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Post Genital Mutilation Giant Clitoral Epidermoid Inclusion Cyst in Benin City, Nigeria

Abstract Objective To report overall occurrence, and the mode of presentation and management of girls with post genital mutilation giant clitoral epidermoid inclusion cyst in an African subregion. Methods This is a prospective experience with female patients who presented at two centers in Benin Cit...

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Published in:Journal of pediatric & adolescent gynecology 2010-12, Vol.23 (6), p.336-340
Main Author: Osifo, Osarumwense David, FWACS, FICS
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description Abstract Objective To report overall occurrence, and the mode of presentation and management of girls with post genital mutilation giant clitoral epidermoid inclusion cyst in an African subregion. Methods This is a prospective experience with female patients who presented at two centers in Benin City, Nigeria, between January 2005 and December 2009 with clitoral epidermoid inclusion cyst following underground traditional female genital mutilation performed on neonates. Results In total, 37 patients were seen with clitoral epidermoid inclusion cyst, 15 (40.5%) were post pubertal girls who could no longer cope with giant cyst that measured more than 3.5 × 6.5 cm in size at an average age of 17 (range 14–21) years. Ignorance, financial constraints, and the fear of possible prosecution by anti-female genital mutilation agencies were reasons for late presentation. Consequently, rapid increase in size of all cysts (100%), mass effect producing dragging discomfort in the vulva of 14 (93.3%) girls, social stigmatization of 12 (80%) girls by peers and spouses, sexual difficulty experienced by 10 (66.7%), and irritating bulge in the perineum of 10 (66.7%) girls, were the most common indications for surgical consultation. Outcomes of cystectomy that included total clitoridectomy performed on on an outpatient basis mainly with local anesthesia were encouraging with no incidence of recurrence recorded on 1-4 years postoperative follow-up. Conclusion Late presentation of girls with giant post genital mutilation clitoral epidermoid inclusion cysts was common. More campaigns against female genital mutilation and government policy aimed at encouraging patients with complications to seek early medical attention, and free treatment for those who present early are advocated.
doi_str_mv 10.1016/j.jpag.2010.02.006
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Methods This is a prospective experience with female patients who presented at two centers in Benin City, Nigeria, between January 2005 and December 2009 with clitoral epidermoid inclusion cyst following underground traditional female genital mutilation performed on neonates. Results In total, 37 patients were seen with clitoral epidermoid inclusion cyst, 15 (40.5%) were post pubertal girls who could no longer cope with giant cyst that measured more than 3.5 × 6.5 cm in size at an average age of 17 (range 14–21) years. Ignorance, financial constraints, and the fear of possible prosecution by anti-female genital mutilation agencies were reasons for late presentation. Consequently, rapid increase in size of all cysts (100%), mass effect producing dragging discomfort in the vulva of 14 (93.3%) girls, social stigmatization of 12 (80%) girls by peers and spouses, sexual difficulty experienced by 10 (66.7%), and irritating bulge in the perineum of 10 (66.7%) girls, were the most common indications for surgical consultation. Outcomes of cystectomy that included total clitoridectomy performed on on an outpatient basis mainly with local anesthesia were encouraging with no incidence of recurrence recorded on 1-4 years postoperative follow-up. Conclusion Late presentation of girls with giant post genital mutilation clitoral epidermoid inclusion cysts was common. More campaigns against female genital mutilation and government policy aimed at encouraging patients with complications to seek early medical attention, and free treatment for those who present early are advocated.</description><identifier>ISSN: 1083-3188</identifier><identifier>EISSN: 1873-4332</identifier><identifier>DOI: 10.1016/j.jpag.2010.02.006</identifier><identifier>PMID: 20685139</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Circumcision, Female - adverse effects ; Clitoris ; Epidermal Cyst - etiology ; Epidermal Cyst - surgery ; Epidermoid inclusion cyst ; Female ; Genital ; Humans ; Mutilation ; Nigeria ; Obstetrics and Gynecology ; Pediatrics ; Vulvar Diseases - etiology ; Vulvar Diseases - surgery ; Young Adult</subject><ispartof>Journal of pediatric &amp; adolescent gynecology, 2010-12, Vol.23 (6), p.336-340</ispartof><rights>North American Society for Pediatric and Adolescent Gynecology</rights><rights>2010 North American Society for Pediatric and Adolescent Gynecology</rights><rights>Copyright © 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. 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Methods This is a prospective experience with female patients who presented at two centers in Benin City, Nigeria, between January 2005 and December 2009 with clitoral epidermoid inclusion cyst following underground traditional female genital mutilation performed on neonates. Results In total, 37 patients were seen with clitoral epidermoid inclusion cyst, 15 (40.5%) were post pubertal girls who could no longer cope with giant cyst that measured more than 3.5 × 6.5 cm in size at an average age of 17 (range 14–21) years. Ignorance, financial constraints, and the fear of possible prosecution by anti-female genital mutilation agencies were reasons for late presentation. Consequently, rapid increase in size of all cysts (100%), mass effect producing dragging discomfort in the vulva of 14 (93.3%) girls, social stigmatization of 12 (80%) girls by peers and spouses, sexual difficulty experienced by 10 (66.7%), and irritating bulge in the perineum of 10 (66.7%) girls, were the most common indications for surgical consultation. Outcomes of cystectomy that included total clitoridectomy performed on on an outpatient basis mainly with local anesthesia were encouraging with no incidence of recurrence recorded on 1-4 years postoperative follow-up. Conclusion Late presentation of girls with giant post genital mutilation clitoral epidermoid inclusion cysts was common. More campaigns against female genital mutilation and government policy aimed at encouraging patients with complications to seek early medical attention, and free treatment for those who present early are advocated.</description><subject>Adolescent</subject><subject>Circumcision, Female - adverse effects</subject><subject>Clitoris</subject><subject>Epidermal Cyst - etiology</subject><subject>Epidermal Cyst - surgery</subject><subject>Epidermoid inclusion cyst</subject><subject>Female</subject><subject>Genital</subject><subject>Humans</subject><subject>Mutilation</subject><subject>Nigeria</subject><subject>Obstetrics and Gynecology</subject><subject>Pediatrics</subject><subject>Vulvar Diseases - etiology</subject><subject>Vulvar Diseases - surgery</subject><subject>Young Adult</subject><issn>1083-3188</issn><issn>1873-4332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><recordid>eNp9kU9v1DAQxSMEoqXwBTig3LiQZWwnjishJFi1S6XyRwIEN8vYs9WErLPYDtJ--060hQMHTvbMvPek-U1VPRWwEiD0y2E17N3NSgI3QK4A9L3qVJheNa1S8j7_wahGCWNOqkc5DwDQd9o8rE4kaNMJdX5affs05VJvMFJxY_1-LjS6QlOsN-RiqdcjlSnx5GJPAdNuolBfRT_OedGsD-ylWL9lO1dUDi_qD3SDidzj6sHWjRmf3L1n1dfLiy_rd831x83V-s1141sBpcEghVFoQMsQ0HTn2DqpW1DaBGj1VmKnEKU0XPTe9Gh4J1DgQtdx06uz6vkxd5-mXzPmYneUPY6jizjN2fZaCV66l6yUR6VPU84Jt3afaOfSwQqwC0872IWnXXhakJZ5sunZXfz8Y4fhr-UPQBa8OgqQl_xNmGz2hNFjoIS-2DDR__Nf_2P3I0XybvyJB8zDNKfI-KywmQ3283LR5aCCb8kgvqtb4QuZvg</recordid><startdate>20101201</startdate><enddate>20101201</enddate><creator>Osifo, Osarumwense David, FWACS, FICS</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20101201</creationdate><title>Post Genital Mutilation Giant Clitoral Epidermoid Inclusion Cyst in Benin City, Nigeria</title><author>Osifo, Osarumwense David, FWACS, FICS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c410t-ed2183e8062dde859e4a2640368d046f2e53ee2280467c87e8108030ad55280c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Circumcision, Female - adverse effects</topic><topic>Clitoris</topic><topic>Epidermal Cyst - etiology</topic><topic>Epidermal Cyst - surgery</topic><topic>Epidermoid inclusion cyst</topic><topic>Female</topic><topic>Genital</topic><topic>Humans</topic><topic>Mutilation</topic><topic>Nigeria</topic><topic>Obstetrics and Gynecology</topic><topic>Pediatrics</topic><topic>Vulvar Diseases - etiology</topic><topic>Vulvar Diseases - surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Osifo, Osarumwense David, FWACS, FICS</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric &amp; adolescent gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Osifo, Osarumwense David, FWACS, FICS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Post Genital Mutilation Giant Clitoral Epidermoid Inclusion Cyst in Benin City, Nigeria</atitle><jtitle>Journal of pediatric &amp; adolescent gynecology</jtitle><addtitle>J Pediatr Adolesc Gynecol</addtitle><date>2010-12-01</date><risdate>2010</risdate><volume>23</volume><issue>6</issue><spage>336</spage><epage>340</epage><pages>336-340</pages><issn>1083-3188</issn><eissn>1873-4332</eissn><abstract>Abstract Objective To report overall occurrence, and the mode of presentation and management of girls with post genital mutilation giant clitoral epidermoid inclusion cyst in an African subregion. 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subjects Adolescent
Circumcision, Female - adverse effects
Clitoris
Epidermal Cyst - etiology
Epidermal Cyst - surgery
Epidermoid inclusion cyst
Female
Genital
Humans
Mutilation
Nigeria
Obstetrics and Gynecology
Pediatrics
Vulvar Diseases - etiology
Vulvar Diseases - surgery
Young Adult
title Post Genital Mutilation Giant Clitoral Epidermoid Inclusion Cyst in Benin City, Nigeria
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