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Zinka, B.; Bormann, C.; Graw, M.; Ackermann, I. (2018): Morphologische Befunde nach Verstümmelung des weiblichen Genitales. Untersuchungen afrikanischer asylsuchender Frauen und Mädchen. In: Gynäkologe, Vol. 51, No. 5: pp. 433-443
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Abstract

Background. Female genital mutilation (FGM) by partial or total removal of the external genital organs is carried out in more than 30 countries worldwide. Objectives. A retrospective analysis of 153 genital investigations was carried out to reveal the morphology of the different types of FGM and provide a basis for future assessments using a comprehensive picture material. Material and methods. At the request of the Federal Office for Migration and Refugees (BAMF), 153 female refugees from 6 different African countries were subjected to a genital examination for the determination of FGM. We systematically examined whether the clitoris, the prepuce of the clitoris, small and large labia were completely present, if we could find scars and whether the introitus was possibly surgically narrowed. The FGM findings were assigned to FGM types I (clitoridectomy), II (excision), III (infibulation) or IV (other) according to the World Health Organization (WHO) classification. Results. Of the examined women and girls (naEuro = 153) 109 came from Nigeria and 27 from Somalia. Of the examined females 52 had a condition corresponding to FGM, including 7 children and adolescents. Clitoridectomy was seen in 18 cases, excision in 30 cases, infibulation in 4 cases. Of the subjects with FGM type II, seven claimed that they had previously been exposed to infibulation and a delivery-related deinfibulation. Scars could be distinguished only rarely and were only slightly expressed. Conclusion. The removal of the clitoris and pupace of the clitoris could usually be easily determined, while the assessment of whether the large and small labia were completely present could be difficult. This was due to the fact that, in most cases, astonishingly no relevant scars could be defined. A differentiation between excision and infibulation in women with conditions after vaginal delivery was not possible.