Epidermal clitoral inclusion cysts: not a rare complication of female genital mutilation

Abstract

Background: Although female genital mutilation (FGM) does not feature in Judeo-Christian populations, it is estimated that, 100-140 million women in the world have undergone some form of FGM. Given the increasing diversity of the western populations, a review of specific complications of FGM is of paramount importance to practicing clinicians. The objective of this study is to report a case series of epidermal clitoral inclusion cysts after FGM in a Muslim population primarily from the Middle East.

Methods: Between January 1998 and July 2009, 32 females underwent surgical removal of epidermal clitoral inclusion cysts in a tertiary referral university hospital. Data regarding age, clinical presentation, operation time, estimated blood loss, presence of intraoperative and post-operative complications, duration of admission to the hospital and long-term follow-up were extracted from the records.

Results: There were 15 women (46.9%) with a definitive history of FGM, 14 (43.8%) did not know whether they had FGM or not and 3 (9.3%) had no history of FGM and were excluded from the analysis. The mean age of subjects was 28.1 years (range 5-91 years). All presented with increasing clitoral mass over a mean duration of 5.2 +/- 4.1 years. The mean diameter of the cyst was 4.2 +/- 2 cm. Regarding treatment, 28 subjects underwent surgical excision, and one underwent incision and drainage of a clitoral abscess. No short- or long-term complications occurred.

Conclusions: Clitoral cysts appear to be a more common complication of FGM than previously thought. Publication of studies that highlight the medical complications of FGM should be encouraged to advocate abandonment of the procedure.