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

Background: Postoperative healing after clitoral reconstruction (CR) for female genital mutilation/cutting can be long and painful due to prolonged clitoral re-epithelialization time (up to 3 months). Autologous platelet-rich plasma (A-PRP) might reduce postoperative clitoral epithelialization time and pain. Objectives: The authors assessed postoperative clitoral re-epithelialization time and pain after intraoperative clitoral administration of A-PRP. Methods: Five consecutive women underwent CR (Foldes technique) followed by the administration of A-PRP Regen Lab SA (Le Mont-sur-Lausanne, Switzerland) plasma and glue, injected inside and applied above the re-exposed clitoris, respectively. We recorded surgical complications, postoperative clitoral pain (visual analogue scale), 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, 3 women between day 54 and 70, and only 1 woman was still taking 1 g of paracetamol twice a day at 2 months postoperative. She had stopped it before the 3-month control. There were no short- or long-term complications. All women described easier access and stimulation of their clitoris as well as improved sexual arousal, lubrication, and pleasure and claimed to be satisfied with their restored body image. Conclusions: A-PRP could expedite postoperative clitoral epithelialization and reduce postoperative pain after CR after female genital mutilation/cutting.

Automated summary

This study assessed the effect of intraoperative administration of autologous platelet-rich plasma (A-PRP) on postoperative clitoral re-epithelialization time and pain. The results showed that all women achieved complete clitoral epithelialization within 80 days, with 3 women completing it between day 54 and 70. Only one woman was still taking painkillers at 2 months postoperative, but had stopped by the 3-month follow-up. All women reported improved clitoral access, stimulation, sexual arousal, lubrication, and pleasure, and were satisfied with their restored body image.