and surgical results of all patients diagnosed with gender dysphoria and submitted to totally laparoscopic gender confirmation surgery in our department between January 2007 and March 2015. In total, 23 patients underwent total hysterectomy with bilateral salpingo-oophorectomy and vaginectomy in a single intervention. The vaginal mucosa was conserved to be used for the penile neourethra during the subsequent phalloplasty. The surgeries had an average operating time of 155 ± 42 minutes. No intraoperative complications were registered. In all patients, the vagina was totally removed, and, in most cases (n = 20), we were able to remove laparoscopically more than 50% of the vagina. Three patients had postoperative complications. One patient presented with hemoperitoneum on the second postoperative day; another presented with prolonged urinary retention, and a third patient developed a perineal hematoma 1 month after surgery. Patients were discharged less than 72 hours after surgery, except the patient who developed a postoperative hemoperitoneum. For all patients, we obtained an adequate specimen of vaginal mucosa to reconstruct the penile neourethra for the subsequent phalloplasty. This study suggests the feasibility of laparoscopic vaginectomy in genital reassignment surgery. The procedure can be executed as a continuation of the hysterectomy with the potential advantage of the laparoscopy providing better exposure of the anatomic structures with low blood losses (less than 500 mL) and few complications. Furthermore, using this approach, adequate-sized vaginal mucosa flaps were

  4. Female Genital Cutting (FGC) and the ethics of care: community engagement and cultural sensitivity at the interface of migration experiences.

    Science.gov (United States)

    Vissandjée, Bilkis; Denetto, Shereen; Migliardi, Paula; Proctor, Jodi

    2014-04-24

    Female Genital Cutting (FGC) anchored in a complex socio-cultural context becomes significant at the interface of access of health and social services in host countries. The practice of FGC at times, understood as a form of gender-based violence, may result in unjustifiable consequences among girls and women; yet, these practices are culturally engrained traditions with complex meanings calling for ethically and culturally sensitive health and social service provision. Intents and meanings of FGC practice need to be well understood before before any policies that criminalize and condemn are derived and implemented. FGC is addressed as a global public health issue with complex legal and ethical dimensions which impacts ability to access services, far beyond gender sensitivity. The ethics of terminology are addressed, building on the sustained controversial debate in regards to the delicate issue of conceptualization. An overview of international policies is provided, identifying the current trend of condemnation of FGC practices. Socio-cultural and ethical challenges are discussed in light of selected findings from a community-based research project. The illustrative examples provided focus on Western countries, with a specific emphasis on Canada. The examples provided converge with the literature confirming the utmost necessity to engage with the FGC practicing communities allowing for ethically sensitive strategies, reduction of harm in relation to systems of care, and prevention of the risk of systematic gendered stigmatization. A culturally competent, gender and ethically sensitive approach is argued for to ensure the provision of quality ethical care for migrant families in host countries. We argue that socio-cultural determinants such as ethnicity, migration, sex and gender need to be accounted for as integral to the social construction of FGC. Working partnerships between the public health sector and community based organisations with a true involvement of

  5. Female genital cutting (FGC) and the ethics of care: community engagement and cultural sensitivity at the interface of migration experiences

    Science.gov (United States)

    2014-01-01

    Background Female Genital Cutting (FGC) anchored in a complex socio-cultural context becomes significant at the interface of access of health and social services in host countries. The practice of FGC at times, understood as a form of gender-based violence, may result in unjustifiable consequences among girls and women; yet, these practices are culturally engrained traditions with complex meanings calling for ethically and culturally sensitive health and social service provision. Intents and meanings of FGC practice need to be well understood before before any policies that criminalize and condemn are derived and implemented. FGC is addressed as a global public health issue with complex legal and ethical dimensions which impacts ability to access services, far beyond gender sensitivity. The ethics of terminology are addressed, building on the sustained controversial debate in regards to the delicate issue of conceptualization. An overview of international policies is provided, identifying the current trend of condemnation of FGC practices. Socio-cultural and ethical challenges are discussed in light of selected findings from a community-based research project. The illustrative examples provided focus on Western countries, with a specific emphasis on Canada. Discussion The examples provided converge with the literature confirming the utmost necessity to engage with the FGC practicing communities allowing for ethically sensitive strategies, reduction of harm in relation to systems of care, and prevention of the risk of systematic gendered stigmatization. A culturally competent, gender and ethically sensitive approach is argued for to ensure the provision of quality ethical care for migrant families in host countries. We argue that socio-cultural determinants such as ethnicity, migration, sex and gender need to be accounted for as integral to the social construction of FGC. Summary Working partnerships between the public health sector and community based organisations

  6. Development of a chip-based multiplexed immunoassay using liposomal nanovesicles and its application in the detection of pathogens causing female lower genital tract infections

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    Wen-Hsiang Su

    2013-03-01

    Conclusion: This microarray chip was a rapid, easy, inexpensive and sensitive tool for detecting female lower genital tract Candida infection in a one-time vaginal sampling process, although the data on the four other pathogens were still unavailable. A larger population study is encouraged to test the validity of this multiplexed immunoassay chip.

  7. Aging rather than stress strongly influences amino acid metabolisms in the brain and genital organs of female mice.

    Science.gov (United States)

    Kodaira, Momoko; Nagasawa, Mao; Yamaguchi, Takeshi; Ikeda, Hiromi; Minaminaka, Kimie; Chowdhury, Vishwajit S; Yasuo, Shinobu; Furuse, Mitsuhiro

    2017-03-01

    Aging and stress affect quality of life, and proper nourishment is one of means of preventing this effect. Today, there is a focus on the amount of protein consumed by elderly people; however, changes in the amino acid metabolism of individuals have not been fully considered. In addition, the difference between average life span and healthy life years is larger in females than it is in males. To prolong the healthy life years of females, in the present study we evaluated the influence of stress and aging on metabolism and emotional behavior by comparing young and middle-aged female mice. After 28 consecutive days of immobilization stress, behavioral tests were conducted and tissue sampling was performed. The results showed that the body weight of middle-aged mice was severely lowered by stress, but emotional behaviors were hardly influenced by either aging or stress. Aging influenced changes in amino acid metabolism in the brain and increased various amino acid levels in the uterus and ovary. In conclusion, we found that aged mice were more susceptible to stress in terms of body-weight reduction, and that amino acid metabolisms in the brain and genital organs were largely influenced by aging rather than by stress. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Outpatients’ Perspectives on Problems and Needs Related to Female Genital Mutilation/Cutting: A Qualitative Study from Somaliland

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    Sarah Fried

    2013-01-01

    Full Text Available Aim. To explore female outpatients’ perspectives on problems related to female genital mutilation/cutting (FGM/C and their views on information, care, and counseling. Setting. An FGM/C support center at a maternity clinic in Hargeisa, Somaliland. Methods. A qualitative, descriptive study, using content analysis of seven semistructured interviews with female outpatients. Results. All participants had been ignorant of the etiology of their FGM/C-related complications and hesitant to seek care. All had undergone infibulation but did not wish the same for their daughters. In recent years they had learnt through religious leaders and media campaigns that infibulation was unapproved by Islam. A less severe FGM/C type, “Sunna,” was more accepted; however, few could define what “Sunna” meant. Condemning and ridiculing attitudes against uncircumcised women prevailed in their community. Conclusions. New ideas and concepts related to FGM/C enter the common discourse in the Somali society while traditional norms and values still prevail. Religion was shown to have a strong impact on FGM/C practices and beliefs. Interventions aiming to raise awareness of health consequences of all types of FGM/C, as well as where to seek care for complications, are needed in Somaliland. Involvement of religious leaders in anti-FGM/C programs is essential.

  9. Symptoms of Posttraumatic Stress Disorder After Ritual Female Genital Surgery Among Bedouin in Israel: Myth or Reality?

    Science.gov (United States)

    Applebaum, Julia; Cohen, Hagit; Matar, Michael; Abu Rabia, Yones; Kaplan, Zeev

    2008-01-01

    Objective: Ritual female genital surgery (RFGS), or female circumcision, is common among certain ethnic groups in Asia and Africa and describes a range of practices involving complete or partial removal of the female external genitalia for nonmedical reasons. Several studies in African populations, in which more severe forms of RFGS are performed, reported an increased prevalence of posttraumatic stress disorder and other psychiatric syndromes among circumcised women than among uncircumcised controls. Among the Bedouin population in southern Israel, RFGS has become a symbolic operation without major mutilation. However, in a study performed in 1999, Bedouin women after RFGS reported difficulties in mother-daughter relationships and trust. This pilot study assessed the mental health of Bedouin women from southern Israel after RFGS compared to age-matched controls without RFGS. Method: The psychological impact of RFGS was assessed in 19 circumcised Bedouin women compared to 18 age-matched controls. The Post Traumatic Stress Disorder Scale, Symptom Checklist, Impact of Event Scale, and a demographics and background questionnaire were used to assess traumatization and psychiatric illnesses. The study was conducted from March to July 2007. Results: No statistically significant differences were found between the 2 groups. Conclusions: The prevailing procedure of RFGS among the Bedouin population of southern Israel had no apparent effect on mental health. PMID:19287554

  10. Female genital schistosomiasis--a differential diagnosis to sexually transmitted disease: genital itch and vaginal discharge as indicators of genital Schistosoma haematobium morbidity in a cross-sectional study in endemic rural Zimbabwe.

    Science.gov (United States)

    Kjetland, Eyrun Floerecke; Kurewa, Edith Nyaradzai; Ndhlovu, Patricia D; Midzi, Nicholas; Gwanzura, Lovemore; Mason, Peter R; Gomo, Exnevia; Sandvik, Leiv; Mduluza, Takafira; Friis, Henrik; Gundersen, Svein Gunnar

    2008-12-01

    To examine the association between schistosomiasis and reproductive tract symptoms. A cross-sectional study was conducted in a Schistosoma haematobium-endemic area of rural Zimbabwe. A total of 483 permanently resident adult women of Mupfure Ward aged 20-49 were interviewed and examined clinically, each providing three consecutive urine samples. Logistic regression analysis was used to control for sexually transmitted diseases (STDs). Women with genital sandy patches had significantly more genital itch (P = 0.009) and perceived their discharge as abnormal (P = 0.003). Eighty percent of the women who had genital itch, yellow discharge, and childhood or current waterbody contact had sandy patches. Fifty-two percent of the women with genital sandy patches did not have detectable S. haematobium ova in urine. Genital schistosomiasis was associated with stress incontinence and pollakisuria, but not with menstrual irregularities, current or previous ulcers, or tumours. Genital schistosomiasis may be a differential diagnosis to the STDs in women who have been exposed to fresh water in endemic areas. Because of the chronic nature of the disease in adults, we suggest to pay special attention to the prevention of morbidity.

  11. Retrospective Analysis of Clinical Features, Treatment and Outcome of Coital Injuries of the Female Genital Tract Consecutive to Consensual Sexual Intercourse in the Limbe Regional Hospital

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    Robert Tchounzou, MD

    2015-12-01

    Conclusions: Coital injuries following consensual sex often present in the form of a life‐threatening condition and young female with no previous sexual experience are particularly exposed. Most lesions can be treated with a simple suture. Tchounzou R and Chichom-Mefire A. Retrospective analysis of clinical features, treatment and outcome of coital injuries of the female genital tract consecutive to consensual sexual intercourse in the Limbe Regional Hospital. Sex Med 2015;3:256–260.

  12. Effects of female genital mutilation/cutting on the sexual function of Sudanese women: a cross-sectional study.

    Science.gov (United States)

    Rouzi, Abdulrahim A; Berg, Rigmor C; Sahly, Nora; Alkafy, Susan; Alzaban, Faten; Abduljabbar, Hassan

    2017-07-01

    Female genital mutilation/cutting (FGM/C) is a cultural practice that involves several types of removal or other injury to the external female genitalia for nonmedical reasons. Although much international research has focused on the health consequences of the practice, little is known about sexual functioning among women with various types of FGM/C. To assess the impact of FGM/C on the sexual functioning of Sudanese women. This is a cross-sectional study conducted at Doctor Erfan and Bagedo Hospital, Jeddah, Saudi Arabia. Eligible women completed a survey and a clinical examination, which documented and verified women's type of FGM/C. The main outcome measure was female sexual function, as assessed by the Arabic Female Sexual Function Index. A total of 107 eligible women completed the survey and the gynecological examination, which revealed that 39% of the women had FGM/C Type I, 25% had Type II, and 36% had Type III. Reliability of self-report of the type of FGM/C was low, with underreporting of the extent of the procedure. The results showed that 92.5% of the women scored lower than the Arabic Female Sexual Function Index cut-off point for sexual dysfunction. The multivariable regression analyses showed that sexual dysfunction was significantly greater with more extensive type of FGM/C, across all sexual function domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) and overall. The study documents that a substantial proportion of women subjected to FGM/C experience sexual dysfunction. It shows that the anatomical extent of FGM/C is related to the severity of sexual dysfunction. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Comparison of sampling methods to measure HIV RNA viral load in female genital tract secretions.

    Science.gov (United States)

    Jaumdally, Shameem Z; Jones, Heidi E; Hoover, Donald R; Gamieldien, Hoyam; Kriek, Jean-Mari; Langwenya, Nontokozo; Myer, Landon; Passmore, Jo-Ann S; Todd, Catherine S

    2017-03-01

    How does menstrual cup (MC) compare to other genital sampling methods for HIV RNA recovery? We compared HIV RNA levels between MC, endocervical swab (ECS), and ECS-enriched cervicovaginal lavage (eCVL) specimens in 51 HIV-positive, antiretroviral therapy-naive women at enrollment, 3 and 6 months, with order rotated by visit. Paired comparisons were analyzed with McNemar's exact tests, signed-rank tests, and an extension of Somer's D for pooled analyses across visits. MC specimens had the highest proportion of quantifiable HIV VL at enrollment and month 3, but more MC specimens (n=12.8%) were insufficient for testing, compared with ECS (2%, P=0.006) and eCVL (0%, P<0.001). Among sufficient specimens, median VL was significantly higher for MC (2.62 log 10 copies/mL) compared to ECS (1.30 log 10 copies/mL, P<0.001) and eCVL (1.60 log 10 copies/mL, P<0.001) across visits. MC may be more sensitive than eCVL and CVS, provided insufficient specimens are reduced. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Multidisciplinary approach to the management of children with female genital mutilation (FGM) or suspected FGM: service description and case series.

    Science.gov (United States)

    Creighton, Sarah M; Dear, Joanna; de Campos, Claudia; Williams, Louise; Hodes, Deborah

    2016-02-29

    To describe the first dedicated clinic in the UK for children with suspected or confirmed female genital mutilation (FGM) including referral patterns, clinical findings and subsequent management. A prospective study of all children seen in a dedicated multidisciplinary FGM clinic for children over a 1-year period. Patients aged under 18 years referred for clinical assessment or for a second opinion on Digital Versatile Disc (DVD) images. Data were collected on reasons for referral, demography, genital examination findings including FGM type, and clinical recommendations. 38 children were referred of whom 18 (47%) had confirmed FGM; most frequently type 4 (61%). Social care and police referred 78% of cases. According to UK law FGM had been performed illegally in three cases. Anonymous information given to the police led to the referral of six children, none of whom had had FGM. Mandatory reporting and increased media attention may increase the numbers of referrals of children with suspected FGM. This patient group have complex needs and management in a dedicated multidisciplinary service is essential. Paediatricians and gynaecologists should have the skills to carry out the consultation and detect all types of FGM including type 4 which was the most common type seen in this series. This is the first dedicated FGM service for children in the UK and similar clinics in high-prevalence areas should be established. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. The psychological and social impact of female genital mutilation: A holistic conceptual framework

    Directory of Open Access Journals (Sweden)

    Jennifer Glover

    2017-06-01

    Full Text Available Objectives: The current research aimed to gain an understanding of women’s experiences of FGM to develop an evidence based holistic conceptual framework for professionals dealing with the impact of FGM and responses required for survivors and their children. Method: Using a grounded theory approach, qualitative semi-structured interviews were carried out with 20 women survivors of FGM. Results: Participant’s related culture, religion, role of men, lack of education, female identity and deception as the major factors influencing their understanding and the impact of FGM. Their experiences of FGM, as well as being influenced by their conceptualisation of the practice, led to effects on their emotional life, relationships, identity, and physical body. The fear resulting from FGM that women described affected their ability to enhance their resilience. All the core categories of emotional, relational, identity, and physical impact, as well as resilience, were further influenced by the key stages of womanhood; including menstruation, marriage and childbirth. Women voiced their views that all the above issues were compounded by their needs not being met and the lack of meaningful and effective service responses. Conclusions: There are complex systems and relationships that influence the psychological and social impact of FGM. These have core implications for clinical and policy in relation to maternity and healthcare services.

  16. Female genital tract abnormalities of Zebu cattle slaughtered at Bahir-Dar Town, north-west Ethiopia.

    Science.gov (United States)

    Abalti, A; Bekana, M; Woldemeskel, M; Lobago, F

    2006-01-01

    A study was conducted to assess the type and prevalence of abnormalities occurring in the female reproductive tracts of 201 Zebu cattle of Fogera type (161 cows and 40 heifers) slaughtered at Bahir-Dar town, north-west Ethiopia. Out of the 201 female genital tracts collected and examined, abnormalities were recorded in 74 (36.8%). The most common abnormalities encountered were ovariobursal adhesion (5.5%), endometritis (3.9%) and cystic ovaries (3.5%). Other abnormalities recorded were ovarian hypoplasia, vaginitis, cervicitis, tortuous cervical canal, mucometra, vaginal cyst, parovarian cyst, hypoplastic cervical rings, cervical cyst, freemartins, closed external cervical os, uterine and oviducts adhesion, cystic uterine tube, remnant of retained fetal membrane and cyst in the uterine wall. The prevalence of the abnormalities was significantly (p < 0.05) higher in parous than in nulliparous cows. Moreover, evidence of ovarian cyclicity was found in 51.6% and 30% of non-pregnant parous and nulliparous cows examined, respectively. This study revealed that reproductive tract abnormalities seem to be an important problem with possible subsequent infertility in Fogera-type Zebu cows in the study area.

  17. Susceptibilities of Chlamydia trachomatis isolates causing uncomplicated female genital tract infections and pelvic inflammatory disease.

    Science.gov (United States)

    Rice, R J; Bhullar, V; Mitchell, S H; Bullard, J; Knapp, J S

    1995-03-01

    The in vitro susceptibilities of 45 recent clinical isolates of Chlamydia trachomatis obtained from women with asymptomatic genital tract infection, mucopurulent cervicitis, or pelvic inflammatory disease to doxycycline, azithromycin, ofloxacin, and clindamycin were determined. In addition, susceptibilities of 12 isolates to amoxicillin and trimethoprim-sulfamethoxazole were also determined. Isolates also were serotyped with a panel of monoclonal antibodies specific for chlamydial major outer membrane protein; 24 of 45 (53%) belonged to serovars Ia and E. For all isolates, the MIC range of doxycycline was 0.008 to 0.06 micrograms/ml, for trimethoprim-sulfamethoxazole it was 0.03 to 0.25 micrograms/ml, for azithromycin it was 0.125 to 2.0 micrograms/ml, for ofloxacin it was 0.5 to 1.0 micrograms/ml, for clindamycin it was 0.25 to 2.0 micrograms/ml, and for amoxicillin it was 0.25 to 4.0 microgram/ml. The ranges of minimum chlamydiacidal concentrations were generally 1 to 4 dilutions above the MICs of most agents, with a rank order similar to those of the MICs. Comparing the minimum chlamydiacidal concentrations for 90% of isolates tested, isolates causing asymptomatic infection belonged to a greater variety of serovars and were relatively more susceptible to doxycycline and azithromycin than isolates causing mucopurulent cervicitis or pelvic inflammatory disease; these differences in susceptibility were not detected among the other study agents. These data indicate that additional studies are needed to better define the apparent association of certain chlamydial serovars with the clinical severity of disease and the in vitro susceptibilities to certain antimicrobial agents.

  18. Sexual coevolution of spermatophore envelopes and female genital traits in butterflies: Evidence of male coercion?

    Directory of Open Access Journals (Sweden)

    Víctor Sánchez

    2014-01-01

    Full Text Available Signa are sclerotized structures located on the inner wall of the corpus bursa of female Lepidoptera whose main function is tearing open spermatophores. The sexually antagonistic coevolution (SAC hypothesis proposes that the thickness of spermatophore envelopes has driven the evolution of the females signa; this idea is based in the fact that in many lepidopterans female sexual receptivity is at least partially controlled by the volume of ejaculate remaining in the corpus bursa. According to the SAC hypothesis, males evolved thick spermatophore envelopes to delay the post-mating recovery of female sexual receptivity thus reducing sperm competition; in response, females evolved signa for breaking spermatophore envelopes faster, gaining access to the resources contained in them and reducing their intermating intervals; the evolution of signa, in turn, favored the evolution of even thicker spermatophore envelopes, and so on. We tested two predictions of the SAC hypothesis with comparative data on the thickness of spermatophore envelopes of eleven species of Heliconiinae butterflies. The first prediction is that the spermatophore envelopes of polyandrous species with signa will be thicker than those of monandrous species without signa. In agreement with this prediction, we found that the spermatophore envelopes of a polyandrous Heliconius species with signa are thicker than those of two monandrous Heliconius species without signa. The second prediction is that in some species with signa males could enforce monandry in females by evolving “very thick” spermatophore envelopes, in these species we predict that their spermatophore envelopes will be thicker than those of their closer polyandrous relatives with signa. In agreement with this prediction, we found that in two out of three comparisons, spermatophore envelopes of monandrous species with signa have thicker spermatophore envelopes than their closer polyandrous relatives with signa. Thus, our

  19. Prevalence and predictors of female genital mutilation among infants in a semi urban community in northern Nigeria.

    Science.gov (United States)

    Ashimi, Adewale O; Amole, Taiwo G; Iliyasu, Zubairu

    2015-12-01

    To determine the prevalence, predictors, of female genital mutilation (FGM) among infants and ascertain if their mothers knew what was done to them in Birnin Kudu northern Nigeria. Cross sectional study which utilised a pretested interviewer administered semi-structured questionnaire to assess occurrence of FGM with physical examination of the infants. Logistic regression analysis was used to assess the relative effect of determinants, after adjusting for other predictor variables. Of the 450 infants, 215(47.8%) (95% Confidence Interval [CI]: 43.1%-52.5%) had experienced one form of FGM. The ages at genital mutilation ranged from 1 to 50 days with a median of 4 days and interquartile range of 7 days. Maternal occupation, education and religion and type of facility accessed were significantly associated with occurrence of FGM in infants (p ≤ 0.05). After controlling for confounders, having a mother without formal education [AOR = 6.39 and 95% CI = 3.99-10.23] (p = 0.001) and one who was employed [Adjusted odds ratio (AOR) = 2.89 and 95% CI = 1.66-5.03] (p = 0.001) increased the likelihood of infant FGM remarkably while utilising tertiary institution for health care reduced the risk by about half [AOR = 0.49 and 95% CI = 0.26-0.92] (p = 0.03). Of the 215 infants that had undergone FGM, there was correlation between the reported and the observed forms of FGM in 16 (7.4%) of the cases. The prevalence of FGM is high with mothers' educational status, type of health facility utilised and occupational status being predictors of FGM among infants in Birnin Kudu. Majority of the mothers are not aware of what was done. Strategies aimed at discouraging this dangerous practice in the community should include female education, involvement of the men as husbands, fathers, traditional and religious leaders. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Clinico-morphological features of the female genital tract: review of the literature

    Directory of Open Access Journals (Sweden)

    S. O. Nikogosyan

    2012-01-01

    Full Text Available In the review are provided data of the world literature on clinical and morphological features of neuroendocrine tumors of the female sexual sphere. Questions of pathogenesis and stages of development of new growths in embryogenesis considered. Historical references are given. Besides, in article questions of diagnostics and treatment of these tumors are taken up.

  1. Perceptions of Female Genital Mutilation/Cutting (FGM/C) among ...

    African Journals Online (AJOL)

    Result: FGM/C is a practice aimed at not only controlling female sexuality but also places girls and women in a socially accepted gender role by curtailing their sexuality. Other than the medical complications associated with FGM/C, respondents also agreed that FGM/C is a violation of human rights and that the communities ...

  2. Chlamydia trachomatis and genital human papillomavirus infections in female university students in Honduras.

    NARCIS (Netherlands)

    Tabora, N.; Zelaya, A.; Bakkers, J.; Melchers, W.J.; Ferrera, A.

    2005-01-01

    Sexually transmitted infections are a serious health problem in Honduras. Human papillomavirus (HPV) and Chlamydia trachomatis are major causes of sexually transmitted diseases. To determine the prevalence of C. trachomatis and HPV in young women, 100 female university students in Honduras were

  3. Reasons for and Experiences With Surgical Interventions for Female Genital Mutilation/Cutting (FGM/C): A Systematic Review.

    Science.gov (United States)

    Berg, Rigmor C; Taraldsen, Sølvi; Said, Maryan A; Sørbye, Ingvil Krarup; Vangen, Siri

    2017-08-01

    Because female genital mutilation/cutting (FGM/C) leads to changes in normal genital anatomy and functionality, women are increasingly seeking surgical interventions for their FGM/C-related concerns. To conduct a systematic review of empirical quantitative and qualitative research on interventions for women with FGM/C-related complications. We conducted systematic searches up to May 2016 in 16 databases to obtain references from different disciplines. We accepted all study designs consisting of girls and women who had been subjected to FGM/C and that examined a reparative intervention for a FGM/C-related concern. We screened the titles, abstracts, and full texts of retrieved records for relevance. Then, we assessed the methodologic quality of the included studies and extracted and synthesized the study data. All outcomes were included. Of 3,726 retrieved references, 71 studies including 7,291 women were eligible for inclusion. We identified three different types of surgical intervention: defibulation or surgical separation of fused labia, excision of a cyst with or without some form of reconstruction, and clitoral or clitoral-labial reconstruction. Reasons for seeking surgical interventions consisted of functional complaints, sexual aspirations, esthetic aspirations, and identity recovery. The most common reasons for defibulation were a desire for improved sexual pleasure, vaginal appearance, and functioning. For cyst excision, cystic swelling was the main reason for seeking excision; for reconstruction, the main reason was to recover identity. Data on women's experiences with a surgical intervention are sparse, but we found that women reported easier births after defibulation. Our findings also suggested that most women were satisfied with defibulation (overall satisfaction = 50-100%), typically because of improvements in their sexual lives. Conversely, the results suggested that defibulation had low social acceptance and that the procedure created distress in

  4. The effect of pioglitazone on non-pregnant female genital tract in experimental diabetes mellitus.

    Science.gov (United States)

    Galeş, Cristina; Zamfir, Carmen; Stoica, B; Nechifor, M

    2013-01-01

    The effects of pioglitazone, a very used drug in the treatment of non-insulin dependent diabetes mellitus, were tested at the level of ovary of non-pregnant female rats. The experiment was performed on three groups of adult non-pregnant female rats. group 1 was a control group (and did not receive any substance), group 2 received streptozotocin 60 mg/kg i.p. (single administration), and group 3 received streptozotocin 60 mg/kg i.p. (single administration) and pioglitazone 5 mg/kg/day p.o., daily for 8 weeks. The plasma glucose, cholesterol and triglyceride levels were determined before drugs administration and during the experiment. After 8 weeks the animals were anesthetized and sacrificed. The ovaries were examined by optical microscopy. A morphometric evaluation was performed. The obtained data were statistically interpreted by ANOVA test. After 8 weeks of treatment the plasma glucose and triglyceride levels were significantly lower in the pioglitazone treated group compared to the streptozotocin only group. In the pioglitazone group the number of primordial and primary ovarian follicles was significantly higher than in streptozotocin only group. The results showed a partial protective action of pioglitazone on ovary in nonpregnant diabetic female rats.

  5. The association between female genital fistula symptoms and gender-based violence: A multicountry secondary analysis of household survey data.

    Science.gov (United States)

    Mallick, Lindsay; Tripathi, Vandana

    2018-01-01

    The Demographic and Health Surveys (DHS), which include standardised questions on female genital fistula symptoms, provide a unique opportunity to evaluate the epidemiology of fistula. This study sought to examine associations between self-reported fistula symptoms and experience of gender-based violence (GBV) among women interviewed in DHS surveys. This study used data from thirteen DHS surveys with standardised fistula and domestic violence modules. Data from the most recent survey in each country were pooled, weighting each survey equally. Multivariable logistic regressions controlled for maternal and demographic factors. Prevalence of fistula symptoms in this sample of 95 625 women ranges from 0.3% to 1.8% by country. The majority of women reporting fistula symptoms (56%) have ever experienced physical violence, and more than one-quarter have ever experienced sexual violence (27%), compared with 38% and 13% among women with no symptoms, respectively. Similarly, 16% of women with fistula symptoms report recently experiencing sexual violence-twice the percentage among women not reporting symptoms (8%). Women whose first experience of sexual violence was from a non-partner have almost four times the odds of reporting fistula symptoms compared with women who never experienced sexual violence. These associations indicate a need to investigate temporal and causal relationships between violence and fistula. The increased risk of physical and sexual violence among women with fistula symptoms suggests that fistula programmes should incorporate GBV into provider training and services. © 2017 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  6. Addressing female genital mutilation in Europe: a scoping review of approaches to participation, prevention, protection, and provision of services.

    Science.gov (United States)

    Baillot, Helen; Murray, Nina; Connelly, Elaine; Howard, Natasha

    2018-02-08

    Public and policy attention to female genital mutilation (FGM) in diaspora communities has increased in Europe, but research remains limited and misinformation abounds. As a first step to addressing these issues, this study explored FGM prevention and response interventions in Europe, using a scoping literature review and key informant interviews. A scoping study design was selected, using Arksey and O'Malley's six-stage scoping framework to review identified sources. Key informant interviews were used to inform and add depth to literature findings. Findings were summarised thematically, guided by the Scottish Government's '4Ps' framework for tackling violence against women (i.e. participation, prevention, protection, providing services). Seventy literature sources, of 1095 screened, plus 16 individual and 3 group interview sources were included. Several countries have developed promising interventions supporting FGM resistance and recovery. However, gaps remain including community participation, professional knowledge and linkages, and evaluation of approaches. This scoping review is an initial attempt to describe available primary evidence on European initiatives responding to FGM. Further research is required to determine whether interventions are effective, while policy and practice development must be shaped and driven by the experiences, needs, and views of affected communities.

  7. Increasing certified nurse-midwives' confidence in managing the obstetric care of women with female genital mutilation/cutting.

    Science.gov (United States)

    Jacoby, Susan D; Smith, Amy

    2013-01-01

    In response to an increase in the number of women who immigrate to the United States from countries that practice female genital mutilation/cutting (FGM/C; infibulation), US clinicians can expand their knowledge and increase confidence in caring for women who have experienced infibulation. This article describes a comprehensive education program on FGM/C and the results of a pilot study that examined its effect on midwives' confidence in caring for women with infibulation. An education program was developed that included didactic information, case studies, a cultural roundtable, and a hands-on skills laboratory of deinfibulation and repair. Eleven certified nurse-midwives (CNMs) participated in this pilot study. Participants completed a measure-of-confidence survey tool before and after the education intervention. Participants reported increased confidence in their ability to provide culturally competent care to immigrant women with infibulation when comparisons of preeducation and posteducation survey confidence logs were completed. Following the education program and the knowledge gained from it, these midwives were more confident about their ability to perform anterior episiotomy and to deliver necessary care to women with FGM/C in a culturally competent context. This education program should be expanded as more women who have experienced infibulation immigrate to the United States. © 2013 by the American College of Nurse-Midwives.

  8. Female genital mutilation and efforts to achieve Millennium Development Goals 3, 4, and 5 in southeast Nigeria.

    Science.gov (United States)

    Lawani, Lucky O; Onyebuchi, Azubuike K; Iyoke, Chukwuemeka A; Okeke, Nwabunike E

    2014-05-01

    To determine the prevalence of female genital mutilation (FGM), the common forms of FGM, reasons for the practice, associated obstetric outcomes, and how these have affected efforts to achieve Millennium Development Goals (MDGs) 3, 4, and 5 in southeast Nigeria. A prospective descriptive study of parturients in southeast Nigeria was conducted from January to December 2012. All primigravid women attending delivery services at 2 health institutions during the study period were recruited, examined, and classified using the 2008 WHO classification for FGM. The mean age of the 516 participants was 27.24±4.80 years and most (66.3%) had undergone FGM. Type II FGM was the most common form, accounting for 59.6% of cases. Most FGM procedures were performed in infancy (97.1%) and for cultural reasons (60.8%). Women who had undergone FGM had significantly higher risk for episiotomy, perineal tear, hemorrhage, cesarean delivery, neonatal resuscitation, fresh stillbirth/early neonatal death, and longer hospitalization, with higher risk ratios associated with higher degrees of FGM. FGM is still a common practice in southeast Nigeria, where its association with adverse reproductive outcomes militates against efforts to achieve MDGs 3, 4, and 5. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  9. Health education and clinical care of immigrant women with female genital mutilation/cutting who request postpartum reinfibulation.

    Science.gov (United States)

    Abdulcadir, Jasmine; McLaren, Sophie; Boulvain, Michel; Irion, Olivier

    2016-10-01

    To evaluate the percentage of women with female genital mutilation/cutting who request postpartum reinfibulation, and to assess outcomes after specific care and counseling. A retrospective review was undertaken of consecutive medical files of immigrant women with FGM/C who attended a center in Geneva, Switzerland, between April 1, 2010, and January 8, 2014. The number of postpartum reinfibulation requests and outcomes were assessed. If a patient requests postpartum reinfibulation despite receiving detailed information and counseling, a longer follow-up is arranged for further counseling. Among 196 women with FGM/C, 8 (4.1%) requested postpartum reinfibulation. All eight were of East African origin, had FGM/C type III, and received a longer and more targeted follow-up than did those who did not request reinfibulation. After at least 1year of follow-up, none of the eight was willing to undergo reinfibulation. One woman who attended the clinic only once during her first pregnancy consulted the emergency ward of the study center 3years later because of postcoital bleeding following infibulation performed in her home country a few months after her second delivery in Switzerland. Specific care and counseling for women with FGM/C type III can improve the acceptability of defibulation without reinfibulation. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  10. Supportive psychotherapy or client education alongside surgical procedures to correct complications of female genital mutilation: A systematic review.

    Science.gov (United States)

    Abayomi, Olukayode; Chibuzor, Moriam T; Okusanya, Babasola O; Esu, Ekpereonne; Odey, Edward; Meremikwu, Martin M

    2017-02-01

    Supportive psychotherapy, in individual or group settings, may help improve surgical outcomes for women and girls living with female genital mutilation (FGM). To assess whether supportive psychotherapy given alongside surgical procedures to correct complications of FGM improves clinical outcomes. We searched major databases including CENTRAL, Medline, African Index Medicus, SCOPUS, PsycINFO, and others. There were no language restrictions. We checked the reference lists of retrieved studies for additional reports of relevant studies. We included studies of girls and women living with any type of FGM who received supportive psychotherapy or client education sessions alongside any surgical procedure to correct health complications from FGM. Two team members independently screened studies for eligibility. There were no eligible studies identified. There is no direct evidence for the benefits or harms of supportive psychotherapy alongside surgical procedures for women and girls living with FGM. Research evidence is urgently needed to guide clinical practice. 42015024639. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  11. Health care for immigrant women in Italy: are we really ready? A survey on knowledge about female genital mutilation

    Directory of Open Access Journals (Sweden)

    Emanuele Caroppo

    2014-03-01

    Full Text Available BACKGROUND: Because of immigration, female genital mutilation (FGM is an issue of increasing concern in western countries. Nevertheless operators without a specific training may ignore the health condition of women subjected to this practice and fail to provide them adequate assistance. The purpose of the study was to estimate the current knowledge about FGM among social and health care assistants working with asylum seeker. MATERIAL AND METHODS: From October to December 2012, a questionnaire was used to interview 41 operators working in CARA (Shelter for Refugees and Asylum Seekers in central and southern Italy. RESULTS: Only 7.3% of respondents states to know well FGM, while 4.9% do not know it at all. 70.7% declare to have never met or assisted a woman with FGM, nevertheless all respondents work with asylum seeker from countries where FGM are performed. CONCLUSIONS: Migration fluxes to Italy over the past decade created a healthcare challenge: women with FGM have specific medical and psychological problems that doctors, nurses and social assistants without specific training are not usually able to manage.

  12. What Works and What Does Not: A Discussion of Popular Approaches for the Abandonment of Female Genital Mutilation

    Directory of Open Access Journals (Sweden)

    R. Elise B. Johansen

    2013-01-01

    Full Text Available The prevalence of Female Genital Mutilation (FGM is reducing in almost all countries in which it is a traditional practice. There are huge variations between countries and communities though, ranging from no change at all to countries and communities where the practice has been more than halved from one generation to the next. Various interventions implemented over the last 30–40 years are believed to have been instrumental in stimulating this reduction, even though in most cases the decrease in prevalence has been slow. This raises questions about the efficacy of interventions to eliminate FGM and an urgent need to channel the limited resources available, where it can make the most difference in the abandonment of FGM. This paper is intended to contribute to the design of more effective interventions by assessing existing knowledge of what works and what does not and discusses some of the most common approaches that have been evaluated: health risk approaches, conversion of excisers, training of health professionals as change agents, alternative rituals, community-led approaches, public statements, and legal measures.

  13. Obstetric outcomes for women with female genital mutilation at an Australian hospital, 2006-2012: a descriptive study.

    Science.gov (United States)

    Varol, Nesrin; Dawson, Angela; Turkmani, Sabera; Hall, John J; Nanayakkara, Susie; Jenkins, Greg; Homer, Caroline S E; McGeechan, Kevin

    2016-10-28

    Women, who have been subjected to female genital mutilation (FGM), can suffer serious and irreversible physical, psychological and psychosexual complications. They have more adverse obstetric outcomes as compared to women without FGM. Exploratory studies suggest radical change to abandonment of FGM by communities after migration to countries where FGM is not prevalent. Women who had been subjected to FGM as a child in their countries of origin, require specialised healthcare to reduce complications and further suffering. Our study compared obstetric outcomes in women with FGM to women without FGM who gave birth in a metropolitan Australian hospital with expertise in holistic FGM management. The obstetric outcomes of one hundred and ninety-six women with FGM who gave birth between 2006 and 2012 at a metropolitan Australian hospital were analysed. Comparison was made with 8852 women without FGM who gave birth during the same time period. Data were extracted from a database specifically designed for women with FGM and managed by midwives specialised in care of these women, and a routine obstetric database, ObstetriX. The accuracy of data collection on FGM was determined by comparing these two databases. All women with FGM type 3 were deinfibulated antenatally or during labour. The outcome measures were (1) maternal: accuracy and grade of FGM classification, caesarean section, instrumental birth, episiotomy, genital tract trauma, postpartum blood loss of more than 500 ml; and (2) neonatal: low birth weight, admission to a special care nursery, stillbirth. The prevalence of FGM in women who gave birth at the metropolitan hospital was 2 to 3 %. Women with FGM had similar obstetric outcomes to women without FGM, except for statistically significant higher risk of first and second degree perineal tears, and caesarean section. However, none of the caesarean sections were performed for FGM indications. The ObstetriX database was only 35 % accurate in recording the correct

  14. Reproducibility and genital sparing with a vaginal dilator used for female anal cancer patients.

    Science.gov (United States)

    Briere, Tina Marie; Crane, Christopher H; Beddar, Sam; Bhosale, Priya; Mok, Henry; Delclos, Marc E; Krishnan, Sunil; Das, Prajnan

    2012-08-01

    Acute vulvitis, acute urethritis, and permanent sexual dysfunction are common among patients treated with chemoradiation for squamous cell carcinoma of the anal canal. Avoidance of the genitalia may reduce sexual dysfunction. A vaginal dilator may help delineate and displace the vulva and lower vagina away from the primary tumor. The goal of this study was to evaluate the positional reproducibility and vaginal sparing with the use of a vaginal dilator. Ten female patients treated with IMRT for anal cancer were included in this study. A silicone vaginal dilator measuring 29 mm in diameter and 114 mm in length was inserted into the vagina before simulation and each treatment. The reproducibility of dilator placement was investigated with antero-posterior and lateral images acquired daily. Weekly cone beam CT (CBCT) imaging was used to confirm coverage of the GTV, which was typically posterior and inferior to the dilator apex. Finally, a planning study was performed to compare the vaginal doses for these 10 patients to a comparable group of 10 female patients who were treated for anal cancer with IMRT without vaginal dilators. The absolute values of the location of the dilator apex were 7.0 ± 7.8mm in the supero-inferior direction, 7.5 ± 5.5 mm in the antero-posterior, and 3.8 ± 3.1mm in the lateral direction. Coverage of the GTV and CTV was confirmed from CBCT images. The mean dose to the vagina was lower by 5.5 Gy, on average, for the vaginal dilator patients, compared to patients treated without vaginal dilators. The vaginal dilator tended to be inserted more inferiorly during treatment than during simulation. For these ten patients, this did not compromise tumor coverage. Combined with IMRT treatment planning, use of a vaginal dilator could allow for maximum sparing of female genitalia for patients undergoing radiation therapy for anal cancer. Published by Elsevier Ireland Ltd.

  15. An exploration of the psychosexual experiences of women who have undergone female genital cutting: A case of the Maasai in Kenya

    OpenAIRE

    Esho, Tammary

    2012-01-01

    The research explored the link between type II Female Genital Cutting (FGC) and sexual functioning. This thesis summary thus draws from an exploratory ethnographic field study carried out among the Maasai people of Kenya where type II FGC is still being practiced. A purposely sample consisting of 28 women and 19 men, within the ages of 15-80 years took part in individual interviews and 5 focus group discussions. Participants responded to openended questions, a method deemed approp...

  16. Estimates of first-generation women and girls with female genital mutilation in the European Union, Norway and Switzerland.

    Science.gov (United States)

    Van Baelen, Luk; Ortensi, Livia; Leye, Els

    2016-12-01

    Female genital mutilation (FGM) is the practice of partial or total removal of female genitalia for non-medical reasons. The procedure has no known health benefits but can cause serious immediate and long-term obstetric, gynaecological and sexual health problems. Health workers in Europe are often unaware of the consequences of FGM and lack the knowledge to treat women adequately. Our goal was to estimate the number of first-generation girls and women in the European Union, Norway and Switzerland who have undergone FGM. Before migration from FGM-practicing countries began, FGM was an unknown phenomenon in Europe. Secondary analysis of data from the 2011 EU census and extrapolation from age-specific FGM prevalence rates in the immigrants' home countries to these data were used to provide our estimates. Estimates based on census and other demographic data were compared to our results for Belgium. In 2011 over half a million first-generation women and girls in the EU, Norway and Switzerland had undergone FGM before immigration. One in two was living in the UK or France, one in two was born in East-Africa. For the first time, scientific evidence gives a reliable estimate of the number of first-generation women and girls in Europe coming from countries where FGM is practiced. The use of census data proves reliable for policy makers to guide their actions, e.g., regarding training needs for health workers who might be confronted with women who have undergone FGM, or the need for reconstructive surgery.

  17. The Global Online Sexuality Survey: public perception of female genital cutting among internet users in the Middle East.

    Science.gov (United States)

    Shaeer, Osama; Shaeer, Eman

    2013-12-01

    Female genital cutting (FGC) is a ritual involving cutting part or all of the female external genitalia, performed primarily in Africa. Understanding the motivation behind FGC whether religious or otherwise is important for formulating the anti-FGC messages in prevention and awareness campaigns. The study aims to provide an investigation of opinion over FGC, the root motive/s behind it, in addition to the current prevalence of FGC among Internet users in the Middle East. The Global Online Sexuality Survey was undertaken in the Middle East via paid advertising on Facebook®, comprising 146 questions. The main outcomes are the prevalence of and public opinion on FGC among Internet users. 31.6% of 992 participants experienced FGC at an average age of 9.6 ± 3.5 years, mostly in Egypt (50.2%). FGC was performed among both Muslims (36.9%) and Christians (18.8%), more in rural areas (78.7%) than urban (47.4%), and was performed primarily by doctors (54.7%) and nurses (9.5%). Whether or not it is necessary for female chastity, FGC was reported as highly necessary (22.5%), and necessary (21.6%). This was more among males, particularly among those with rural origin, with no difference as per educational level. This is in contrast to only 3.7% regarding FGC as a mandate of Islam. Religious opinion among Muslims was: 55.4% anti-FGC and 44.6% pro-FGC. An important motivation driving FGC seems to be males seeking female chastity rather than religion, especially with FGC not being an Islamic mandate, not to undermine the importance of religion among other motives. School and university education were void of an effective anti-FGC message, which should be addressed. There is a shift toward doctors and nurses for performing FGC, which is both a threat and an opportunity. We propose that the primary message against FGC should be delivered by medical and paramedical personnel who can deliver a balanced and confidential message. © 2013 International Society for Sexual Medicine.

  18. Diagnosis and staging of female genital tract melanocytic lesions using pump-probe microscopy (Conference Presentation)

    Science.gov (United States)

    Robles, Francisco E.; Selim, Maria A.; Warren, Warren S.

    2016-02-01

    Melanoma of the vulva is the second most common type of malignancy afflicting that organ. This disease caries poor prognosis, and shows tendencies to recur locally and develop distant metastases through hematogenous dissemination. Further, there exists significant clinical overlap between early-stage melanomas and melanotic macules, benign lesions that are believed to develop in about 10% of the general female population. In this work we apply a novel nonlinear optical method, pump-probe microscopy, to quantitatively analyze female genitalia tract melanocytic lesions. Pump-probe microscopy provides chemical information of endogenous pigments by probing their electronic excited state dynamics, with subcellular resolution. Using unstained biopsy sections from 31 patients, we find significant differences between melanin type and structure in tissue regions with invasive melanoma, melanoma in-situ and non-malignant melanocytic proliferations (e.g., nevi, melanocytic macules). The molecular images of non-malignant lesion have a well-organized structure, with relatively homogenous pigment chemistry, most often consistent with that of eumelanin with large aggregate size or void of metals, such as iron. On the other hand, pigment type and structure observed in melanomas in-situ and invasive melanomas is typically much more heterogeneous, with larger contributions from pheomelanin, melanins with larger metal content, and/or melanins with smaller aggregate size. Of most significance, clear differences can be observed between melanocytic macules and vulvar melanoma in-situ, which, as discussed above, can be difficult to clinically distinguish. This initial study demonstrates pump-probe microscopy's potential as an adjuvant diagnostic tool by revealing systematic chemical and morphological differences in melanin pigmentation among invasive melanoma, melanoma in-situ and non-malignant melanocytic lesions.

  19. Genital manifestations and reproductive health in female residents of a Wuchereria bancrofti-endemic area in Tanzania

    DEFF Research Database (Denmark)

    Bernhard, P; Makunde, R W; Magnussen, P

    2000-01-01

    To assess the significance of lymphatic filariasis for the development of chronic genital manifestations and for reproductive health in women, we conducted a cross-sectional study of 2 villages in north-eastern Tanzania including interview and gynaecological examination of adult women, focusing...... or reproductive health, and chronic manifestations of lymphatic filariasis of the genitals does not appear to be a substantial problem in women....

  20. Usefulness of multiplex PCR in the diagnosis of genital tuberculosis in females with infertility.

    Science.gov (United States)

    Sankar, M M; Kumar, P; Munawwar, A; Kumar, M; Singh, J; Singh, A; Parashar, D; Malhotra, N; Duttagupta, S; Singh, S

    2013-03-01

    The purpose of this investigation was to evaluate the usefulness of multiplex polymerase chain reaction (m-PCR) in detecting uterine tuberculosis in women with infertility. In a prospective study, endometrial curetting from 620 females with infertility were investigated using laparoscopy, hysteroscopy, histopathology, smear microscopy, mycobacterial culture in BACTEC MGIT™ 960, and in-house m-PCR. The mean age of the women was 29.75 ± 4.66 years. The majority (596) sought medical attention for infertility; of them, 455 (76.34 %) presented with primary and 141 (23.65 %) with secondary infertility. A total of 158 (25.48 %) women were diagnosed as having uterine tuberculosis by at least one of the diagnostic methods. Among them, laparoscopy was positive in 46 (29.11 %), hysteroscopy in 77 (48.73 %), histopathology in only 8 (5.06 %), smear for acid fast bacilli in 4 (2.53 %), and liquid culture in 24 (15.18 %) patients. The in-house m-PCR was positive in 135 (85.44 %) women. Of these, 129 (95.55 %) samples were positive for Mycobacterium tuberculosis, while 6 (4.44 %) were positive for non-tuberculous mycobacterial DNA. Of the 129 M. tuberculosis PCR-positive women, 112 received anti-tubercular treatment and 23 of these conceived and fell pregnant after the completion of treatment. For the diagnosis of uterine tuberculosis, m-PCR was found to be the most efficient diagnostic tool compared to the other methods.

  1. Estimating the magnitude of female genital mutilation/cutting in Norway: an extrapolation model.

    Science.gov (United States)

    Ziyada, Mai M; Norberg-Schulz, Marthe; Johansen, R Elise B

    2016-02-02

    With emphasis on policy implications, the main objective of this study was to estimate the numbers of two main groups affected by FGM/C in Norway: 1) those already subjected to FGM/C and therefore potentially in need for health care and 2) those at risk of FGM/C and consequently the target of preventive and protective measures. Special attention has been paid to type III as it is associated with more severe complications. Register data from Statistics Norway (SSB) was combined with population-based survey data on FGM/C in the women/girls' countries of origin. As of January 1(st) 2013, there were 44,467 first and second-generation female immigrants residing in Norway whose country of origin is one of the 29 countries where FGM/C is well documented. About 40 pct. of these women and girls are estimated to have already been subjected to FGM/C prior to immigration to Norway. Type III is estimated in around 50 pct. of those already subjected to FGM/C. Further, a total of 15,500 girls are identified as potentially at risk, out of which an approximate number of girls ranging between 3000 and 7900 are estimated to be at risk of FGM/C. Reliable estimates on FGM/C are important for evidence-based policies. The study findings indicate that about 17,300 women and girls in Norway can be in need of health care, in particular the 9100 who are estimated to have type III. Preventive and protective measures are also needed to protect girls at risk (3000 to 7900) from being subjected to FGM/C. Nevertheless, as there are no appropriate tools at the moment that can single these girls out of all who are potentially at risk, all girls in the potentially at risk group (15,500) should be targeted with preventive measures.

  2. Dynamics of change in the practice of female genital cutting in Senegambia: testing predictions of social convention theory.

    Science.gov (United States)

    Shell-Duncan, Bettina; Wander, Katherine; Hernlund, Ylva; Moreau, Amadou

    2011-10-01

    Recent reviews of intervention efforts aimed at ending female genital cutting (FGC) have concluded that progress to date has been slow, and call for more efficient programs informed by theories on behavior change. Social convention theory, first proposed by Mackie (1996), posits that in the context of extreme resource inequality, FGC emerged as a means of securing a better marriage by signaling fidelity, and subsequently spread to become a prerequisite for marriage for all women. Change is predicted to result from coordinated abandonment in intermarrying groups so as to preserve a marriage market for uncircumcised girls. While this theory fits well with many general observations of FGC, there have been few attempts to systematically test the theory. We use data from a three year mixed-method study of behavior change that began in 2004 in Senegal and The Gambia to explicitly test predictions generated by social convention theory. Analyses of 300 in-depth interviews, 28 focus group discussions, and survey data from 1220 women show that FGC is most often only indirectly related to marriageability via concerns over preserving virginity. Instead we find strong evidence for an alternative convention, namely a peer convention. We propose that being circumcised serves as a signal to other circumcised women that a girl or woman has been trained to respect the authority of her circumcised elders and is worthy of inclusion in their social network. In this manner, FGC facilitates the accumulation of social capital by younger women and of power and prestige by elder women. Based on this new evidence and reinterpretation of social convention theory, we suggest that interventions aimed at eliminating FGC should target women's social networks, which are intergenerational, and include both men and women. Our findings support Mackie's assertion that expectations regarding FGC are interdependent; change must therefore be coordinated among interconnected members of social networks

  3. Knowledge and perspectives of female genital cutting among the local religious leaders in Erbil governorate, Iraqi Kurdistan region.

    Science.gov (United States)

    Ahmed, Hamdia M; Kareem, Mosleh S; Shabila, Nazar P; Mzori, Barzhang Q

    2018-03-07

    Religious leaders are one of the key actors in the issue of female genital cutting (FGC) due to the influential position they have in the community and the frequent association of FGC with the religion. This study aimed to assess the knowledge and perspectives of the local religious leaders in Erbil governorate, Iraqi Kurdistan Region about different aspects of FGC. In-depth interviews were conducted with a sample of 29 local religious leaders. A semi-structured questionnaire was used that included questions about their knowledge, understanding, and perspectives on different aspects of FGC such as the reasons for practicing it, their contact and communication with the community regarding the practice and perspectives about banning the practice by law. Participants believed that FGC is useful for reducing or regulating the sexual desire of women to prevent adultery and engagement in pre and extramarital sexual relations and to enhance hygiene of women. They indicated that there is no any risk in doing FGC if there is no excessive cut. Most participants indicated that FGC is attributed to the religion and some considered it a tradition mixed with the religion. People rarely ask the advice of the religious leaders regarding FGC, but they frequently complain about the effects of the practice. Participants did not support having a law to ban FGC either because they thought it would be against the religion's advice on FGC or it will not work. The local religious leaders lack adequate knowledge about different aspects of FGC particularly the health consequences. There are different and disputing viewpoints about the reasons for practicing FGC, and there is poor support for having a law banning the practice. There is an essential need for enhancing the knowledge of the local religious leaders regarding FGC and its adverse effects on the women's health.

  4. Decline of supportive attitudes among husbands toward female genital mutilation and its association to those practices in Yemen.

    Directory of Open Access Journals (Sweden)

    Ghadah Abdulmajid Al-Khulaidi

    Full Text Available OBJECTIVES: To elucidate the attitudes of women and their husband's towards female genital mutilation (FGM and their associations with the continuation of FGM upon their daughters. METHODS: Subjects were 10,345 (in 1997 and 11,252 (in 2003 ever married women aged 15 to 49 years from the Yemen Demographic Health Surveys. Performances of FGM on the most-recently-born daughters were investigated. Attitudes of women and their husbands were assessed by their opinions on the continuation of FGM. The association between the attitudes of women and their husbands and performance of FGM on the most-recently-born daughters were investigated after adjusting for age and education of the women. FINDINGS: The percentage among the most-recently-born daughters who received FGM of women who had undergone FGM declined from 61.9% in 1997 to 56.5% in 2003 (p<0.001. The percentages of women who had undergone FGM and who supported the continuation of FGM and of husbands who also supported its continuation decreased from 78.2% and 60.1% in 1997 to 70.9% and 49.5% in 2003, respectively (both p<0.001. When the women or the husbands did not agree with FGM, it was less likely to be performed on their daughter than when the women or the husbands agreed in 1997 (odds ratio=0.11, 95% confidence interval 0.07-0.16 and odds ratio=0.07, 95% confidence interval 0.04-0.12, respectively and in 2003 (odds ratio=0.12, 95% confidence interval 0.09-0.16 and odds ratio=0.11, 95% confidence interval 0.07-0.16, respectively. CONCLUSION: Non-supportive attitudes of women and their husbands towards the continuation of FGM have become common and were associated with their decision not to perform FGM upon their daughters.

  5. Decline of Supportive Attitudes among Husbands toward Female Genital Mutilation and Its Association to Those Practices in Yemen

    Science.gov (United States)

    Al-Khulaidi, Ghadah Abdulmajid; Nakamura, Keiko; Seino, Kaoruko; Kizuki, Masashi

    2013-01-01

    Objectives To elucidate the attitudes of women and their husband’s towards female genital mutilation (FGM) and their associations with the continuation of FGM upon their daughters. Methods Subjects were 10,345 (in 1997) and 11,252 (in 2003) ever married women aged 15 to 49 years from the Yemen Demographic Health Surveys. Performances of FGM on the most-recently-born daughters were investigated. Attitudes of women and their husbands were assessed by their opinions on the continuation of FGM. The association between the attitudes of women and their husbands and performance of FGM on the most-recently-born daughters were investigated after adjusting for age and education of the women. Findings The percentage among the most-recently-born daughters who received FGM of women who had undergone FGM declined from 61.9% in 1997 to 56.5% in 2003 (p<0.001). The percentages of women who had undergone FGM and who supported the continuation of FGM and of husbands who also supported its continuation decreased from 78.2% and 60.1% in 1997 to 70.9% and 49.5% in 2003, respectively (both p<0.001). When the women or the husbands did not agree with FGM, it was less likely to be performed on their daughter than when the women or the husbands agreed in 1997 (odds ratio=0.11, 95% confidence interval 0.07-0.16 and odds ratio=0.07, 95% confidence interval 0.04-0.12, respectively) and in 2003 (odds ratio=0.12, 95% confidence interval 0.09-0.16 and odds ratio=0.11, 95% confidence interval 0.07-0.16, respectively). Conclusion Non-supportive attitudes of women and their husbands towards the continuation of FGM have become common and were associated with their decision not to perform FGM upon their daughters. PMID:24367582

  6. Prevalence and associated factors of female genital mutilation among Somali refugees in eastern Ethiopia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Deressa Wakgari

    2009-07-01

    Full Text Available Abstract Background Eastern Ethiopia hosts a substantial number of refugees originated from Somalia. Female genital mutilation (FGM is a common practice in the area, despite the campaigns to eliminate it. Methods A cross-sectional study was conducted among 492 respondents sampled from three refugee camps in Somali Regional State, Eastern Ethiopia, to determine the prevalence and associated factors of FGM. Data were collected using pre-tested structured questionnaires. Results Although the intention of the parents to circumcise their daughters was high (84%, 42.4% of 288 ≤12 girls were reported being undergone FGM. The prevalence increased with age, and about 52% and 95% were circumcised at the age of 7–8 and 11–12 years, respectively. Almost all operations were performed by traditional circumcisers (81% and birth attendants (18%. Clitoral cutting (64% and narrowing of the vaginal opening through stitching (36% were the two common forms of FGM reported by the respondents. Participation of the parents in anti-FGM interventions is statistically associated with lower practice and intention of the procedures. Conclusion FGM is widely practised among the Somali refugee community in Eastern Ethiopia, and there was a considerable support for the continuation of the practice particularly among women. The findings indicate a reported shift of FGM from its severe form to milder clitoral cutting. More men than women positively viewed anti-FGM interventions, and fewer men than women had the intention to let their daughters undergo FGM, indicating the need to involve men in anti-FGM activities.

  7. Female Genital Mutilation/Cutting in the United States: Updated Estimates of Women and Girls at Risk, 2012

    Science.gov (United States)

    Stupp, Paul; Okoroh, Ekwutosi; Besera, Ghenet; Goodman, David; Danel, Isabella

    2016-01-01

    Objectives In 1996, the U.S. Congress passed legislation making female genital mutilation/cutting (FGM/C) illegal in the United States. CDC published the first estimates of the number of women and girls at risk for FGM/C in 1997. Since 2012, various constituencies have again raised concerns about the practice in the United States. We updated an earlier estimate of the number of women and girls in the United States who were at risk for FGM/C or its consequences. Methods We estimated the number of women and girls who were at risk for undergoing FGM/C or its consequences in 2012 by applying country-specific prevalence of FGM/C to the estimated number of women and girls living in the United States who were born in that country or who lived with a parent born in that country. Results Approximately 513,000 women and girls in the United States were at risk for FGM/C or its consequences in 2012, which was more than three times higher than the earlier estimate, based on 1990 data. The increase in the number of women and girls younger than 18 years of age at risk for FGM/C was more than four times that of previous estimates. Conclusion The estimated increase was wholly a result of rapid growth in the number of immigrants from FGM/C-practicing countries living in the United States and not from increases in FGM/C prevalence in those countries. Scientifically valid information regarding whether women or their daughters have actually undergone FGM/C and related information that can contribute to efforts to prevent the practice in the United States and provide needed health services to women who have undergone FGM/C are needed. PMID:26957669

  8. Lactobacillus crispatus dominant vaginal microbiome is associated with inhibitory activity of female genital tract secretions against Escherichia coli.

    Directory of Open Access Journals (Sweden)

    Jeny P Ghartey

    Full Text Available Female genital tract secretions inhibit E. coli ex vivo and the activity may prevent colonization and provide a biomarker of a healthy microbiome. We hypothesized that high E. coli inhibitory activity would be associated with a Lactobacillus crispatus and/or jensenii dominant microbiome and differ from that of women with low inhibitory activity.Vaginal swab cell pellets from 20 samples previously obtained in a cross-sectional study of near-term pregnant and non-pregnant healthy women were selected based on having high (>90% inhibition or low (<20% inhibition anti-E. coli activity. The V6 region of the 16S ribosomal RNA gene was amplified and sequenced using the Illumina HiSeq 2000 platform. Filtered culture supernatants from Lactobacillus crispatus, Lactobacillus iners, and Gardnerella vaginalis were also assayed for E. coli inhibitory activity.Sixteen samples (10 with high and 6 with low activity yielded evaluable microbiome data. There was no difference in the predominant microbiome species in pregnant compared to non-pregnant women (n = 8 each. However, there were significant differences between women with high compared to low E. coli inhibitory activity. High activity was associated with a predominance of L. crispatus (p<0.007 and culture supernatants from L. crispatus exhibited greater E. coli inhibitory activity compared to supernatants obtained from L. iners or G. vaginalis. Notably, the E. coli inhibitory activity varied among different strains of L. crispatus.Microbiome communities with abundant L. crispatus likely contribute to the E. coli inhibitory activity of vaginal secretions and efforts to promote this environment may prevent E. coli colonization and related sequelae including preterm birth.

  9. Providing information to improve body image and care-seeking behavior of women and girls living with female genital mutilation: A systematic review and meta-analysis.

    Science.gov (United States)

    Esu, Ekpereonne; Okoye, Ifeyinwa; Arikpo, Iwara; Ejemot-Nwadiaro, Regina; Meremikwu, Martin M

    2017-02-01

    Female genital mutilation (FGM) has become recognized worldwide as an extreme form of violation of the human rights of girls and women. Strategies have been employed to curb the practice. To conduct a systematic review of randomized and nonrandomized studies of the effects of providing educational interventions on the body image and care-seeking behavior of girls and women living with FGM with the view to ending the practice. CENTRAL, MEDLINE, and other databases were searched up to August 10, 2015 without any language restrictions. Studies that provided education to women and/or girls living with any type of FGM or residing in countries where FGM is predominantly practiced were included. Two authors independently screened and collected data. We summarized dichotomous outcomes using odds ratios and evidence was assessed using the GRADE system (Grading of Recommendations Assessment, Development, and Evaluation). Educational interventions resulted in fewer women recommending FGM for their daughters and also reduced the incidence of FGM cases among daughters of women who received the educational interventions. These findings need to be validated with large randomized trials. 42015024637. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  10. Study of genital lesions

    Directory of Open Access Journals (Sweden)

    Anand Kumar B

    2003-03-01

    Full Text Available A total of one hundred patients (75 males and 25 females age ranged from 17-65 years with genital lesions attending the STD clinic of Bowring and LC Hospitals Bangalore constituted the study group. Based on clinical features, the study groups were classified as syphilis (39, chancroid (30, herpes genitolis (13, condylomato lato (9, LGV (7t condylomata acuminata (5, genital scabies (3, granuloma inguinole (2 and genital candidiasis (1. In 68% microbiological findings confirmed the clinical diagnosis. Of the 100 cases 13% and 2% were positive for HIV antibodies and HbsAg respectively.

  11. Genital Herpes

    Science.gov (United States)

    ... legs, buttocks, or genital area Swollen glands Unusual vaginal discharge If you have any symptoms of genital herpes, ... J.M. (2008). Understanding Herpes Simplex Virus: Transmission, Diagnosis, and Considerations in Pregnancy ... ...

  12. Correlation of male genital filaments and female spermathecal ducts in New World sand flies of the Lutzomyia intermedia species complex (Diptera: Psychodidae, Phlebotominae

    Directory of Open Access Journals (Sweden)

    Marcondes Carlos Brisola

    2003-01-01

    Full Text Available The lengths of the male genital filaments and female spermathecal ducts were measured in phlebotomine sand flies of the Lutzomyia intermedia species complex and the ratios between these characters calculated. Ratios for L. intermedia s. s. from Northeast vs Southeast Brazil (Espírito Santo and Minas Gerais, Espírito Santo/Minas Gerais vs Rio de Janeiro/São Paulo and L. intermedia vs L. neivai were significantly different at P < 0.1, 0.05 and 0.01 respectively when compared using ANOVA. The spermathecal ducts and genital filaments of L. intermedia were significantly longer than those of L. neivai (P < 0.01 and could be used to differentiate these species. The taxonomic and biological significance of these differences is discussed.

  13. Evaluating the impact of existing legislation in Europe with regard to Female Genital Mutilation. Spanish National Report

    Directory of Open Access Journals (Sweden)

    VVAA .

    2014-02-01

    Full Text Available Introduction The Spanish Report on the evaluation of existing legislation with regard to Female Genital Mutilation (FGM is the result of a research project supported by the European Commision Daphne Programme. The project Evaluating the impact of existing legislation in Europe with regard to female genital mutilation, has been coordinated by the International Centre for Reproductive Health of Ghent University (Belgium from january 2003 to march 2004. The project included as partners the Foundation for Women’s Health, Research and Development (FORWARD, United Kingdom; Lund University (Sweden; Commission pour l'Abolition des Mutilations Sexuelles, (CAMS, France, the Centre of Studies on Citizenship, Migration and Minorities of the University of Valencia (GECIM, Spain, and the above mentioned ICRH (Ghent University, Belgium . The Spanish report is an interdisciplinary research done by the Centre of Studies on Citizenship, Migration and Minorities (University of València, directed by professor Javier De Lucas, and which counts with researchers and collaborators both, from the University of Valencia and other Universities such as University of Barcelona and University Rovira i Virgili of Tarragona; in the fields of Law (Penal Law, Constitutional Law, Theory and Philosophy of Law, Sociology and Antropology. The Group of researchers includes as well lawyers and public prosecutors. Practice of Female Genital Mutilation in Spain, like other european countries, address this rite that is introduced by immigrants from countries where the practice is prevalent (as we may see in chapter 3, as a violation of women’s rights and consider that such violation cannot be justified by respect of cultural traditions or initiation ceremonies. The increasing of immigration in Spain, has been a fact in last years, and it would be an important issue in future, increasing too the number of girls at risk in our country. In Spain, since october 2003, we have anew

  14. Evaluating the impact of existing legislation in Europe with regard to Female Genital Mutilation. Spanish National Report

    Directory of Open Access Journals (Sweden)

    VVAA .

    2014-02-01

    Full Text Available Introduction The Spanish Report on the evaluation of existing legislation with regard to Female Genital Mutilation (FGM is the result of a research project supported by the European Commision Daphne Programme. The project Evaluating the impact of existing legislation in Europe with regard to female genital mutilation, has been coordinated by the International Centre for Reproductive Health of Ghent University (Belgium from january 2003 to march 2004. The project included as partners the Foundation for Women’s Health, Research and Development (FORWARD, United Kingdom; Lund University (Sweden; Commission pour l'Abolition des Mutilations Sexuelles, (CAMS, France, the Centre of Studies on Citizenship, Migration and Minorities of the University of Valencia (GECIM, Spain, and the above mentioned ICRH (Ghent University, Belgium . The Spanish report is an interdisciplinary research done by the Centre of Studies on Citizenship, Migration and Minorities (University of València, directed by professor Javier De Lucas, and which counts with researchers and collaborators both, from the University of Valencia and other Universities such as University of Barcelona and University Rovira i Virgili of Tarragona; in the fields of Law (Penal Law, Constitutional Law, Theory and Philosophy of Law, Sociology and Antropology. The Group of researchers includes as well lawyers and public prosecutors. Practice of Female Genital Mutilation in Spain, like other european countries, address this rite that is introduced by immigrants from countries where the practice is prevalent (as we may see in chapter 3, as a violation of women’s rights and consider that such violation cannot be justified by respect of cultural traditions or initiation ceremonies. The increasing of immigration in Spain, has been a fact in last years, and it would be an important issue in future, increasing too the number of girls at risk in our country. In Spain, since october 2003, we have anew

  15. UK-414,495, a selective inhibitor of neutral endopeptidase, potentiates pelvic nerve-stimulated increases in female genital blood flow in the anaesthetized rabbit

    Science.gov (United States)

    Wayman, CP; Baxter, D; Turner, L; Van Der Graaf, PH; Naylor, AM

    2010-01-01

    Background and purpose: Female sexual arousal consists of a number of physiological responses resulting from increased genital blood. Vasoactive intestinal peptide (VIP), neuropeptide Y and to a lesser extent nitric oxide are neurotransmitters found in the vasculature of the genitalia. Neutral endopeptidase (NEP) modulates the activity of neuropeptides including VIP. The aim of this study was to investigate the control of genital blood flow by VIP and endogenous neuropeptides using a selective NEP inhibitor [UK-414,495, ((R)-2-({1-[(5-ethyl-1,3,4-thiadiazol-2-yl) carbamoyl]cyclopentyl}methyl) valeric acid)]. Experimental approach: Vaginal and clitoral blood flow (VBF and CBF) were monitored using laser Doppler in terminally anaesthetized New Zealand rabbits. Increases in VBF and CBF were induced by either electrical stimulation of the pelvic nerve or by i.v. infusion of VIP. Key results: Stimulation of the pelvic nerve increased VBF and CBF, compared with basal flow. Increases were mimicked by infusion of exogenous VIP. UK-414,495 dose-dependently potentiated pelvic nerve-stimulated increases in VBF (EC50= 37 ± 9 nM; 3.6 × IC50 rabbit NEP). Nerve-stimulated increases in VBF and CBF were both enhanced after UK-414,495. UK-414,495 increased the amplitude and duration of VIP-induced increases in VBF. UK-414,495 had no effect on basal VBF or cardiovascular parameters. Conclusions and implications: Inhibition of NEP potentiates pelvic nerve-stimulated increases in genital blood flow. This suggests that the endogenous neurotransmitter mediating genital blood flow is a substrate for NEP (most likely VIP). NEP inhibitors may restore sexual arousal in women adversely affected by female sexual arousal disorder. This article is commented on by Angulo, pp. 48–50 of this issue. To view this commentary visit http://dx.doi.org/10.1111/j.1476-5381.2010.00693.x PMID:20412068

  16. A Comparative Study of Potassium Hydroxide versus CO2 Laser Vaporization in The Treatment of Female Genital Warts: A Controlled Clinical Trial.

    Science.gov (United States)

    Asadi, Nasrin; Hemmati, Ensie; Namazi, Golnaz; Jahromi, Mahnaz Pakniat; Sarraf, Zahra; Pazyar, Nader; Salehi, Alireza

    2016-07-01

    Genital warts are the most common viral sexually transmitted disease affecting 1% of the population. A prospective, open-label controlled trial was performed to compare topical 5% potassium hydroxide (KOH) solution with CO2 laser in the treatment of female genital warts. Seventy patients were enrolled in the study after convenience sampling. Right-sided lesions of the patients were treated by CO2 laser every 3 weeks. The left-sided lesions of the same patients were treated by topical 5% KOH solution twice a day using a toothpick with cotton wrap on the tip. The patients were visited at 3, 6, and 9 weeks after initiation of the treatment and followed up for 6 months after the last visit. Out of seventy patients, sixty three completed the study and were analyzed. A total of 56 KOH treated-patients (88.9%) showed complete response. On the other hand, 56 laser-treated patients (88.9%) presented complete clearing of the lesion. There was not any difference in response to both modalities of treatment. Complications of KOH solution and CO2 laser were 24% and 19% respectively (P>0.05), but serious adverse events were not observed. The patients under KOH treatment displayed a recurrence rate of 11.1% (7 cases), while the same patients with CO2 laser therapy demonstrated a recurrence rate of 7.9% (5 cases) (P=0.54). Topical 5% KOH solution was as effective as CO2 laser in the treatment of female genital warts. There was not any serious complication in the application of KOH solution. This could be used as a new treatment for genital warts. IRCT201412207848N1.

  17. The 'heat' goes away: sexual disorders of married women with female genital mutilation/cutting in Kenya.

    Science.gov (United States)

    Esho, Tammary; Kimani, Samuel; Nyamongo, Isaac; Kimani, Violet; Muniu, Samuel; Kigondu, Christine; Ndavi, Patrick; Guyo, Jaldesa

    2017-12-02

    Female genital mutilation/cutting (FGM/C) has been implicated in sexual complications among women, although there is paucity of research evidence on sexual experiences among married women who have undergone this cultural practice. The aim of this study was to investigate the sexual experiences among married women in Mauche Ward, Nakuru County. Quantitative and qualitative data collection methods were used. Quantitative data were obtained from 318 married women selected through multistage sampling. The women were categorized into: cut before marriage, cut after marriage and the uncut. A questionnaire was used to collect demographic information while psychometric data were obtained using a female sexual functioning index (FSFI) tool. The resulting quantitative data were analyzed using SPSS® Version 22. Qualitative data were obtained from five FGDs and two case narratives. The data were organized into themes, analyzed and interpreted. Ethical approval for the study was granted by Kenyatta National Hospital-University of Nairobi Ethics and Research Committee. The mean age of the respondents was 30.59 ± 7.36 years. The majority (74.2%) had primary education and 76.1% were farmers. Age (p = 0.008), number of children (p = 0.035) and education (p = 0.038) were found to be associated with sexual functioning. The cut women reported lower sexual functioning compared to the uncut. ANOVA results show the reported overall sexual functioning to be significantly (p = 0.019) different across the three groups. Women cut after marriage (mean = 22.81 ± 4.87) scored significantly lower (p = 0.056) than the uncut (mean = 25.35 ± 3.56). However, in comparison to the cut before marriage there was no significant difference (mean = 23.99 ± 6.63). Among the sexual functioning domains, lubrication (p = 0.008), orgasm (p = 0.019) and satisfaction (p = 0.042) were significantly different across the three groups. However, desire

  18. Ionizing radiations and their impact on basic functions of the genital system on the women (external exposure)

    International Nuclear Information System (INIS)

    Marinova, G.

    1976-01-01

    produce functional changes in the human female genital system. (A.B.)

  19. Female Genital Cutting

    Science.gov (United States)

    ... Expand all | Collapse all What is FGC? The World Health Organization (WHO) and the United Nations (UN) define FGC ... What are the different types of FGC? The World Health Organization (WHO) describes four major types of FGC. Types ...

  20. Female Genital Mutilation

    African Journals Online (AJOL)

    FINEPRINT

    Community, Edo State, to help develop programs and interventions to curtail this harmful cultural practice. A community based ... 95%CI=0.028-0.869; p=0.034) and attitude towards FGM (OR=0.115; 95%CI=0.056-0.235; p?0.001)were identified as ..... Nigeria and ICF International.Nigeria. Demographic and Health Survey ...

  1. FEMALE GENITAL MUTILATION

    African Journals Online (AJOL)

    and tattoos, are ethnically distinctive and confer on women a higher status due to the training that is associated with this rite. Circumcision also promotes social cohesion and integration within cultures, as it confers social acceptability. The authors are 5th-year medical students at the University. ofCape Town. ThI?Jj wrote ...

  2. Infection of female primary lower genital tract epithelial cells after natural pseudotyping of HIV-1: possible implications for sexual transmission of HIV-1.

    Directory of Open Access Journals (Sweden)

    Yuyang Tang

    Full Text Available The global AIDS pandemic continues to expand and in some regions of the world, such as southern Africa, the prevalence of HIV-1 infection exceeds 20%. The devastating spread of the virus in young women in these countries appears disproportional to overall risk of infection. Regions with high prevalence of HIV-1 are often also highly endemic for other pathogenic viruses including HSV, CMV and HTLV. We propose that acquisition by HIV-1 of the envelope glycoproteins of other viruses, in a process we call "natural pseudotyping," expands the cellular tropism of HIV-1, enabling it to infect female genital epithelial cells directly and thereby dramatically increasing risk of infection during sexual intercourse. In this proof-of-concept study, we demonstrate that when HIV-1 co-infects T cells along with the gammaretrovirus xenotropic murine leukemia virus-related virus (XMRV, progeny HIV-1 particles are produced capable of infecting primary vaginal, ectocervical and endocervical epithelial cells. These cell types are normally resistant to HIV-1 infection. Infection of primary genital cells was neutralized by antisera against the XMRV glycoprotein, confirming that infection was mediated by the XMRV glycoprotein acquired through pseudotyping of HIV. Inhibition by AZT showed that active replication of HIV-1 occurred in these cells and ruled out non-specific endocytic uptake of the virus. These results demonstrate that natural pseudotyping can expand the tropism of HIV-1 to include genital epithelial cells and have potential implications for sexual transmission of the virus.

  3. Novel Role for Interleukin-17 in Enhancing Type 1 Helper T Cell Immunity in the Female Genital Tract following Mucosal Herpes Simplex Virus 2 Vaccination.

    Science.gov (United States)

    Bagri, Puja; Anipindi, Varun C; Nguyen, Philip V; Vitali, Danielle; Stämpfli, Martin R; Kaushic, Charu

    2017-12-01

    It is well established that interferon gamma (IFN-γ) production by CD4 + T cells is critical for antiviral immunity against herpes simplex virus 2 (HSV-2) genital infection. However, the role of interleukin-17A (IL-17A) production by CD4 + T cells in HSV-2 antiviral immunity is yet to be elucidated. Here we demonstrate that IL-17A plays an important role in enhancing antiviral T helper type 1 (T h 1) responses in the female genital tract (FGT) and is essential for effective protection conferred by HSV-2 vaccination. While IL-17A did not play a critical role during primary genital HSV-2 infection, seen by lack of differences in susceptibility between IL-17A-deficient ( IL-17A -/- ) and wild-type (WT) C57BL/6 mice, it was critical for mediating antiviral responses after challenge/reexposure. Compared to WT mice, IL-17A -/- mice (i) infected intravaginally and reexposed or (ii) vaccinated intranasally and challenged intravaginally demonstrated poor outcomes. Following intravaginal HSV-2 reexposure or challenge, vaccinated IL-17A -/- mice had significantly higher mortality, greater disease severity, higher viral shedding, and higher levels of proinflammatory cytokines and chemokines in vaginal secretions. Furthermore, IL-17A -/- mice had impaired T h 1 cell responses after challenge/reexposure, with significantly lower proportions of vaginal IFN-γ + CD4 + T cells. The impaired T h 1 cell responses in IL-17A -/- mice coincided with smaller populations of IFN-γ + CD4 + tissue resident memory T (T RM ) cells in the genital tract postimmunization. Taken together, these findings describe a novel role for IL-17A in regulating antiviral IFN-γ + T h 1 cell immunity in the vaginal tract. This strategy could be exploited to enhance antiviral immunity following HSV-2 vaccination. IMPORTANCE T helper type 1 (T h 1) immunity, specifically interferon gamma (IFN-γ) production by CD4 + T cells, is critical for protection against genital herpesvirus (HSV-2) infection, and

  4. Injured bodies, damaged lives: experiences and narratives of Kenyan women with obstetric fistula and Female Genital Mutilation/Cutting.

    Science.gov (United States)

    Mwanri, Lillian; Gatwiri, Glory Joy

    2017-03-14

    It is well acknowledged that Female Genital Mutilation/Cutting (FGM/C/C) leads to medical, psychological and sociocultural sequels. Over 200 million cases of FGM/C exist globally, and in Kenya alone, a total of 12,418,000 (28%) of women have undergone FGM/C, making the practice not only a significant national, but also a global health catastrophe. FGM/C is rooted in patriarchal and traditional cultures as a communal experience signifying a transition from girlhood to womanhood. The conversations surrounding FGM/C have been complicated by the involvement of women themselves in perpetuating the practice. A qualitative inquiry employing face-to-face, one-on-one, in-depth semi-structured interviews was used in a study that included 30 women living with obstetric fistulas in Kenya. Using the Social Network Framework and a feminist analysis we present stories of Kenyan women who had developed obstetric fistulas following prolonged and obstructed childbirth. Of the 30 participants, three women reported that health care workers informed them that FGM/C was one of the contributing factors to their prolonged and obstructed childbirth. They reported serious obstetric complications including: the development of obstetric fistulas, lowered libido, poor quality of life and maternal and child health outcomes, including death. Fistula and subsequent loss of bodily functionalities such as uncontrollable leakage of body wastes, was reported by the women to result in rejection by spouses, families, friends and communities. Rejection further led to depression, loss of work, increased sense of apathy, lowered self-esteem and image, as well as loss of identity and communal sociocultural cohesion. FGM/C is practised in traditional, patriarchal communities across Africa. Although the practice aims to bind community members and to celebrate a rite of passage; it may lead to harmful health and social consequences. Some women with fistula report their fistula was caused by FGM/C. Concerted

  5. Female genital mutilation: a systematic review of research on its economic and social impacts across four decades

    Directory of Open Access Journals (Sweden)

    Emmanuel Kabengele Mpinga

    2016-10-01

    Full Text Available Background: Global efforts to end female genital mutilation (FGM have intensified in recent decades because of the rising awareness that such a practice is an act of extreme violence against women and girls. Articles on FGM have been published highlighting the combined efforts of international and non-governmental organizations, governments, as well as religious and civil society groups to end the practice. However, the consequences of this research are not well known, and it seems that the socioeconomic aspects of the practice are underreported. Objective: This review aims to characterize over a 40-year period the scientific output on the consequences of FGM in African countries, the most affected region known for the high prevalence of FGM, and review data on the socioeconomic consequences of the practice. Design: A systematic review of literature was done, looking at the following databases: PubMed, Embase, CINAHL, BDSP, Web of Science, PsycINFO, FRANCIS, Sociological Abstracts, WHOLIS, RERO, and SAPHIR. The analysis was limited to articles concerning the African continent, published in English and French, from January 1, 1972, to December 31, 2011. Results: One hundred ninety-eight articles were reviewed. More than half of the articles were published during the last decade of the study period. The majority of papers were published in biomedical journals (64.1%. Most studies looked at Africa as a region (33.3%. Nigeria was the single country most investigated (19.2%, followed by Egypt (10.6%. Most first authors were affiliated to non-African countries (60.6%: among them 21.2% were US-based, 4% were from African institutions, and 16.2% from Nigeria. The medical and psychological consequences (51.5% and the prevalence and ethics of the practice (34.4% were the most frequently investigated topics. The socioeconomic consequences were addressed in a minority of the papers (14.1%: they were classified into direct economic consequences (2.5%, school

  6. Geographic Variation and Factors Associated with Female Genital Mutilation among Reproductive Age Women in Ethiopia: A National Population Based Survey.

    Directory of Open Access Journals (Sweden)

    Tesfaye Setegn

    Full Text Available Female genital mutilation (FGM is a common traditional practice in developing nations including Ethiopia. It poses complex and serious long-term health risks for women and girls and can lead to death. In Ethiopia, the geographic distribution and factors associated with FGM practices are poorly understood. Therefore, we assessed the spatial distribution and factors associated with FGM among reproductive age women in the country.We used population based national representative surveys. Data from two (2000 and 2005 Ethiopian demographic and health surveys (EDHS were used in this analysis. Briefly, EDHS used a stratified, two-stage cluster sampling design. A total of 15,367 (from EDHS 2000 and 14,070 (from EDHS 2005 women of reproductive age (15-49 years were included in the analysis. Three outcome variables were used (prevalence of FGM among women, prevalence of FGM among daughters and support for the continuation of FGM. The data were weighted and descriptive statistics (percentage change, bivariate and multivariable logistic regression analyses were carried out. Multicollinearity of variables was assessed using variance inflation factors (VIF with a reference value of 10 before interpreting the final output. The geographic variation and clustering of weighted FGM prevalence were analyzed and visualized on maps using ArcGIS. Z-scores were used to assess the statistical difference of geographic clustering of FGM prevalence spots.The trend of FGM weighted prevalence has been decreasing. Being wealthy, Muslim and in higher age categories are associated with increased odds of FGM among women. Similarly, daughters from Muslim women have increased odds of experiencing FGM. Women in the higher age categories have increased odds of having daughters who experience FGM. The odds of FGM among daughters decrease with increased maternal education. Mass media exposure, being wealthy and higher paternal and maternal education are associated with decreased odds

  7. Geographic Variation and Factors Associated with Female Genital Mutilation among Reproductive Age Women in Ethiopia: A National Population Based Survey.

    Science.gov (United States)

    Setegn, Tesfaye; Lakew, Yihunie; Deribe, Kebede

    2016-01-01

    Female genital mutilation (FGM) is a common traditional practice in developing nations including Ethiopia. It poses complex and serious long-term health risks for women and girls and can lead to death. In Ethiopia, the geographic distribution and factors associated with FGM practices are poorly understood. Therefore, we assessed the spatial distribution and factors associated with FGM among reproductive age women in the country. We used population based national representative surveys. Data from two (2000 and 2005) Ethiopian demographic and health surveys (EDHS) were used in this analysis. Briefly, EDHS used a stratified, two-stage cluster sampling design. A total of 15,367 (from EDHS 2000) and 14,070 (from EDHS 2005) women of reproductive age (15-49 years) were included in the analysis. Three outcome variables were used (prevalence of FGM among women, prevalence of FGM among daughters and support for the continuation of FGM). The data were weighted and descriptive statistics (percentage change), bivariate and multivariable logistic regression analyses were carried out. Multicollinearity of variables was assessed using variance inflation factors (VIF) with a reference value of 10 before interpreting the final output. The geographic variation and clustering of weighted FGM prevalence were analyzed and visualized on maps using ArcGIS. Z-scores were used to assess the statistical difference of geographic clustering of FGM prevalence spots. The trend of FGM weighted prevalence has been decreasing. Being wealthy, Muslim and in higher age categories are associated with increased odds of FGM among women. Similarly, daughters from Muslim women have increased odds of experiencing FGM. Women in the higher age categories have increased odds of having daughters who experience FGM. The odds of FGM among daughters decrease with increased maternal education. Mass media exposure, being wealthy and higher paternal and maternal education are associated with decreased odds of women

  8. Geographic Variation and Factors Associated with Female Genital Mutilation among Reproductive Age Women in Ethiopia: A National Population Based Survey

    Science.gov (United States)

    Setegn, Tesfaye; Lakew, Yihunie; Deribe, Kebede

    2016-01-01

    Background Female genital mutilation (FGM) is a common traditional practice in developing nations including Ethiopia. It poses complex and serious long-term health risks for women and girls and can lead to death. In Ethiopia, the geographic distribution and factors associated with FGM practices are poorly understood. Therefore, we assessed the spatial distribution and factors associated with FGM among reproductive age women in the country. Method We used population based national representative surveys. Data from two (2000 and 2005) Ethiopian demographic and health surveys (EDHS) were used in this analysis. Briefly, EDHS used a stratified, two-stage cluster sampling design. A total of 15,367 (from EDHS 2000) and 14,070 (from EDHS 2005) women of reproductive age (15–49 years) were included in the analysis. Three outcome variables were used (prevalence of FGM among women, prevalence of FGM among daughters and support for the continuation of FGM). The data were weighted and descriptive statistics (percentage change), bivariate and multivariable logistic regression analyses were carried out. Multicollinearity of variables was assessed using variance inflation factors (VIF) with a reference value of 10 before interpreting the final output. The geographic variation and clustering of weighted FGM prevalence were analyzed and visualized on maps using ArcGIS. Z-scores were used to assess the statistical difference of geographic clustering of FGM prevalence spots. Result The trend of FGM weighted prevalence has been decreasing. Being wealthy, Muslim and in higher age categories are associated with increased odds of FGM among women. Similarly, daughters from Muslim women have increased odds of experiencing FGM. Women in the higher age categories have increased odds of having daughters who experience FGM. The odds of FGM among daughters decrease with increased maternal education. Mass media exposure, being wealthy and higher paternal and maternal education are associated

  9. Distinct Effects of the Cervicovaginal Microbiota and Herpes Simplex Type 2 Infection on Female Genital Tract Immunology.

    Science.gov (United States)

    Shannon, B; Gajer, P; Yi, T J; Ma, B; Humphrys, M S; Thomas-Pavanel, J; Chieza, L; Janakiram, P; Saunders, M; Tharao, W; Huibner, S; Shahabi, K; Ravel, J; Kaul, R

    2017-05-01

    Genital inflammation is a key determinant of human immunodeficiency virus (HIV) transmission, and may increase HIV-susceptible target cells and alter epithelial integrity. Several genital conditions that increase HIV risk are more prevalent in African, Caribbean, and other black (ACB) women, including bacterial vaginosis and herpes simplex virus type-2 (HSV-2) infection. Therefore, we assessed the impact of the genital microbiota on mucosal immunology in ACB women and microbiome-HSV-2 interactions. Cervicovaginal secretions and endocervical cells were collected by cytobrush and Instead Softcup, respectively. T cells and dendritic cells were assessed by flow cytometry, cytokines by multiplex enzyme-linked immunosorbent assay (ELISA), and the microbiota by 16S ribosomal ribonucleic acid gene sequencing. The cervicovaginal microbiota of 51 participants were composed of community state types (CSTs) showing diversity (20/51; 39%) or predominated by Lactobacillus iners (22/51; 42%), L. crispatus (7/51; 14%), or L. gasseri (2/51; 4%). High-diversity CSTs and specific bacterial phyla (Gardnerella vaginalis and Prevotella bivia) were strongly associated with cervicovaginal inflammatory cytokines, but not with altered endocervical immune cells. However, cervical CD4+ T-cell number was associated with HSV-2 infection and a distinct cytokine profile. This suggests that the genital microbiota and HSV-2 infection may influence HIV susceptibility through independent biological mechanisms. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  10. The Applicability of Behaviour Change in Intervention Programmes Targeted at Ending Female Genital Mutilation in the EU: Integrating Social Cognitive and Community Level Approaches

    Science.gov (United States)

    Brown, Katherine; Barrett, Hazel

    2013-01-01

    With increased migration, female genital mutilation (FGM) also referred to as female circumcision or female genital cutting is no longer restricted to Africa, the Middle East, and Asia. The European Parliament estimates that up to half a million women living in the EU have been subjected to FGM, with a further 180,000 at risk. Aware of the limited success of campaigns addressing FGM, the World Health Organization recommended a behavioural change approach be implemented in order to end FGM. To date, however, little progress has been made in adopting a behaviour change approach in strategies aimed at ending FGM. Based on research undertaken as part of the EU's Daphne III programme, which researched FGM intervention programmes linked to African communities in the EU (REPLACE), this paper argues that behaviour change has not been implemented due to a lack of understanding relating to the application of the two broad categories of behaviour change approach: individualistic decision-theoretic and community-change game-theoretic approaches, and how they may be integrated to aid our understanding and the development of future intervention strategies. We therefore discuss how these can be integrated and implemented using community-based participatory action research methods with affected communities. PMID:23983698

  11. The Applicability of Behaviour Change in Intervention Programmes Targeted at Ending Female Genital Mutilation in the EU: Integrating Social Cognitive and Community Level Approaches

    Directory of Open Access Journals (Sweden)

    Katherine Brown

    2013-01-01

    Full Text Available With increased migration, female genital mutilation (FGM also referred to as female circumcision or female genital cutting is no longer restricted to Africa, the Middle East, and Asia. The European Parliament estimates that up to half a million women living in the EU have been subjected to FGM, with a further 180,000 at risk. Aware of the limited success of campaigns addressing FGM, the World Health Organization recommended a behavioural change approach be implemented in order to end FGM. To date, however, little progress has been made in adopting a behaviour change approach in strategies aimed at ending FGM. Based on research undertaken as part of the EU’s Daphne III programme, which researched FGM intervention programmes linked to African communities in the EU (REPLACE, this paper argues that behaviour change has not been implemented due to a lack of understanding relating to the application of the two broad categories of behaviour change approach: individualistic decision-theoretic and community-change game-theoretic approaches, and how they may be integrated to aid our understanding and the development of future intervention strategies. We therefore discuss how these can be integrated and implemented using community-based participatory action research methods with affected communities.

  12. The Effects of Hormones and Vaginal Microflora on the Glycome of the Female Genital Tract: Cervical-Vaginal Fluid.

    Directory of Open Access Journals (Sweden)

    Bernard J Moncla

    -glucosidase activity that was much lower in the postmenopausal group (P<0.001. These studies present compelling evidence that the vaginal ecosystem responds to the presence of different vaginal microorganisms. These effects were so influential that it required us to remove subjects with BV for data interpretation of the impact of hormones. We also suggest that certain changes occurring in vaginal/cervical proteins are due to bacteria or their products. Therefore, the quantitation of vaginal mucins and lectin binding offers a new method to monitor bacteria-host interactions in the female reproductive tract. The data suggest that some of the changes in these components are the result of host processing, such as the increases in mucin content, while the microflora is responsible for the increases in glycosidases and the decreases in lectin binding. The methods should be considered a valid marker for insult to the female genital tract.

  13. The Effects of Hormones and Vaginal Microflora on the Glycome of the Female Genital Tract: Cervical-Vaginal Fluid.

    Science.gov (United States)

    Moncla, Bernard J; Chappell, Catherine A; Debo, Brian M; Meyn, Leslie A

    2016-01-01

    that was much lower in the postmenopausal group (P<0.001). These studies present compelling evidence that the vaginal ecosystem responds to the presence of different vaginal microorganisms. These effects were so influential that it required us to remove subjects with BV for data interpretation of the impact of hormones. We also suggest that certain changes occurring in vaginal/cervical proteins are due to bacteria or their products. Therefore, the quantitation of vaginal mucins and lectin binding offers a new method to monitor bacteria-host interactions in the female reproductive tract. The data suggest that some of the changes in these components are the result of host processing, such as the increases in mucin content, while the microflora is responsible for the increases in glycosidases and the decreases in lectin binding. The methods should be considered a valid marker for insult to the female genital tract.

  14. Using the Female Sexual Function Index (FSFI) to evaluate sexual function in women with genital mutilation undergoing surgical reconstruction: a pilot prospective study.

    Science.gov (United States)

    Vital, Mathilde; de Visme, Sophie; Hanf, Matthieu; Philippe, Henri-Jean; Winer, Norbert; Wylomanski, Sophie

    2016-07-01

    Few prospective studies have evaluated sexual function in women with female genital mutilation by cutting (FGM/C) before and after clitoral reconstructive surgery, and none used a validated questionnaire. A validated questionnaire, the Female Sexual Function Index (FSFI) was used for the first time, to assess the impact of reconstructive surgery on sexual function in women with female genital mutilation/cutting (FGM/C) before and after clitoral reconstructive surgery. Women with FGM/C consulting at the Nantes University Hospital for clitoral reconstruction between 2013 and 2014 were prospectively included. All patients completed a questionnaire at inclusion, describing their social, demographic, and FGM/C characteristics. They were also asked to complete the FSFI as well as a questionnaire about clitoral sensations, symptoms of depression or anxiety, and self-esteem before and 3 and 6 months after the surgery. Paired Wilcoxon and McNemar tests were used to compare data. Of the 12 women included, 9 (75%) had type II mutilations. Results showed a global sexual dysfunction (median FSFI summary score=17) before surgery. Clitoral sensations were absent in 8 women (67%). Six months after surgery, all FSFI dimensions except lubrication had improved significantly (median FSFI summary score=29, P=0.009). Ten women had clitoral sensations, and 11 (92%) were satisfied with their surgery. This study shows that 6 months after clitoral reconstructive surgery, women reported a multidimensional positive improvement in their sexual function. The FSFI is a promising tool for routine standardized assessment of the sexual function of women with FGM/C for determining appropriate management and assessing it. Larger studies with validated questionnaires assessing self-esteem, depression, and body image are also needed to develop an integrative approach and to provide evidence-based recommendations about management of these women. Copyright © 2016 Elsevier Ireland Ltd. All rights

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

    Science.gov (United States)

    Adinew, Yohannes Mehretie; Mekete, Beza Tamirat

    2017-12-01

    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. 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. 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. 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.

  16. [Clitoral reconstruction after female genital mutilation at CHU Yalgado of Ouagadougou, Burkina Faso. About 68 patients operated].

    Science.gov (United States)

    Ouédraogo, C M R; Madzou, S; Simporé, A; Combaud, V; Ouattara, A; Millogo, F; Ouédraogo, A; Kiemtore, S; Zamane, H; Sawadogo, Y A; Kaien, P; Dramé, B; Thieba, B; Lankoandé, J; Descamps, P

    2016-11-01

    The objective of this survey was to assess the results of a new clitoral transposition technique in the obstetrics and gynecology department of CHUYO. A cohort of 68 women victims of genital mutilation has received clitoral reconstruction by a new technique of transposition of the clitoris. They were operated and followed for 12 months in CHUYO gynecology ward in Ouagadougou. We evaluated the management of pain, anatomical aspect, functional and occurrence of complications. Anatomically have no new increase was within a neoclitoris, and a very satisfactory ratio of 100 % of women with clitoral massif visible in the 12th month assessment. Functionally, before clitoral reconstruction half of the women had mild pain or discomfort during sexual intercourse. However, clitoral reconstruction after the 6th month and 12th month this pain or mild discomfort were 3.18 % and 0 % respectively. In addition, we noted a sensitive neoclitoris in all women, after one year. Very few postoperative complications were observed in this series compared to previous series. These results are of interest in this new clitoral transposition technique in favor of women victims of genital mutilation. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Investigation of Toll-Like Receptor-2 (2258G/A and Interferon Gamma (+874T/A Gene Polymorphisms among Infertile Women with Female Genital Tuberculosis.

    Directory of Open Access Journals (Sweden)

    Venkanna Bhanothu

    Full Text Available Toll-like receptor 2 (TLR2 and interferon-gamma (IFN-γ coordinate with a diverse array of cellular programs through the transcriptional regulation of immunologically relevant genes and play an important role in immune system, reproductive physiology and basic pathology. Alterations in the functions of TLR2 2258G (guanine/ A, IFN-γ (+874T/A and signalling molecules that result from polymorphisms are often associated with susceptibility or resistance, which may, in turn, establish the innate host response to various infectious diseases. Presently, we proposed to investigate the risk of common single nucleotide polymorphism (SNP of TLR2 and IFN-γ genes, for their effect on infertility in women with female genital tuberculosis (FGTB and healthy women as controls.Genotyping of TLR2 and IFN-γ gene polymorphisms was performed by amplification refractory mutation system multi-gene/multi-primer polymerase chain reaction followed by restriction fragment length polymorphism in 175 FGTB patients and 100 healthy control women (HCW. The TLR2 polymorphism [adenine (A allele] was observed in 57.7 and 58.0% of FGTB patients and HCW, respectively. The IFN-γ (+874T/A polymorphism (A allele was significant in 74.3 and 71.0% of FGTB patients and HCW, respectively, while the odds ratios for the AA and TA genotypes for predisposition of FGTB were found to be 0.304 and 1.650 in HCW, respectively. The SNP of TLR2 was not associated with FGTB but the SNP of IFN-γ was found to be associated with mycobacteria infections and to induce infertility.At present, we hypothesize that infertile women with FGTB and HCW without tuberculosis (TB have identical frequency of TLR variants, which may be adequate in the production of IFN-γ in response to Mycobacterium tuberculosis infections. Thus, the study appears to be the first of its kind reporting a mutation in the IFN-γ gene [+874 T (thymine to A] responsible for susceptibility to TB infections and further inducing

  18. Genital Herpes

    Science.gov (United States)

    Genital herpes is a sexually transmitted disease (STD) caused by a herpes simplex virus (HSV). It can cause sores on ... also infect their babies during childbirth. Symptoms of herpes are called outbreaks. You usually get sores near ...

  19. Frequency-Dependent Social Transmission and the Interethnic Transfer of Female Genital Modification in the African Diaspora and Indigenous Populations of Colombia.

    Science.gov (United States)

    Ross, Cody T; Campiño, Patricia Joyas; Winterhalder, Bruce

    2015-12-01

    We present a quantitative account based on ethnographic and documentary research of the prevalence of female genital modification (FGMo) in the African diaspora and indigenous populations of Colombia. We use these data to test hypotheses concerning the cultural evolutionary drivers of costly trait persistence, attenuation, and intergroup transmission. The uptake of FGMo by indigenous populations in Colombia is consistent with frequency-dependent hypotheses for the social transmission of the FGMo trait from the African diaspora population in the period following the era of slavery in Colombia. The prevalence and severity of practices related to FGMo decline with level of sociocultural integration into mainstream Colombian culture. Our results provide empirical support for the cultural evolutionary models proposed by Ross et al. (2015) to describe the transmission dynamics of FGMo and other costly traits. Analysis of costly trait dynamics contributes knowledge useful to applied anthropology and may be of interest in policy design and human rights monitoring in Colombia and elsewhere.

  20. Intervention of the hospital midwife in the case of a pregnant women who had undergone female genital mutilation. A case study.

    Science.gov (United States)

    Díaz-Jiménez, Désirée; Rodríguez-Villalón, Marta; Moreno-Dueñas, María Begoña

    Female genital mutilation, condemned by all UN member countries has spread throughout the world as a result of migratory flows and is practiced under the guise of a custom, tradition or culture. In Spain, it is punishable as a personal injury offence under the current penal code. A clinical case study reviewedthe main actions of the midwife in this kind of injury in a pregnant woman during labour. The data collected from the physical examination and the midwife's assessment according to the Virginia Henderson model are presented and a complete care plan developed. From the case it can be concluded that in the hospital area, midwives can and should reinforce and complete the work with these women and their families, of informing, educating and reinforcing the decision not to mutilate. This work should have been started in, the health centre. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  1. Multiple intraepithelial neoplasias of the lower female genital tract: the reliability of HPV mRNA test.

    Science.gov (United States)

    Frega, Antonio; Sesti, Francesco; Sopracordevole, Francesco; Biamonti, Alberto; Votano, Sergio; Catalano, Angelica; Milazzo, Giusi Natalia; Gentile, Marco; Ricciardi, Enzo; French, Deborah; Moscarini, Massimo

    2014-04-01

    Human papillomavirus (HPV) is the most important pathogenetic factor of intraepithelial neoplasias of the lower genital tract. HPV-DNA and mRNA tests are applied for the management of epithelial dysplasias. The aims of this multicentric retrospective study were to compare the 2 molecular tests before the onset of metachronous intraepithelial lesions and to analyze the different characteristics between synchronous and metachronous lesions and their relationship to the pathologic mechanisms. The study concerns 55 cases of multiple intraepithelial neoplasias of the lower genital tract. Clinical features of patients with synchronous and metachronous lesions were analyzed. During a 3-year follow-up, HPV-DNA and mRNA tests were performed every 6 months after treatment of the initial lesion. HPV-DNA and mRNA results were analyzed 12 and 6 months before, at time of the onset of the metachronous lesion, and 6 months after its treatment. We observed 31 synchronous lesions and 24 metachronous lesions. Immunodeficiency and multiple genotypes were associated with the synchronous lesions (p = .04 and p = .02, respectively). During the follow-up, positive DNA and mRNA tests increased before the appearance of the metachronous lesion and decreased 6 months after; mRNA test was significantly better than the DNA test 6 months before the appearance of the lesion (p = .04) and at the time of its appearance (p = .02). Our results support the hypothesis that a positive HPV-mRNA test could be a marker of persistent infection and a risk factor for the onset of metachronous lesions.

  2. Evaluation of Immunoglobulin A1 (IgA1) Protease and IgA1 Protease-Inhibitory Activity in Human Female Genital Infection with Neisseria gonorrhoeae

    Science.gov (United States)

    Hedges, Spencer R.; Mayo, Matthew S.; Kallman, Lisa; Mestecky, Jiri; Hook, Edward W.; Russell, Michael W.

    1998-01-01

    Immunoglobulin A1 (IgA1) protease, an enzyme that selectively cleaves human IgA1, may be a virulence factor for pathogenic organisms such as Neisseria gonorrhoeae. Host protection from the effects of IgA1 protease includes antibody-mediated inhibition of IgA1 protease activity, and it is believed that the relative balance between IgA1 protease and inhibitory antibodies contributes to the pathogenesis of disease caused by IgA1 protease-producing organisms. We have examined the levels of these two opposing factors in genital tract secretions and sera from women with uncomplicated infection with N. gonorrhoeae. When IgA1 in cervical mucus was examined by Western blotting, no evidence of cleavage fragments characteristic of IgA1 protease activity was seen in gonococcus-infected or control patients. Cleavage fragments typical of IgA1 protease were detected, however, after the addition of exogenous IgA1 protease to cervical mucus. Degraded IgA1 was detected in some vaginal wash samples, but the fragment pattern was not typical of IgA1 protease activity. All N. gonorrhoeae isolates from the infected patients produced IgA1 protease in vitro. All but two serum samples and 16 of 65 cervical mucus samples displayed inhibitory activity against gonococcal IgA1 protease, but there was no significant difference in the level of inhibitory activity between gonococcus-infected and noninfected patients in either cervical mucus or serum. There was no difference in the levels of IgA1 protease-inhibitory activity in serum or cervical mucus collected from patients at recruitment and 2 weeks later. These results suggest that cleavage of IgA1 by gonococcal IgA1 protease within the lumen of the female lower genital tract is unlikely to be a significant factor in the pathogenesis of infections by N. gonorrhoeae. PMID:9826361

  3. A description of female genital mutilation and force-feeding practices in Mauritania: implications for the protection of child rights and health.

    Science.gov (United States)

    Ouldzeidoune, Nacerdine; Keating, Joseph; Bertrand, Jane; Rice, Janet

    2013-01-01

    To establish the prevalence of female genital mutilation (FGM) and force feeding (gavage) practices among children in Mauritania; to investigate factors related to FGM and gavage practices and attitude in Mauritania; and to explore implications related to the protection of children's rights and welfare. Data from the Mauritania 2000-2001 DHS were used in this analysis. Data were collected from men and women about their attitude toward the continuation of FGM and gavage; women only were asked if they ever experienced one of these practices. Chi-square statistics were used to investigate differences in attitude and practice of FGM and gavage by demographic characteristics. Binary logistic regression was used to identify socio-demographic factors related to FGM and gavage outcomes. The overall prevalence of FGM was 77% but varied depending on ethnicity. The majority of both female and male respondents favored the continuation of the practice (64% and 70%, respectively). Almost a quarter (23%) of women reported being force fed as a child and 32% of women and 29% of men approved the continuation of the practice. Gavage is almost exclusively practiced among Arabs. The practice of both FGM and gavage is ongoing, although the prevalence and attitude towards both appears to vary as a function of ethnicity, wealth, education, marital status, and age. Contextually relevant intervention and enforcement strategies are needed to challenge these cultural norms and protect the rights and welfare of children in Mauritania.

  4. A description of female genital mutilation and force-feeding practices in Mauritania: implications for the protection of child rights and health.

    Directory of Open Access Journals (Sweden)

    Nacerdine Ouldzeidoune

    Full Text Available OBJECTIVES: To establish the prevalence of female genital mutilation (FGM and force feeding (gavage practices among children in Mauritania; to investigate factors related to FGM and gavage practices and attitude in Mauritania; and to explore implications related to the protection of children's rights and welfare. METHODS: Data from the Mauritania 2000-2001 DHS were used in this analysis. Data were collected from men and women about their attitude toward the continuation of FGM and gavage; women only were asked if they ever experienced one of these practices. Chi-square statistics were used to investigate differences in attitude and practice of FGM and gavage by demographic characteristics. Binary logistic regression was used to identify socio-demographic factors related to FGM and gavage outcomes. FINDINGS: The overall prevalence of FGM was 77% but varied depending on ethnicity. The majority of both female and male respondents favored the continuation of the practice (64% and 70%, respectively. Almost a quarter (23% of women reported being force fed as a child and 32% of women and 29% of men approved the continuation of the practice. Gavage is almost exclusively practiced among Arabs. CONCLUSION: The practice of both FGM and gavage is ongoing, although the prevalence and attitude towards both appears to vary as a function of ethnicity, wealth, education, marital status, and age. Contextually relevant intervention and enforcement strategies are needed to challenge these cultural norms and protect the rights and welfare of children in Mauritania.

  5. Crossing borders: Discussing the evidence relating to the mental health needs of women exposed to female genital mutilation

    OpenAIRE

    Mulongo, Peggy; McAndrew, Sue; Hollins Martin, Caroline

    2014-01-01

    The terms ‘female circumcision’ (FC), ‘FG cutting’ (FGC) and ‘FG mutilation’ (FGM) refer to procedures involving the partial or total removal of the external female genitalia for non-medical reasons. In practicing countries, FGC/FC is more widely used, as it is believed to be inoffensive, providing more impartial ways of discussing the practice. Positive beliefs about FC/FGC include virginity, marriage prospects, family reputation, or passage to adulthood. Regardless of terminology, the pract...

  6. Adult Gli2+/-;Gli3Δ699/+ Male and Female Mice Display a Spectrum of Genital Malformation.

    Directory of Open Access Journals (Sweden)

    Fei He

    Full Text Available Disorders of sexual development (DSD encompass a broad spectrum of urogenital malformations and are amongst the most common congenital birth defects. Although key genetic factors such as the hedgehog (Hh family have been identified, a unifying postnatally viable model displaying the spectrum of male and female urogenital malformations has not yet been reported. Since human cases are diagnosed and treated at various stages postnatally, equivalent mouse models enabling analysis at similar stages are of significant interest. Additionally, all non-Hh based genetic models investigating DSD display normal females, leaving female urogenital development largely unknown. Here, we generated compound mutant mice, Gli2+/-;Gli3Δ699/+, which exhibit a spectrum of urogenital malformations in both males and females upon birth, and also carried them well into adulthood. Analysis of embryonic day (E18.5 and adult mice revealed shortened anogenital distance (AGD, open ventral urethral groove, incomplete fusion of scrotal sac, abnormal penile size and structure, and incomplete testicular descent with hypoplasia in male mice, whereas female mutant mice displayed reduced AGD, urinary incontinence, and a number of uterine anomalies such as vaginal duplication. Male and female fertility was also investigated via breeding cages, and it was identified that male mice were infertile while females were unable to deliver despite becoming impregnated. We propose that Gli2+/-;Gli3Δ699/+ mice can serve as a genetic mouse model for common DSD such as cryptorchidism, hypospadias, and incomplete fusion of the scrotal sac in males, and a spectrum of uterine and vaginal abnormalities along with urinary incontinence in females, which could prove essential in revealing new insights into their equivalent diseases in humans.

  7. Genital herpes

    OpenAIRE

    Hollier, Lisa M; Straub, Heather

    2011-01-01

    Genital herpes is an infection with herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2). The typical clinical features include painful shallow anogenital ulceration. It is among the most common sexually transmitted diseases, with up to 23% of adults in the UK and US having antibodies to HSV-2.

  8. Genital Herpes

    Science.gov (United States)

    ... best way to prevent genital herpes is abstinence. Teens who do have sex must properly use a latex condom every time ... reviewed: February 2016 More on this topic for: ... I Find Out If My Boyfriend Has an STD Before We Have Sex? Telling Your Partner You Have an STD View ...

  9. An exploration of attitudes towards female genital mutilation (FGM) in men and women accessing FGM clinical services in London: a pilot study.

    Science.gov (United States)

    Larsson, Martina; Cohen, Pollyanna; Hann, Gayle; Creighton, Sarah M; Hodes, Deborah

    2018-03-21

    This pilot study researched the attitudes towards and the knowledge of female genital mutilation (FGM) in adult women with FGM and their partners. The participant population consisted of English-speaking women and men over 18 years old attending specialist FGM clinics in two London hospitals. The participants completed a questionnaire on the attitudes and the knowledge of FGM, which were adapted with permission from the United Nations Children's Fund and the United States Agency for International Development household surveys. 54 participants (51 women, 3 men) took part in the surveys. 89% of participants thought that FGM should be stopped (95%CI: 0.81-0.97) and 72% said they knew FGM is illegal in the United Kingdom (UK). 15% reported that FGM caused no danger, or were unaware of any danger to women's health. This study demonstrates the opposition to FGM by participants, but some lack of knowledge regarding the legal and health implications. The exploration of attitudes in diaspora community groups is often cited as key to safeguarding girls from FGM. This is one of the first UK studies of individuals from FGM-practising communities, and we recommend use of the study questionnaires for a multicentre, cross-community study. Impact statement What is already known about this subject? Women and children are affected by female genital mutilation (FGM) globally and in the United Kingdom (UK). The majority of knowledge on practices and the attitudes towards FGM comes from UNICEF and USAID research in Africa and there is scant data on FGM practices in diaspora communities in the UK. What do the results of this study add? This study provides an appropriate questionnaire and protocol for use in community-based national research to improve healthcare for women by collecting up-to-date data on the attitudes towards FGM among the members of FGM-practising communities in the UK. What are the implications of these findings for clinical practice and further research? The

  10. Molecular Detecting of fungi and Bacteria in the ‎Blood of Patients With Genital System ‎Inflammatory Infection

    Directory of Open Access Journals (Sweden)

    Mohammad Ibrahim Khalil

    2017-12-01

    Full Text Available A PCR technique was used to detect fungi and bacteria in the blood of patients with inflammatory infection of genital system, three primer sets were used to detect E. Coli , Candida spp. and existence of other fungi  The results showed infection by both microorganisms. All patients had bacteria in the blood stream while 30 % of them had a Candida spp. and the same percentage of other fungi species in blood

  11. Effects of a traditional Chinese medicine, Longdanxiegan formula granule, on Toll-like receptor pathway in female guinea pigs with recurrent genital herpes.

    Science.gov (United States)

    Kuang, Lin; Deng, Yihui; Liu, Xiaodan; Zou, Zhixiang; Mi, Lan

    2016-04-01

    The aim of the present study was to investigate the effects of Longdanxiegan formula granule (LDXGFG), a Chinese traditional medicine on Toll-like receptor (TLR) pathway in recurrent genital herpes. An experimental recurrent genital herpes model was constructed using herpes guinea pig model. The effect of LDXGFG on expression levels of TLR pathway genes were detected using real-time polymerase chain reaction. Furthermore, the dendritic cells and Langerhans cells were isolated and the TLR pathway genes of these cells were assayed after LDXGFG treatment. The result suggested two different expression patterns of TLR pathway genes in genital herpes and recurrent genital herpes, including upregulated genes and downregulated genes. TLR1, TLR4, TLR6, TLR7, TLR8, TLR9, and TLR10 showed a significant decrease while, TLR2, TLR3, and TLR5 increased in genital herpes and recurrent genital herpes guinea pigs. Meanwhile, the downregulated genes in genital herpes and recurrent genital herpes were stimulated by LDXGFG. By contrast, the upregulated genes decreased significantly after LDXGFG treatment. In both dendritic cells and Langerhans cells, the TLR pathway genes exhibited same pattern: the LDXGFG corrected the abnormal expression of TLR pathway genes. The present results suggest that LDXGFG is an alternative, inexpensive, and lasting-effect medicine for herpes simplex virus 2 infection. Copyright © 2016. Published by Elsevier B.V.

  12. Cognitive behavioral therapy for post-traumatic stress disorder, depression, or anxiety disorders in women and girls living with female genital mutilation: A systematic review.

    Science.gov (United States)

    Adelufosi, Adegoke; Edet, Bassey; Arikpo, Dachi; Aquaisua, Ememobong; Meremikwu, Martin M

    2017-02-01

    Female genital mutilation (FGM) is associated with psychological consequences such as post-traumatic stress disorder (PSTD), depression, and anxiety disorders. Cognitive behavioral therapy (CBT), an empirically supported form of psychotherapy, may be an effective treatment for these psychological sequelae of FGM. To assess the effectiveness of CBT among individuals living with any type of FGM and diagnosed to have PTSD, depression, or anxiety disorders. CENTRAL, Medline, African Index Medicus, SCOPUS, PILOTS, POPLINE, PsycINFO, WHOLIS, LILACS, ERIC, NYAM Library, CINAHL, Web of Science were searched from inception up to August 10, 2015. Both randomized and nonrandomized studies comparing the efficacy of CBT to other forms of interventions for PTSD, depression, or anxiety disorders in individuals with FGM, were systematically reviewed. We did not identify any studies with eligible design that addressed the objective of the review. There are no included studies. Future studies need to look beyond establishing the prevalence and correlates of FGM to conducting well-designed, randomized controlled studies or well-designed interventional observational studies for the management of the psychological consequences of women and girls living with FGM. CRD42015024458. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  13. Antepartum or intrapartum deinfibulation for childbirth in women with type III female genital mutilation: A systematic review and meta-analysis.

    Science.gov (United States)

    Esu, Ekpereonne; Udo, Atim; Okusanya, Babasola O; Agamse, David; Meremikwu, Martin M

    2017-02-01

    There remains no consensus on the best timing of deinfibulation in women with type III female genital mutilation (FGM). To conduct a systematic review of the effects of antepartum or intrapartum deinfibulation on childbirth outcomes in women with type III FGM. The following major databases were searched: Cochrane Central Register for Controlled Trials (CENTRAL), MEDLINE, Scopus, Web of Science, and ClinicalTrials.gov, from inception until August 2015 without any language restrictions. Studies of pregnant women or girls with type III FGM who were deinfibulated antepartum or intrapartum were included. Two team members independently screened and collected data. Quality of evidence was assessed using GRADE. Summary odds ratios and proportions were calculated when possible. There is no evidence of a significant difference between antepartum and intrapartum deinfibulation for obstetric outcomes such as duration of labor, perineal lacerations, episiotomies, postpartum hemorrhage, and cesarean deliveries. Outcomes in women living with type III FGM and those who have undergone deinfibulation were not statistically different; however, trends show a benefit for deinfibulation. All studies were underpowered to detect statistical differences. Larger studies are required to have full confidence in these findings. CRD42015024464. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  14. Surgical and nonsurgical interventions for vulvar and clitoral pain in girls and women living with female genital mutilation: A systematic review.

    Science.gov (United States)

    Ezebialu, Ifeanyichukwu; Okafo, Obiamaka; Oringanje, Chukwudi; Ogbonna, Udoezuo; Udoh, Ekong; Odey, Friday; Meremikwu, Martin M

    2017-02-01

    Vulvar and clitoral pain are known complications of female genital mutilation (FGM). Several interventions have been used to treat these conditions. This review focuses on surgical and nonsurgical interventions to improve vulvar and clitoral pain in women living with FGM. To evaluate the impact of nonsurgical and surgical interventions for alleviating vulvar and clitoral pain in women living with any type of FGM and to assess the associated adverse events. The search included the following major databases: Cochrane Central Register for Controlled Trials (CENTRAL), MEDLINE, Scopus, Web of Science, and ClinicalTrials.gov. These were searched from inception until August 10, 2015 without any language restrictions. Study designs included randomized controlled trials, cluster randomized trials, nonrandomized trials, cohort studies, case-control studies, controlled before-and-after studies, historical control studies, and interrupted time series with reported data comparing outcomes among women with FGM who were treated for clitoral or vulvar pain with either surgical or nonsurgical interventions. Two team members independently screened studies for eligibility. No studies were included. Limited information exists on management of vulvar and clitoral pain in women living with FGM. This constitutes an important area for further research. CRD42015024521. © 2017 International Federation of Gynecology and Obstetrics.The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  15. Deinfibulation for preventing or treating complications in women living with type III female genital mutilation: A systematic review and meta-analysis.

    Science.gov (United States)

    Okusanya, Babasola O; Oduwole, Olabisi; Nwachuku, Nuria; Meremikwu, Martin M

    2017-02-01

    Deinfibulation is a surgical procedure carried out to re-open the vaginal introitus of women living with type III female genital mutilation (FGM). To assess the impact of deinfibulation on gynecologic or obstetric outcomes by comparing women who were deinfibulated with women with type III FGM or women without FGM. Major databases including CENTRAL, MEDLINE, and Scopus were searched until August 2015. We included nonrandomized studies that compared obstetric outcomes of women with deinfibulation, type III FGM (not deinfibulated during labor), and no FGM. Quality of evidence was determined following the GRADE methodology. Summary measures were calculated using odds ratios at 95% confidence intervals. We found no randomized controlled trials. We included four case-control studies. The quality of evidence was very low. Compared with women with type III FGM at delivery, deinfibulated women had a significant reduction in the risk of having a cesarean delivery or postpartum hemorrhage. Compared with women without FGM, deinfibulated women had a similar risk of episiotomy, cesarean delivery, vaginal lacerations, postpartum hemorrhage, and blood loss at vaginal delivery. The length of second stage of labor, mean maternal hospital stay, and Apgar scores less than 7 were also comparable. Low-quality evidence suggests deinfibulation improves birth outcomes for women with type III FGM. CRD42015024466. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  16. Prioritizing and synthesizing evidence to improve the health care of girls and women living with female genital mutilation: An overview of the process.

    Science.gov (United States)

    Stein, Karin; Hindin, Michelle J; Chou, Doris; Say, Lale

    2017-02-01

    Female genital mutilation (FGM) constitutes a harmful traditional practice that can have a profound impact on the health and well-being of girls and women who undergo the procedure. In recent years, due to international migration, healthcare providers worldwide are increasingly confronted with the need to provide adequate health care to this population. Recognizing this situation the WHO recently developed the first evidence-based guidelines on the management of health complications from FGM. To inform the guideline recommendations, an expert-driven, two-step process was conducted. The first step consisted of developing and ranking a list of priority research questions for the evidence retrieval. The second step involved conducting a series of systematic reviews and qualitative data syntheses. In the present paper, we first provide the methodology used in the development and ranking of the research questions (step 1) and then detail the common methodology for each of the systematic reviews and qualitative evidence syntheses (step 2). © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  17. Host Nectin-1 Promotes Chlamydial Infection in the Female Mouse Genital Tract, but Is Not Required for Infection in a Novel Male Murine Rectal Infection Model.

    Directory of Open Access Journals (Sweden)

    Jessica A Slade

    Full Text Available Chlamydia trachomatis is the most common bacterial sexually transmitted pathogen, but more than 70% of patients fail to seek treatment due to the asymptomatic nature of these infections. Women suffer from numerous complications from chronic chlamydial infections, which include pelvic inflammatory disease and infertility. We previously demonstrated in culture that host cell nectin-1 knockdown significantly reduced chlamydial titers and inclusion size. Here, we sought to determine whether nectin-1 was required for chlamydial development in vivo by intravaginally infecting nectin-1-/- mice with Chlamydia muridarum and monitoring chlamydial shedding by chlamydial titer assay. We observed a significant reduction in chlamydial shedding in female nectin-1-/- mice compared to nectin-1+/+ control mice, an observation that was confirmed by PCR. Immunohistochemical staining in mouse cervical tissue confirmed that there are fewer chlamydial inclusions in Chlamydia-infected nectin-1-/- mice. Notably, anorectal chlamydial infections are becoming a substantial health burden, though little is known regarding the pathogenesis of these infections. We therefore established a novel male murine model of rectal chlamydial infection, which we used to determine whether nectin-1 is required for anorectal chlamydial infection in male mice. In contrast to the data from vaginal infection, no difference in rectal chlamydial shedding was observed when male nectin-1+/+ and nectin-1-/- mice were compared. Through the use of these two models, we have demonstrated that nectin-1 promotes chlamydial infection in the female genital tract but does not appear to contribute to rectal infection in male mice. These models could be used to further characterize tissue and sex related differences in chlamydial infection.

  18. Presence of Ureaplasma diversum in the genital tracts of female dairy cattle in Mato Grosso State, Brazil.

    Science.gov (United States)

    Azevedo, Jaqueline B; Silva, Gustavo S; Rocha, Priscylla S; Pitchenin, Letícia C; Dutra, Valéria; Nakazato, Luciano; de Oliveira, Anderson Castro Soares; Pescador, Caroline A

    2017-02-01

    Ureaplasma diversum infection in bovine females may result in various reproductive problems, including granular vulvovaginitis, abortion, weak calves, salpingitis, and spontaneous abortion. The presence of U. diversum in a dairy bovine population from midwestern Brazil has not been established. The aim of this study was to determine whether U. diversum was present in dairy cattle from midwestern Brazil using polymerase chain reaction (PCR). Vulvovaginal mucus was analyzed from 203 cows located in six municipalities in the north region of Mato Grosso State, Brazil. A total of 25% of dairy cows with vulvovaginitis were positive for U. diversum. The factors evaluated were included in a multivariable logistic regression model with the presence of at least one positive cow in the herd serving as the dependent variable. Three variables were significantly associated with a U. diversum-positive PCR and were included in the final multivariable model: number of parities, vulvar lesions, and reproductive problems. For each new parity, the chance of U. diversum infection decreased 0.03-fold, indicating that cows with the highest number of parities were more protected. The presence of vulvar lesions was increased 17.6-fold in females positive for U. diversum, suggesting that this bacterium could be related to the red granular lesions in the vulvar mucosa, whereas reproductive problems were increased 7.6-fold. However, further investigations should be conducted to ascertain the effects of U. diversum in association with other mycoplasma species in the herds studied.

  19. Crossing borders: discussing the evidence relating to the mental health needs of women exposed to female genital mutilation.

    Science.gov (United States)

    Mulongo, Peggy; McAndrew, Sue; Hollins Martin, Caroline

    2014-08-01

    The terms 'Female Circumcision' (FC), 'FG Cutting' (FGC) and 'FG Mutilation' (FGM) refer to procedures involving the partial or total removal of the external female genitalia for non-medical reasons. In practicing countries, FGC/FC is more widely used, as it is believed to be inoffensive, providing more impartial ways of discussing the practice. Positive beliefs about FC/FGC include virginity, marriage prospects, family reputation, or passage to adulthood. Regardless of terminology, the practice exists in at least 28 African counties, and a few Asian and Middle Eastern countries. In Western society, FGM is considered a breach of human rights, being outlawed in a number of countries. With immigration trends, FGC is now prominent in Western society among practicing communities. While the past decade has seen an increase in studies and recommendations for health-care support related to the physical health consequences of FGM, little is known about the psychological impact and its management. For many girls and women, FGC is a traumatic practice, transforming it to FGM and affecting their mental health. This discussion paper focuses on evidence relating to the mental health consequences of FGM, therapeutic interventions, and the mental health nurse's role in addressing the needs of this group of women. © 2014 The Authors. International Journal of Mental Health Nursing published by Wiley Publishing Asia Pty Ltd on behalf of Australian College of Mental Health Nurses Inc.

  20. Eosinophil granule proteins ECP and EPX as markers for a potential early-stage inflammatory lesion in female genital schistosomiasis (FGS)

    DEFF Research Database (Denmark)

    Ramarokoto, Charles Emile; Kildemoes, Anna M. O.; Randrianasolo, Bodo Sahondra

    2014-01-01

    pathology, as viable schistosome egg granulomas often are eosinophil rich. Here it was investigated whether eosinophil granule proteins ECP (eosinophil cationic protein) and EPX (eosinophil protein-X) in urine and genital lavage can be used as markers for active FGS lesions. METHODS: Uro-genital samples...... with GSP. This could indicate that RP lesions might be more recently established and thus represent an earlier inflammatory lesion stage. CONCLUSION: ECP in genital lavage might be a future tool aiding the identification of FGS pathology at a stage where reversibility remains a possibility following...

  1. Male genital cancers.

    Science.gov (United States)

    Gilliland, F D; Key, C R

    1995-01-01

    The estimated 165,000 cancers of the male genital system that will occur in the United States during 1993 represent one fourth of the expected 600,000 newly diagnosed cancers in American males for the year. Data were collected by the Surveillance, Epidemiology, and End Results (SEER) program. This paper examines histologic data collected by the SEER program from 1973-1987 and focuses on incidence, stage at diagnosis, and survival for the dominant histologic types of cancer that occur in the four major topographic divisions of the male genital system: prostate gland, testis, penis, and scrotum. Some less common histologic types within each organ are also discussed. The incidence of male genital cancer has increased rapidly over the period of study. Cancers of the prostate, most of which are adenocarcinomas, represent more than 92% of all male genital cancers. Among adolescents and young men, germ cell cancers of the testis predominate, but decline rapidly in occurrence after 40 years of age. Blacks had higher incidence rates for prostate cancer than whites; however, the situation was reversed for testicular cancer. Survival increased dramatically for testicular cancer. Cancers of the penis and scrotum of any histologic type are uncommon in the United States. The increased incidence of prostate adenocarcinomas and testis germ cell tumors indicates the need for further etiologic studies as a basis for prevention efforts.

  2. Female genital mutilation/cutting in The Gambia: long-term health consequences and complications during delivery and for the newborn

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    Kaplan A

    2013-06-01

    Full Text Available Adriana Kaplan,1–3 Mary Forbes,4 Isabelle Bonhoure,2 Mireia Utzet,5 Miguel Martín,5 Malick Manneh,4 Haruna Ceesay41Chair of Social Knowledge Transfer/ Parc de Recerca UAB - Santander, Department of Social and Cultural Anthropology, Universitat Autònoma de Barcelona, Barcelona, Spain; 2Interdisciplinary Group for the Study and Prevention of Harmful Traditional Practices, Department of Social and Cultural Anthropology, Universitat Autónoma de Barcelona, Barcelona Spain; 3Wassu Gambia Kafo, Fajara F Section, Banjul, The Gambia; 4School of Enrolled Community Health Nurses and Midwives, Ministry of Health, Mansakonko, Lower River Region, The Gambia; 5Africa and Latin America Research Group, Unit of Biostatistics, Faculty of Medicine, Autonomus University of Barcelona, Barcelona, SpainBackground: Female genital mutilation/cutting (FGM/C is a harmful traditional practice deeply rooted in 28 Sub-Saharan African countries. Its prevalence in The Gambia is 76.3%. The objective of this study was to gain precise information on the long-term health consequences of FGM/C in The Gambia as well as on its impact on delivery and on the health of the newborns.Methods: Data were collected from 588 female patients examined for antenatal care or delivery in hospitals and health centers of the Western Health Region, The Gambia. The information collected, both through a questionnaire and medical examination, included sociodemographic factors, the presence or not of FGM/C, the types of FGM/C practiced, the long-term health consequences of FGM/C, complications during delivery and for the newborn. Odds ratios, their 95% confidence intervals, and P values were calculated.Results: The prevalence of patients who had undergone FGM/C was 75.6% (type I: 75.6%; type II: 24.4%. Women with type I and II FGM/C had a significantly higher prevalence of long-term health problems (eg, dysmenorrhea, vulvar or vaginal pain, problems related to anomalous healing (eg, fibrosis, keloid

  3. Hox gene expression in the embryonic genital system of the sea turtle Lepidochelys olivacea (Eschscholt, 1829), a species with temperature-dependent sex determination.

    Science.gov (United States)

    Sifuentes-Romero, Itzel; Merchant-Larios, Horacio; García-Gasca, Alejandra

    2010-09-01

    Hox genes are conserved transcription factors which regulate embryonic morphogenesis and differentiation. For the first time, we examined the quantitative and spatial expression of two Hox 5' genes, HoxD11 and HoxA13, in the developing genital system of the olive ridley Lepidochelys olivacea, a species with temperature-dependent sex determination. Quantitative and spatial expression patterns of both genes suggest a role in the female pathway rather than the male pathway. For instance, both genes, especially HoxA13, were expressed in the undifferentiated gonad during the thermosensitive period at a female promoting temperature, and downregulated in the differentiated gonad. By contrast, expression of both genes was low in gonads incubated at a male promoting temperature and did not change significantly in the differentiated gonad. Furthermore, we found high expression levels of HoxA13 in the paramesonephric duct at the male promoting temperature but not at the female promoting temperature, suggesting a role for this Hox gene in the partial regression of the Müllerian duct in males. Copyright 2010 Elsevier B.V. All rights reserved.

  4. Genital and extra-genital screening for gonorrhoea using the BD Probetec ET system with an in-house PCR method targeting the porA pseudogene as confirmatory test

    DEFF Research Database (Denmark)

    Skovgaard, Sissel; Larsen, Helle Kiellberg; Sand, Carsten

    2012-01-01

    for Chlamydia trachomatis testing were also examined for GC on the BD Viper™ platform using the BD Probetec ET system. In order to avoid false-positive results all GC BD reactive samples were re-tested using a PCR method with the porA pseudogene as target. Using this method we screened 170% more samples for GC...... than in the previous year, in the same population, and diagnosed more than twice as many GC-positive episodes. The BD system can be used successfully to screen extra-genital as well as genital specimen types for GC in a low-prevalence area if it is combined with a validated confirmatory PCR test....

  5. Factors associated with the support of pricking (female genital cutting type IV) among Somali immigrants - a cross-sectional study in Sweden.

    Science.gov (United States)

    Wahlberg, Anna; Johnsdotter, Sara; Ekholm Selling, Katarina; Källestål, Carina; Essén, Birgitta

    2017-08-08

    Pricking, classified as female genital cutting (FGC) type IV by the World Health Organization, is an under-researched area gaining momentum among diaspora communities. Our aim was to explore factors associated with being supportive of pricking among Somalis in Sweden. In a cross-sectional design, attitudes and knowledge regarding FGC, and measures of socioeconomic status, acculturation, and social capital, were assessed by a 49-item questionnaire in four municipalities in Sweden. Data were collected in 2015 from 648 Somali men and women, ≥ 18 years old, of which 113 supported the continuation of pricking. Logistic regression was used for the analysis. Those more likely to support the continuation of pricking were older, originally from rural areas, and newly arrived in Sweden. Further, those who reported that they thought pricking was: acceptable, according to their religion (aOR: 10.59, 95% CI: 5.44-20.62); not a violation of children's rights (aOR: 2.86, 95% CI: 1.46-5.61); and did not cause long-term health complications (aOR: 5.52, 95% CI: 2.25-13.52) had higher odds of supporting pricking. Religion was strongly associated with the support of pricking among both genders. However, for men, children's rights and the definition of pricking as FGC or not were important aspects in how they viewed pricking, while, for women, health complications and respectability were important. Values known to be associated with FGC in general are also related to pricking. Hence, there seems to be a change in what types of FGC are supported rather than in their perceived values.

  6. Evaluation of progress with using community conversation as a strategy to encourage district level abandonment of female genital mutilation and/or cutting in 10 districts in Ethiopia

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    Ellen Alem

    2013-10-01

    Full Text Available Background: Female genital mutilation and/or cutting (FGM/C, whilst widespread, is declining in Ethiopia; 81% of 45–49-year-old women were circumcised in a 2005 survey, and 62%of 15–19-year-olds. Objectives: This evaluation examined progress in abandoning FGM/C in ten woredas(districts where strategy based on the social convention theory had led to official declarations of abandonment and assessed if the strategy could accelerate the declining trend of the FGM/C practice in Ethiopia. Method: Quantitative and qualitative instruments collected data from a document review, a household survey (1275 households, in-depth and key informant interviews and focus group discussions. Results: Overall, there were encouraging results in terms of awareness creation and behavioural change to some extent. Sixty-nine percent of women and 41% of girls interviewed perceived a decline in the practice (range 40% – 90% after the declaration. Seventy-six percent of women said they would not circumcise girls in the future. The involvement of influential people such as religious leaders, elders, health extension workers, and law enforcement officials in the teaching contributed immensely to the awareness creation. However, some districts reports indicated the practice had gone underground. The costs of facilitating the strategy varied from USD 3 to 7 per person, with better results where costs were higher. The abandonment events tended to costaround 25% of total costs, an area where cost efficiency can be improved. Conclusion: The evaluation has informed the dialogue around the development of the country’s first national budgeted strategy that aims to accelerate the abandonment of all harmful traditionalpractices.

  7. Virility, pleasure and female genital mutilation/cutting. A qualitative study of perceptions and experiences of medicalized defibulation among Somali and Sudanese migrants in Norway.

    Science.gov (United States)

    Johansen, R Elise B

    2017-02-10

    The most pervasive form of female genital mutilation/cutting-infibulation-involves the almost complete closure of the vaginal orifice by cutting and closing the labia to create a skin seal. A small opening remains for the passage of urine and menstrual blood. This physical closure has to be re-opened-defibulated-later in life. When they marry, a partial opening is made to enable sexual intercourse. The husband commonly uses his penis to create this opening. In some settings, a circumciser or traditional midwife opens the infibulated scar with a knife or razor blade. Later, during childbirth, a further opening is necessary to make room for the child's passage. In Norway, public health services provide surgical defibulation, which is less risky and painful than traditional forms of defibulation. This paper explores the perceptions and experiences of surgical defibulation among migrants in Norway and investigates whether surgical defibulation is an accepted medicalization of a traditional procedure or instead challenges the cultural underpinnings of infibulation. Data derived from in-depth interviews with 36 women and men of Somali and Sudanese origin and with 30 service providers, as well as participant observations in various settings from 2014-15, were thematically analyzed. The study findings indicate that, despite negative attitudes towards infibulation, its cultural meaning in relation to virility and sexual pleasure constitutes a barrier to the acceptance of medicalized defibulation. As sexual concerns regarding virility and male sexual pleasure constitute a barrier to the uptake of medicalized defibulation, health care providers need to address sexual concerns when discussing treatment for complications in infibulated women. Furthermore, campaigns and counselling against this practice also need to tackle these sexual concerns.

  8. Application of seminal plasma to female genital tract prior to embryo transfer in assisted reproductive technology cycles (IVF, ICSI and frozen embryo transfer).

    Science.gov (United States)

    Ata, Baris; Abou-Setta, Ahmed M; Seyhan, Ayse; Buckett, William

    2018-02-28

    The female genital tract is not exposed to seminal plasma during standard assisted reproductive technology (ART) cycles. However, it is thought that the inflammatory reaction triggered by seminal plasma may be beneficial by inducing maternal tolerance to paternal antigens expressed by the products of conception, and may increase the chance of successful implantation and live birth. To assess the effectiveness and safety of application of seminal plasma to the female genital tract prior to embryo transfer in ART cycles. We searched the following databases from inception to October 2017: Cochrane Gynaecology and Fertility Group Specialised Register of Controlled Trials, Cochrane Central Register of Studies Online (CRSO), MEDLINE, Embase, CINAHL and PsycINFO. We also searched trial registers for ongoing trials, including International Clinical Trials Registry Platform (ICTRP) Search Portal and ClinicalTrials.gov. Other sources searched were; Web of Knowledge, OpenGrey, LILACS, PubMed, Google Scholar and the reference lists of relevant articles. We included randomised controlled trials (RCTs) conducted among women undergoing ART, comparing any procedure that would expose the female genital tract to seminal plasma during the period starting five days before embryo transfer and ending two days after it versus no seminal plasma application. Two review authors independently selected trials, assessed risk of bias, and extracted data. We pooled data to calculate relative risks (RRs) and 95% confidence intervals (CIs). We assessed statistical heterogeneity using the I 2 statistic. We assessed the overall quality of the evidence for the main outcomes using GRADE methods. Our primary outcomes were live birth rate and miscarriage rate. Secondary outcomes were live birth/ongoing pregnancy rate, clinical pregnancy rate, multiple pregnancy rate, ectopic pregnancy rate and the incidence of other adverse events. We included 11 RCTs (3215 women). The quality of the evidence ranged

  9. Genital tuberculosis: an important cause of ectopic pregnancy in India.

    Science.gov (United States)

    Sharma, Jai B; Naha, Moumita; Kumar, Sunesh; Roy, Kallol K; Singh, Neeta; Arora, Raksha

    2014-10-01

    To assess the role of genital tuberculosis as an etiological factor for ectopic pregnancy. A total of eighteen women of ectopic pregnancy with concomitant female genital tuberculosis and a total of one hundred thirty six patients of ectopic pregnancy over a period of three years were enrolled. Mean age of patients with ectopic pregnancy and concomitant female genital tuberculosis was twenty-six and mean parity was 0.7. Most of these patients were in poor socio-economic group. Diagnosis of female genital tuberculosis was made by presence of granuloma in histopathological examination of endometrial aspirate or tubal specimen, positive acid fast bacilli in microscopy or culture, positive polymerase chain reaction in endometrial tissue and positive findings of genital tuberculosis during laparoscopy or laparotomy. Genital tuberculosis was responsible for 13.2% of all cases of ectopic pregnancy in the present study. Genital tuberculosis appears to be an important cause of ectopic pregnancy in India.

  10. Association between injectable progestin-only contraceptives and HIV acquisition and HIV target cell frequency in the female genital tract in South African women: a prospective cohort study.

    Science.gov (United States)

    Byrne, Elizabeth H; Anahtar, Melis N; Cohen, Kathleen E; Moodley, Amber; Padavattan, Nikita; Ismail, Nasreen; Bowman, Brittany A; Olson, Gregory S; Mabhula, Amanda; Leslie, Alasdair; Ndung'u, Thumbi; Walker, Bruce D; Ghebremichael, Musie S; Dong, Krista L; Kwon, Douglas S

    2016-04-01

    The use of injectable progestin-only contraceptives has been associated with increased risk of HIV acquisition in observational studies, but the biological mechanisms of this risk remain poorly understood. We aimed to assess the effects of progestins on HIV acquisition risk and the immune environment in the female genital tract. In this prospective cohort, we enrolled HIV-negative South African women aged 18-23 years who were not pregnant and were living in Umlazi, South Africa from the Females Rising through Education, Support, and Health (FRESH) study. We tested for HIV-1 twice per week to monitor incident infection. Every 3 months, we collected demographic and behavioural data in addition to blood and cervical samples. The study objective was to characterise host immune determinants of HIV acquisition risk, including those associated with injectable progestin-only contraceptive use. Hazard ratios (HRs) were estimated using Cox proportional hazards methods. Between Nov 19, 2012, and May 31, 2015, we characterised 432 HIV-uninfected South African women from the FRESH study. In this cohort, 152 women used injectable progestin-only contraceptives, 43 used other forms of contraception, and 222 women used no method of long-term contraception. Women using injectable progestin-only contraceptives were at substantially higher risk of acquiring HIV (12·06 per 100 person-years, 95% CI 6·41-20·63) than women using no long-term contraception (3·71 per 100 person-years, 1·36-8·07; adjusted hazard ratio [aHR] 2·93, 95% CI 1·09-7·868, p=0·0326). HIV-negative injectable progestin-only contraceptive users had 3·92 times the frequency of cervical HIV target cells (CCR5+ CD4 T cells) compared with women using no long-term contraceptive (p=0·0241). Women using no long-term contraceptive in the luteal phase of the menstrual cycle also had a 3·25 times higher frequency of cervical target cells compared with those in the follicular phase (p=0·0488), suggesting that a

  11. Cosmetic genital surgery in children and adolescents.

    Science.gov (United States)

    Wood, Paul L

    2017-08-11

    Clinicians are faced with increasing requests for female cosmetic genital surgery and prominent amongst these is labiaplasty. The implications of labiaplasty in adolescence are explored with emphasis on what is known about normal genital appearances, pubertal development, anatomy and physiology and the options for surgical intervention including risks and implications. Faced with what is known to date on female cosmetic genital surgery then such interventions should be avoided in adolescence in the absence of defined medical indications until at least the age of 18 years. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Anatomy and physiology of genital organs - women.

    Science.gov (United States)

    Graziottin, Alessandra; Gambini, Dania

    2015-01-01

    "Anatomy is destiny": Sigmund Freud viewed human anatomy as a necessary, although not a sufficient, condition for understanding the complexity of human sexual function with a solid biologic basis. The aim of the chapter is to describe women's genital anatomy and physiology, focusing on women's sexual function with a clinically oriented vision. Key points include: embryology, stressing that the "female" is the anatomic "default" program, differentiated into "male" only in the presence of androgens at physiologic levels for the gestational age; sex determination and sex differentiation, describing the interplay between anatomic and endocrine factors; the "clitoral-urethral-vaginal" complex, the most recent anatomy reading of the corpora cavernosa pattern in women; the controversial G spot; the role of the pelvic floor muscles in modulating vaginal receptivity and intercourse feelings, with hyperactivity leading to introital dyspareunia and contributing to provoked vestibulodynia and recurrent postcoital cystitis, whilst lesions during delivery reduce vaginal sensations, genital arousability, and orgasm; innervation, vessels, bones, ligaments; and the physiology of women's sexual response. Attention to physiologic aging focuses on "low-grade inflammation," genital and systemic, with its impact on women sexual function, especially after the menopause, if the woman does not or cannot use hormone replacement therapy. © 2015 Elsevier B.V. All rights reserved.

  13. Genital Problems in Infants (Female)

    Science.gov (United States)

    ... Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea Ear Problems Elimination Problems Elimination Problems in Infants and Children Eye Problems Facial Swelling Feeding Problems in Infants ...

  14. The Coadministration of N-Acetylcysteine Ameliorates the Effects of Arsenic Trioxide on the Male Mouse Genital System

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    Raquel Frenedoso da Silva

    2016-01-01

    Full Text Available Arsenic trioxide (As2O3 has shown effectiveness in treatment of leukemia but is also associated with reproductive toxicity. Since remediation with N-acetylcysteine (NAC may mitigate the adverse effects caused by exposure, we assessed the effects of As2O3 and its potential reversibility after exposure cessation or coadministration of NAC. Animals received 0.3 or 3.0 mg/Kg/day of As2O3 subcutaneously and 40 mM of NAC in tap water. As2O3 treatment impaired spermatogenesis and sperm motility and decreased seminal vesicle weight and testosterone serum levels; after suspension of treatment, these parameters remained altered. When NAC was administered, animals showed improvement in sperm parameters and seminal vesicle weight. In vitro epididymal contractility was increased in As2O3-treated animals. We concluded that As2O3 is toxic to the male mouse genital system by compromising sperm quality and quantity; these effects persisted even after suspension of the treatment. However, the coadministration of NAC ameliorates the harmful effects of the drug on the male genital system.

  15. What do we know about assessing healthcare students and professionals' knowledge, attitude and practice regarding female genital mutilation? A systematic review.

    Science.gov (United States)

    Abdulcadir, Jasmine; Say, Lale; Pallitto, Christina

    2017-05-22

    Improving healthcare providers' capacities of prevention and treatment of female genital mutilation (FGM) is important given the fact that 200 million women and girls globally are living with FGM. However, training programs are lacking and often not evaluated. Validated and standardized tools to assess providers' knowledge, attitude and practice (KAP) regarding FGM are lacking. Therefore, little evidence exists on the impact of training efforts on healthcare providers' KAP on FGM. The aim of our paper is to systematically review the available published and grey literature on the existing quantitative tools (e.g. scales, questionnaires) measuring healthcare students' and providers' KAP on FGM. We systematically reviewed the published and grey literature on any quantitative assessment/measurement/evaluation of KAP of healthcare students and providers about FGM from January 1 st , 1995 to July 12 th , 2016. Twenty-nine papers met our inclusion criteria. We reviewed 18 full text questionnaires implemented and administered to healthcare professionals (students, nurses, midwives and physicians) in high and low income countries. The questionnaires assessed basic KAP on FGM. Some included personal and cultural beliefs, past clinical experiences, personal awareness of available clinical guidelines and laws, previous training on FGM, training needs, caregiver's confidence in management of women with FGM, communication and personal perceptions. Identified gaps included the medical, psychological or surgical treatments indicated to improve girls and women's health; correct diagnosis, recording ad reporting capacities; clitoral reconstruction and psychosexual care of circumcised women. Cultural and personal beliefs on FGM were investigated only in high prevalence countries. Few questionnaires addressed care of children, child protection strategies, treatment of short-term complications, and prevention. There is a need for implementation and testing of interventions aimed at

  16. Specific-pathogen-free pigs as an animal model for studying Chlamydia trachomatis genital infection.

    Science.gov (United States)

    Vanrompay, Daisy; Hoang, Thi Q T; De Vos, Liselotte; Verminnen, Kristel; Harkinezhad, Taher; Chiers, Koen; Morré, Servaas A; Cox, Eric

    2005-12-01

    The purpose of the present study was to evaluate pigs as a large-animal model for female genital infection with two Chlamydia trachomatis human serovar E strains. Sixteen-week-old specific-pathogen-free female pigs (gilts) were intravaginally infected with the trachoma type E reference strain Bour or the urogenital serovar E strain 468. Several conclusions can be drawn from our findings on the pathogenicity of a primary C. trachomatis genital infection in gilts. First of all, we demonstrated that the serovar E strains Bour and 468 could ascend in the genital tract of gilts. The serovar E strains could replicate in the superficial columnar cervical epithelium and in the superficial epithelial layer of the uterus, which are known to be the specific target sites for a C. trachomatis genital infection in women. Second, inflammation and pathology occurred at the replication sites. Third, the organisms could trigger a humoral immune response, as demonstrated by the presence of immunoglobulin M (IgM), IgG, and IgA in both serum and genital secretion samples. Our findings imply that the pig model might be useful for studying the pathology, pathogenesis, and immune response to a C. trachomatis infection of the genital system.

  17. Implications of Genital Mutilation at Autopsy.

    Science.gov (United States)

    Byard, Roger W

    2017-07-01

    Given the potential significance of mutilation of the external genitalia in medicolegal fatalities, a review of the literature was undertaken to identify subcategories. Such mutilations may have been sustained sometime before death, around the time of death, or after death. The most common type of ante mortem genital mutilations involves cultural practices such as male circumcision. Less common male mutilations such as subincisions are tribally based. Female genital mutilation is found particularly in African, Middle Eastern, or Asian populations. Self-inflicted genital injuries are most common in males and may be related to attempts at suicide, or to self-harming practices. The latter have a strong association with psychiatric illnesses. Postmortem injuries may arise from animal predation or deliberate mutilation of a corpse. The latter may be associated with ante mortem genital injuries in sadistic homicides. The range of possible causes of genital mutilations in forensic cases necessitates extremely careful evaluation. © 2017 American Academy of Forensic Sciences.

  18. New histochemical and morphological findings in the female genital tract of Boophilus microplus (Acari, Ixodidae: an attempt toward the elucidation of fertilization in ticks Novas características histoquímicas e morfológicas no trato genital feminino de Boophilus microplus (Acari: Ixodidae: uma tentativa para a elucidação da fertilização nos carrapatos

    Directory of Open Access Journals (Sweden)

    Casimiro García-Fernández

    2005-09-01

    Full Text Available At present not only is the site of fertilization in ticks still unknown but it is also unclear as to how this mystery can be solved. Signs of fertilization can be observed throughout the female genital tract and these can be clues for the elucidation of the unsolved questions relating to ticks fertilization. In Boophilus microplus (Canestrini, 1887 the most important signs are the following: the final eversion of the acrosomal canal in females ready for oviposition; the presence of small tubules, resembling the subplasmalemal process of the spermatozoon between the oviduct cells; budding nuclei throughout the female genital tract; and the two Feulgen and DAPI positive areas in the oocyte at vitelogenesis. These morphological characteristics suggest that fertilization takes place in the internal cylinder which extends from the uterus to the ovary itself.Até o momento, não só o lugar da fertilização em carrapatos é desconhecido, mas também não é claro como este mistério possa ser esclarecido. Sinais de fertilização podem ser observados ao longo do trato genital feminino e estes podem ser pistas para a elucidação das questões relacionadas à fertilização em ácaros. Em Boophilus microplus (Canestrini, 1887, os sinais mais importantes são os seguintes: a eversão final do canal acrossômico em fêmeas prestes à oviposição; a presença de pequenos túbulos assemelhando-se a processos subplasmalêmicos dos espermatozóides entre as células do oviduto; brotamentos nucleares ao longo do trato genital feminino e as duas áreas Feulgen e DAPI positivas nos ovócitos em processo de vitelogênese. Estas características morfológicas sugerem que a fertilização ocorra no cilindro interno, o qual se estende desde o útero até o ovário inclusive.

  19. Apoptosis modulation in the immune system reveals a role of neutrophils in tissue damage in a murine model of chlamydial genital infection.

    Science.gov (United States)

    Zortel, Tom; Schmitt-Graeff, Annette; Kirschnek, Susanne; Häcker, Georg

    2018-03-07

    Chlamydial infection frequently causes damage to the female genital tract. The precise mechanisms of chlamydial clearance and tissue damage are unknown but studies suggest immunopathology with a particular role of neutrophils. The goal of this study was to understand the contribution of the immune system, in particular neutrophils. Using Chlamydia muridarum, we infected mice with a prolonged immune response due to expression of Bcl-2 in haematopoietic cells (Bcl-2-mice), and mice where mature neutrophils are lacking due to the deletion of Mcl-1 in myeloid cells (LysM-cre-mcl-1-flox-mice; Mcl-1-mice). We monitored bacterial clearance, cellular infiltrate and long-term tissue damage. Both mutant strains showed slightly delayed clearance of the acute infection. Bcl-2-mice had a strongly increased inflammatory infiltrate concerning almost all cell lineages. The infection of Bcl-2-mice caused increased tissue damage. The loss of neutrophils in Mcl-1-mice was associated with substantial quantitative and qualitative alterations of the inflammatory infiltrate. Mcl-1-mice had higher chlamydial burden and reduced tissue damage, including lower incidence of hydrosalpinx and less uterine dilation. Inhibition of apoptosis in the haematopoietic system increases inflammation and tissue damage. Neutrophils have broad functions, including a role in chlamydial clearance and in tissue destruction.

  20. Systemic infection by equid herpesvirus-1 in a Grevy's zebra stallion (Equus grevyi) with particular reference to genital pathology.

    Science.gov (United States)

    Blunden, A S; Smith, K C; Whitwell, K E; Dunn, K A

    1998-11-01

    A severe multi-systemic form of equid herpesvirus-1 infection is described in an adult zebra stallion. There was multifocal necrotizing rhinitis, marked hydrothorax and pulmonary oedema, with viral antigen expression in degenerating epithelial cells, local endothelial cells and intravascular leucocytes of the nasal mucosa and lung. Specific localization of EHV-1 infection was seen in the testes and epididymides, including infection of Leydig cells and germinal epithelium, which would have facilitated venereal shedding of virus in life. The case provided a unique opportunity to study hitherto undescribed aspects of the pathogenesis of naturally occurring EHV-1 infection in the male equine genital tract. Restriction digests of the isolate demonstrated a pattern similar to that of EHV-1 isolates previously recovered from aborted zebra and onager fetuses.