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Autologous Platelet-Rich Plasma in Clitoral Reconstructive Surgery After Female Genital Mutilation/Cutting: A Pilot Case Study.

BACKGROUND
Post-operative healing after clitoral reconstruction (CR) for Female Genital Mutilation/Cutting (FGM/C) can be long and painful due to prolonged clitoral re-epithelialization time (3 months). Autologous Platelet-Rich Plasma (A-PRP) might reduce post operative clitoral epithelialization time and pain.


OBJECTIVES
We assessed post-op clitoral re epithelialization time and pain after the use of intraoperative clitoral administration of A-PRP.


METHODS
Five consecutive women underwent CR (Foldès technique) followed by the administration of A-PRP Regen Lab SA (Le Mont-sur-Lausanne, Switzerland) plasma and glue, respectively injected inside and applied above the re-exposed clitoris. We recorded surgical complications, post-operative clitoral pain (VAS), painkiller intake, time to complete re epithelialization and the experienced subjective changes in sexual response and perception of their own body image referred by women.


RESULTS
Sexual distress/dysfunction as well as the desire to be physically and symbolically "repaired" were the reasons behind women's requests for surgery. None of the women suffered from chronic vulvar or non-vulvar pain. All women achieved complete clitoral epithelialization by day 80. Three between day 54 and 70. Only one woman was still taking 1 g of Paracetamol twice a day at two-months post-op. She had stopped it before the three-month control. We did not have short nor long term complications. All women described easier access and stimulation of their clitoris, improved sexual arousal, lubrication, and pleasure, and said to be satisfied of their restored body image.


CONCLUSIONS
A-PRP could expedite post-op clitoral epithelialization and reduce post op pain after CR after FGM/C.