Introduction: Female Genital Bilharzia (FGB) is a pathology secondary to infection by Schistosoma haematobium. It is one of the neglected tropical diseases, capable of causing infertility, difficulties in childbirth a...Introduction: Female Genital Bilharzia (FGB) is a pathology secondary to infection by Schistosoma haematobium. It is one of the neglected tropical diseases, capable of causing infertility, difficulties in childbirth and even cervical cancer. It represents a real public health problem. We therefore conducted a study in the maternity ward of the Saint-Louis regional hospital, with the overall aim of determining the prevalence of FBG in patients undergoing colposcopy. The specific objectives were to define the patient profile, and to compare colposcopic images with the World Health Organization (WHO) atlas. Methodology: We conducted a descriptive, analytical cross-sectional study of all colposcopic images taken at the maternity ward of the Saint-Louis regional hospital from August 1, 2018, to September 30, 2020, i.e. 25 months. The images were compared with the BGF images described in the WHO atlas. Results: We collected 178 colposcopy images. FBG images numbered 50, or 28%. The mean age of the patients was 44.5 years ±11.4 at the extremes of 18 and 78 years. Mean gestational age was 4.69 ± 2.72. Among patients with a bilharzian lesion on the cervix, visual acid inspection (VIA) was negative in 60% of cases (p = 0.007, Odd Ratio = 3.6 (1.49 - 9.07)). Conclusion: the results of our study show that FBG is a reality in our daily practice. It occurs in adult, multigestating, non-occupational women whose examination reveals a negative visual inspection with acetic acid (VIA). Healthcare providers therefore need to be trained in the recognition of lesions associated with genital bilharziasis, and public awareness needs to be raised.展开更多
Background: Female Genital Mutilation is still practiced in Ebonyi State in Southeast Nigeria, despite the complications that follows it and government legislation against the practice. Aim: To determine the impact of...Background: Female Genital Mutilation is still practiced in Ebonyi State in Southeast Nigeria, despite the complications that follows it and government legislation against the practice. Aim: To determine the impact of Culture, Beliefs, attitude and Peer Group Influence on the persistence Female Genital Mutilation practice in the State especially in the rural areas. Materials and Methods: Qualitative study that used Focused Group Discussion and In-depth interviews for data collection. Those willing and given consent were recruited into the group discussion according to age, marital status, educational level and their location in the state. In-depth interviews were used with the Stake Holders, Opinion Leaders, Traditional Rulers and the Clergy. Result: A total of 454 participants were recruited from the 13 local government areas of Ebonyi State but only 420 (92.5%) participated. The age ranges of participants were 25 to 35 years for single males and females while the married participants male and female were aged 35 to 70 years. One hundred single females (23.8%) and 94 single males (21.4%) participated while 97 (23.1%) married women and 95 (22.6%) married men participated. Out of the 26 health workers recruited only 22 (5.2%) participated. Four traditional rulers, 4 women leaders, 4 youth leaders and 2 clergy 12 (2.9%) in number had in-depth interviews. All the participants had knowledge of FGM and its practice. Rural health workers are getting more involved. ‘Female Genital Crushing’ is replacing actual cutting. The participants all agreed there is no benefit and the practice should stop. Conclusion: Female Genital Mutilation is secretly practiced and is getting replaced by “Female Genital Crushing” perpetrated by rural health workers as well as mothers, fathers, traditional birth attendants and the peer group playing a major role with low knowledge of the Law against Female genital mutilation.展开更多
Background: The practice of female genital cutting as a cultural obligation is widespread in Kenya but there is little consensus about its effects on health. Some of the health risks associated with female genital cut...Background: The practice of female genital cutting as a cultural obligation is widespread in Kenya but there is little consensus about its effects on health. Some of the health risks associated with female genital cut range from minor and short-term to major and long-term effects including pain, bleeding, infections, and, in the extreme, death. Female genital cut is widespread among the Kisii but there is no adequate information about how it is currently practised and the value people attach to it. Objective: The objective was to establish the value of female genital cut as well as the health risks associated with the practice among the Kisii community of western Kenya. Methods: This was a cross-sectional study, which employed a mixed method approach to generate both quantitative and qualitative data. The quantitative data were obtained from a randomly selected sample of 373 respondents while quantitative data were generated from focus group discussions as well as key informants interviews. Results: The Kisii consider female genital cut a cultural identifier inherited from past generations and whose main value is a rite of passage from girlhood to womanhood. Majority (63%) had heard of the health risks associated with female genital cut including transmission of infections, excessive bleeding and pain. But most of the community did not seem to know the long-term health consequences associated with female genital cut. Even though knowledge on the campaigns to eradicate the practice was found to be wide spread, the community’s response toward the campaigns was less than positive. Conclusions: The authors conclude that female genital cut continues to persist in this community because of its value as a rite of passage, which currently has no substitute. This cultural demand by far outweighs the health risks associated with female genital cut, which are being mitigated through medicalization of the practice. For intervention programmes to succeed a more culturally sensitive campaign that is acceptable or appropriate alternative rite of passage is required.展开更多
Objective: The aim of this study is to evaluate the acute and long-term effects of female genital mutilation (FGM) among women in Sharkia Governorate. Method: This was a cross-sectional descriptive study carried out i...Objective: The aim of this study is to evaluate the acute and long-term effects of female genital mutilation (FGM) among women in Sharkia Governorate. Method: This was a cross-sectional descriptive study carried out in Zagazic University Hospital (ZUH) over a two years period from January 2012 to January 2014. The overall sample consisted of 1500 women. An interview was utilized to collect the necessary data. The questionnaires were administered face to face, in Arabic language. Four open and 25 close-ended questions were used to collect socio-demographic data of the sample: women’s experience about the circumcision, occurrence of health hazards after circumcision, and sexual effects on married women. Intention of all women (circumcised or not) to circumcise?their daughters was also documented. Results: This study revealed that the prevalence of FGM in?Sharkia Governorate was about 85.5%. The majority of circumcised women were Muslims (94.4%), married (87.9%), housewife (81.4%), illiterate or with low education level (45.5% and 38.5% respectively) and from rural areas (82.2%). The most common types of FGM were type I (49.2%) and type II (50.8%). The most common motive of FGM was the religious cause (46.6%). The majority of circumcised women (59%) denied the occurrence of any acute complication. The reported acute complications in this study were bleeding (19.6%), urine retention (2.3%), infection (6.3%) and difficult walking (12.8%). The majority of circumcised women (86%) denied the occurrence of any problems at labor related to circumcision. The reported problems at labor in this study were narrowing of introitus (8.4%), laceration (0.7%) and bleeding (4.9%). In this study, 74.6% of circumcised women believed that there was no effect of circumcision on their sexual satisfaction and 92.1% of circumcised women believed that there was no effect of circumcision on their husband’s sexual satisfaction. Approximately 16% of circumcised women complained of dyspareunia and believed that it was related to circumcision. Conclusion: Female circumcision is deeply rooted in our community and laws alone will not eradicate it. Moreover, this approach may drive it underground. Increased media coverage, statements by ministers, religious leaders and non-governmental organizations may lead to increased discussion of the topic at a local level. Spreading the message by means of pictures, song and drama as well as economic development will be more effective.展开更多
Background: Female Genital Mutilation/Cutting (FGM/C) often has lifelong negative consequences for a woman’s physical and mental health but is still practiced in some parts of Kenya including Kajiado County. We aimed...Background: Female Genital Mutilation/Cutting (FGM/C) often has lifelong negative consequences for a woman’s physical and mental health but is still practiced in some parts of Kenya including Kajiado County. We aimed to estimate the current prevalence as well as the socio-cultural beliefs and power relations that are in favor of or against the practice in Kajiado, Kenya. Methods: A mixed method cross-sectional study was conducted in Kajiado County. The study targeted: women of reproductive age (15 to 49 years);community health volunteers (CHVs);opinion leaders;health care workers;officials from the ministries of Education, Health, Culture, Gender and Social Services;Community Health Assistants (CHAs);Traditional Birth Attendants (TBAs);teachers;morans and adolescent boys and girls aged 10 to 24 years. Data were collected both quantitatively through a household questionnaire and qualitatively through the focus group discussions and key informant interviews. Factors influencing Female Genital Mutilation/Cutting (FGM/C) were classified as either social, cultural beliefs or economic. Results: From the study, quantitative results revealed that the prevalence of FGM/C in Kajiado County was 91%, with most of them (96.7%) practicing type 2 (excision) circumcisions. From the interviews, girls undergo the cut as a rite of passage to womanhood and thus a prerequisite for marriage. It is also believed that girls who are uncircumcised cannot be helped by TBAs in delivery. It is believed that their blood is poisonous and can cause bad omen to whoever comes in contact with dirty blood. Additionally, it is believed that girls go through the cut to avoid conflict and natural phenomena;for instance, drought and outbreaks of diseases that kill many people. Finally, it is a practice that earns respect for the parents of the girls and incentives as dowry to the father of the girl. TBAs that perform FGM/C get paid in cash and kind. Conclusion: Female genital mutilation/cutting practice in Kajiado County is still high. Efforts to end the practice will need to have an integrated approach to include all the players. Suggested alternatives to the cut must, therefore, be inclusive so as to address the myths/beliefs, misconceptions, socio-cultural and economic factors in favor of the vice. The alternatives must be inclusive for the beneficiaries, supporters, and practitioners.展开更多
Female genital mutilation (FGM) is partial or total excision of female external genitalia or other deliberate injury to the female genital organs for non-therapeutic purpose. It is cultural and traditional practice. F...Female genital mutilation (FGM) is partial or total excision of female external genitalia or other deliberate injury to the female genital organs for non-therapeutic purpose. It is cultural and traditional practice. Female genital mutilation may result in immediate complications such as severe pain and bleeding and long-term complications such as: psychological, psychosexual, trauma, infertility, urinary and genital complications.展开更多
Introduction: Female Genital Mutilation (FGM) is a public health problem. There are 100 to 140 million girls and women who suffer every year in the world [1]. The aim of this study is to improve the medical care and r...Introduction: Female Genital Mutilation (FGM) is a public health problem. There are 100 to 140 million girls and women who suffer every year in the world [1]. The aim of this study is to improve the medical care and reduce complications of FGM at the Regionalhospital of N’zérékoré, to determine their frequency, and to evaluate the maternal-fetalprognosis. Methods: The study was conducted at the Regional Hospital of N’zérékoré. This was a cross-sectional, descriptive and analytic study of 6 months, from 1 September 2016 to 28 February 2017, including all pregnant women admitted for childbirth who had a complication of female genital mutilation. Results: A total of 1295 women gave birth in the service, of which 1204 women were women with female genital mutilation. Given a frequency of 92.97%, of these 1204 mutilated women, 223 presented obstetrical complications during their delivery, a proportion of 17.22%. They were mostly young patients, mostly housewives who were not in school. Type II FGM was the most common (53.06%). Obstetric complications were dominated by complicated perinatal tears (54.08%), and hemorrhages (40.81%). The catch was dominated by perineorrhaphy. Conclusion: The frequency of FGM was 92.97% and that of their obstetric complications 17.22%. Most were house-wives, not in school. There was FGM type II. The abandonment of FGM would reduce maternal and perinatal morbidity and mortality.展开更多
Background: Female genital mutilation (FGM) or female circumcision is all procedures involving partial or total removal of the external female genital organ or other injuries to the female genital organ whether for cu...Background: Female genital mutilation (FGM) or female circumcision is all procedures involving partial or total removal of the external female genital organ or other injuries to the female genital organ whether for cultural or any other non-therapeutic reasons. Female genital mutilation causes numerous complications. Four in such cases multiplies obstetric complications. The aim of this study was to identify obstetric complications due to FGM. Patients and Material: We conducted a comparative prospective case-control study for three months, from January 1st to March 31st, 2014 in the maternity of N’Djamena Mother and Child. It focused on identifying neonatal and/or maternal complications during childbirth due to FGM. The study population consisted of pregnant women at term admitted for delivery labor. All parturients had to present the same sociodemographic and clinical profiles. A history of FGM was the main distinguishing criterion. Results: During the study period, we recorded 312 births to women with genital mutilation, among 1905 deliveries, representing a prevalence of 16.4%. One hundred ninety-one cases of circumcised women responding to the inclusion criteria were selected. Most of these women were between the ages of 20 and 29. The extreme age group was 15 and 39 (with a mean of 24.5 years). FGM was significant in age group over 20 years (Khi2 = 10.8;OR = 2.6 [1.4 - 4.9];P = 0.001). The type II of FGM which removed a part of the clitoris and the adjacent labia minora represented 64.40% patients in the group of women with FGM. Perinea laceration was the frequent maternal complication among parturient with FGM (Khi2 = 9.8;OR = 2.2 [1.4 to 3.6];P = 0.0007). FGM type III was associated with a high proportion of maternal complication (Khi2 = 11.2;OR = 7.3 [1.97 - 31.6];P = 0.0001). Still births were significantly higher in the group of parturient with FGM (11.5%, P = 0.015). Conclusion: Female genital mutilation is a common cultural practice in our country;it contributes to worsening maternal and fetal complications.展开更多
Background: Current evidence has focused on the complications of female genital mutilation/cutting (FGM/C) types 2 and 3, and there is a gap in the knowledge of the complications of FGM/C types 1 and 4, which are ofte...Background: Current evidence has focused on the complications of female genital mutilation/cutting (FGM/C) types 2 and 3, and there is a gap in the knowledge of the complications of FGM/C types 1 and 4, which are often considered milder forms of cutting. Case Presentation: A 23-year-old Somali woman with FGM/C was referred for chronic clitoral pain and superficial dyspareunia after several inconclusive gynecological examinations. Her clitoris was found to be entrapped under the scar of the cut clitoral hood. We surgically lysed the scar and reconstructed a prepuce. At the two-month follow-up, the patient reported no pain and physiologic sexual response. Conclusion: Clitoral pain and dyspareunia after FGM/C can be due to the incarceration of the clitoral glans. Treatment is surgical lysis of the scar.展开更多
<p> <b><span style="font-family:Verdana;">Introduction: </span></b><span style="font-family:""><span style="font-family:Verdana;">Female gen...<p> <b><span style="font-family:Verdana;">Introduction: </span></b><span style="font-family:""><span style="font-family:Verdana;">Female genital fistula (FGF), remains a world concern, especially in low developed country. Obstructive (blocked) delivery labor is his principal cause, sometimes by pelvic surgery (urogenital or obstetrical, rectal) more rarely by congenital urogenital malformation, excision, pelvic neoplasm, pelvic radiotherapy. We were interested in iatrogenic FGF treated in the special referral fistula center. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">We report 35 cases of iatrogenic female genital fistula. Are included only cases by urogenital surgery, excision in the National Referal Center of Obstetrical Fistula. Were not included cases happened by over 12 hours blocked delivery labor, caustic destruction, pelvic cancer pelvic infection and those with incomplete file. The epidemiologic, clinical and therapeutic information were studied. All ethical protocols were respected. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">CNRFO recorded 743 cases of female genital fistula from May 23 2013 to May 23 May 2018 within 35 iatrogenic cases (4.71%). Patients were 19 - 29 years old (42.85%), average age 35 years old, extremes 19 - 60 years, without occupation (82.86), grand multiparous 48.57%, with a mean of 4 previous deliveries. The principal constancies were hysterectomies 71.43%, caesarean section 17.14%, genital excision 11.42%, and cystocele cure 11.42%. The anatomical finds were soft vagina tissue 97.14% uretero-vaginal fistula 45.71% (2 cases post Caesarean, 14 cases post hysterectomy), vesico-vaginal 31.43% (all post hysterectomy), ureteral 11.42% (all post caesarean), 1 vesico-uterine 5.71% (case post caesarean), 1 case after a cystocele cure, 2 uretro-vaginal 11.42% secondary of genital excision. Treatment was ureteral reimplantation (18/31) cases by abdominal way, fistulorraphy (12/31) and 1uretroplasty by vaginal, 4 cases treated with transurethral bladder probe. 30 were cured by fistulas surgery, 1 urinary tress incontinency and 1 not closed, and 4 of transurethral bladder probe were cured. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The female genital fistula is sometimes the consequence of Caesarean, hysterectomy, gynecological surgery, urologic surgery and some traditional practices.</span></span> </p>展开更多
Female genital mutilation/cutting(FGM/C)is a harmful traditional practice with severe health implications among women and girls.This study determined whether knowledge reduced the practice of female genital mutilation...Female genital mutilation/cutting(FGM/C)is a harmful traditional practice with severe health implications among women and girls.This study determined whether knowledge reduced the practice of female genital mutilation and identified the socio-demographic factors that predicted the practice of female genital among parents in Ekiti State,Nigeria.A cross-sectional quantitative research method was employed among 600 selected parents in the three senatorial districts of Ekiti-State,Nigeria between March and June 2019.A pretested structured questionnaire was used to collect data.Our analysis revealed that 468(78%)of the respondents believed that the practice was high as against 132(22%)who said the practice was low.Female is two times more likely to practice FGM than male(OR=1.614,B=0.479,p<0.05,CI=1.088-2.394).Respondents with low knowledge were significantly 11 times likely to practice female genital mutilation compared with respondents with high knowledge(OR=10.597,B=2.361,p<0.05,CI=6.813-16.483).Those who lived in rural areas were two times significantly(OR=1.690,B=0.525,p<0.05,CI=3.246-13.197)likely to practice female genital mutilation than the urban dwellers.The study concluded that respondents’knowledge,location(urban/rural),sex,age,and ethnicity were strong predictors of the practice of FGM/C in Ekiti-State,Nigeria.With these findings in mind,the community institutions would play a great role in changing the community through spreading information about the health implications of FGM/C for the practice to be drastically reduced.展开更多
Female genital mutilation (FGM) is still a topical practice in several African regions or countries. They constitute a violation of human rights, in particular because of their harmful consequences for the health of t...Female genital mutilation (FGM) is still a topical practice in several African regions or countries. They constitute a violation of human rights, in particular because of their harmful consequences for the health of the people who suffer them and are the source of various complications. We report a case of FGM complications in the form of total coalescence of the labia majora with a small hole from which urine flows permanently. The management was a disinfubilation with suturing of the edges and urethral reimplantation and the evolution was favorable with complete healing after two (2) weeks.展开更多
With advances in the standards of living and public perceptions,female genital cosmetic surgery is becoming a new hot topic in the field of plastic surgery,gaining considerable interest recently among beauty seekers a...With advances in the standards of living and public perceptions,female genital cosmetic surgery is becoming a new hot topic in the field of plastic surgery,gaining considerable interest recently among beauty seekers and professionals alike.However,the needs of beauty pursuers seem to be exuberant but vague;on the other hand,practitioners who have received strict professional training are still desperately needed.Additionally,interestdriven marketing and promotion render the field prone to chaos,resulting in widespread attention and concerns regarding the scientificity,safety,effectiveness,and necessity of the performance of multiple treatment procedures.Extensive survey of the relevant literature was performed,and several beauty seekers as well as surgeons with working experience of pertinent techniques were consulted,in order to examine the current status and future developments of this field.展开更多
OBJECTIVE To analyze the clinical characteristics,pathologic diagnosis,treatment and prognosis of amelanotic melanoma in the female genital tract(AMFGT).METHODS The medical records of 6 patients with AMFGT between 199...OBJECTIVE To analyze the clinical characteristics,pathologic diagnosis,treatment and prognosis of amelanotic melanoma in the female genital tract(AMFGT).METHODS The medical records of 6 patients with AMFGT between 1991 and 2006 in our hospital were reviewed.RESULTS Of these cases,4 were preliminarily misdiagnosed as chorioepithelioma,sarcoma,adenocarcinoma or lymphoma.Two patients were determined to have AMFGT preoperatively after positive immunohistochemical staining for both S-100 protein and HMB-45.Specimens removed from all 6 cases were tested for immunohistochemical staining,as well as H&E histochemical stains.S-100 and vimentin were both positive in all patients,and HMB-45 was positive in 3 out of 5 patients.Four patients recurred(at 6,6,12 and 19 months) a er primary treatments.Three patients died(at 13,18 and 19 months) a er the initial diagnosis.CONCLUSION Because of an absence of pigmentation AMFGT is extremely difficult to diagnose.Combined immunohistochemical staining,such as the S-100 protein,HMB-45 and vimentin etc,is important in the evaluation of AMFGT.Correct diagnosis plays a crucial role in the treatment of this disease.展开更多
Objective:This study aims to offer an update assessment of the knowledge of Chinese oncologists on female fertility preservation,and identify the determinants that influence the implementation of fertility preservatio...Objective:This study aims to offer an update assessment of the knowledge of Chinese oncologists on female fertility preservation,and identify the determinants that influence the implementation of fertility preservation.Methods:A total of 713 Chinese oncologists with different specialties completed the online self-report questionnaire to assess their understanding of fertility risks in cancer treatment,knowledge on female fertility preservation,and perceptions on the barriers in referring patients for fertility preservation.Results:Although most oncologists were familiar with fertility risk in cancer treatment,half of them lacked the knowledge for reproduction and preservation methods.In the multivariable model,oncologists in a hospital with a specialized reproductive institution,positive precaution for fertility risk,and fertility preservation discussion with patients were significantly correlated with the possibility of fertility preservation referral.Conclusions:The intervention targets based on the update evaluation and identified influencing determinants will be helpful for all the oncofertility researchers,oncologists and institutions in future efforts for well-established female fertility preservation services.展开更多
Background Women’s health in resource-limited settings can benefit from the integrated management of high-burden diseases,such as female genital schistosomiasis(FGS)and human papilloma virus(HPV)-related cervical can...Background Women’s health in resource-limited settings can benefit from the integrated management of high-burden diseases,such as female genital schistosomiasis(FGS)and human papilloma virus(HPV)-related cervical cancer.In schistosomiasis-endemic countries such as Madagascar,data on FGS and HPV prevalence are lacking as well as preventive measures for both conditions.This study aims to estimate the prevalence of FGS and HPV in rural Madagascar,and to examine associated risk factors to identify opportunities for improving women’s health.Methods After initial community outreach activities,interested women aged 18-49 years were recruited consecutively in 2021 at three primary health care centers in the district of Marovoay.FGS was detected by colposcopy.Colposcopy images were double-blind reviewed by two independent specialists.A Luminex bead-based assay was performed on cervical vaginal lavage specimens for HPV typing.Crude(CPR)and adjusted prevalence ratios(APR)of associations between selected factors and FGS and HPV positivity were estimated using univariable and multivariable binary Poisson regression with 95%confidence intervals(CIs).Results Among 500 women enrolled,302 had complete information on FGS and HPV diagnosis,and were thus eligible for analysis.Within the sample,189(62.6%,95%CI:56.9-68.1)cases of FGS were detected.A total of 129 women(42.7%,95%CI:37.1-48.5)tested positive for HPV.In total,80 women(26.5%,95%CI:21.6-31.8)tested positive for both conditions.No association was observed between FGS and HPV positivity,while previous pregnancy(APR=0.65,95%CI:0.43-0.78)and older age(APR=0.59,95%CI:0.42-0.81)are showing a negative association with HPV infection compared to no previous pregnancy and younger age groups.Conclusions The results of the study show that FGS and HPV are highly prevalent in rural Madagascar.The concurrent prevalence of these two conditions requires urgent adaptations of public health strategies to improve women’s health,such as integrated services at primary level of care.展开更多
To study the clinicopathologic features and immunoprofile of angiomyofibroblastoma (AMF) with emphasis on differential diagnosis Methods Seven vulvar, two vaginal and one perineal angiomyofibroblastomas were evaluated...To study the clinicopathologic features and immunoprofile of angiomyofibroblastoma (AMF) with emphasis on differential diagnosis Methods Seven vulvar, two vaginal and one perineal angiomyofibroblastomas were evaluated by light microscopy and immunohistochemistry The immunohistochemical studies were performed on paraffin embedded sections using the standard ABC method with a panel of antibodies Results Angiomyofibroblastoma predominantly occurred in middle aged women in the genital region, especially in the superficial area of the vulva Clinically, most of the tumors presented as slowly growing painless masses and were often diagnosed as Bartholin’s gland cysts Histologically, the tumors were all well circumscribed and characterized by alternating hypocellular and hypercellular areas with abundant thin walled blood vessels The tumor cells were bland and spindle shaped or epithelioid and tended to concentrate around the vessels or cluster in small nests Immunohistochemically, the tumor cells expressed vimentin and estrogen receptor protein in all 10 cases and desmin in 9 cases Three cases showed weak or focal immunoreactivity to alpha smooth muscle actin and muscle specific actin All ten patients were treated by local excision Follow up showed a benign course with no signs of recurrence Conclusions Angiomyofibroblastoma is a distinctive neoplasm that has a propensity to occur in the female genital tract Recognition of this entity is important to avoid misdiagnosis with other vulvar angiomyxoid展开更多
文摘Introduction: Female Genital Bilharzia (FGB) is a pathology secondary to infection by Schistosoma haematobium. It is one of the neglected tropical diseases, capable of causing infertility, difficulties in childbirth and even cervical cancer. It represents a real public health problem. We therefore conducted a study in the maternity ward of the Saint-Louis regional hospital, with the overall aim of determining the prevalence of FBG in patients undergoing colposcopy. The specific objectives were to define the patient profile, and to compare colposcopic images with the World Health Organization (WHO) atlas. Methodology: We conducted a descriptive, analytical cross-sectional study of all colposcopic images taken at the maternity ward of the Saint-Louis regional hospital from August 1, 2018, to September 30, 2020, i.e. 25 months. The images were compared with the BGF images described in the WHO atlas. Results: We collected 178 colposcopy images. FBG images numbered 50, or 28%. The mean age of the patients was 44.5 years ±11.4 at the extremes of 18 and 78 years. Mean gestational age was 4.69 ± 2.72. Among patients with a bilharzian lesion on the cervix, visual acid inspection (VIA) was negative in 60% of cases (p = 0.007, Odd Ratio = 3.6 (1.49 - 9.07)). Conclusion: the results of our study show that FBG is a reality in our daily practice. It occurs in adult, multigestating, non-occupational women whose examination reveals a negative visual inspection with acetic acid (VIA). Healthcare providers therefore need to be trained in the recognition of lesions associated with genital bilharziasis, and public awareness needs to be raised.
文摘Background: Female Genital Mutilation is still practiced in Ebonyi State in Southeast Nigeria, despite the complications that follows it and government legislation against the practice. Aim: To determine the impact of Culture, Beliefs, attitude and Peer Group Influence on the persistence Female Genital Mutilation practice in the State especially in the rural areas. Materials and Methods: Qualitative study that used Focused Group Discussion and In-depth interviews for data collection. Those willing and given consent were recruited into the group discussion according to age, marital status, educational level and their location in the state. In-depth interviews were used with the Stake Holders, Opinion Leaders, Traditional Rulers and the Clergy. Result: A total of 454 participants were recruited from the 13 local government areas of Ebonyi State but only 420 (92.5%) participated. The age ranges of participants were 25 to 35 years for single males and females while the married participants male and female were aged 35 to 70 years. One hundred single females (23.8%) and 94 single males (21.4%) participated while 97 (23.1%) married women and 95 (22.6%) married men participated. Out of the 26 health workers recruited only 22 (5.2%) participated. Four traditional rulers, 4 women leaders, 4 youth leaders and 2 clergy 12 (2.9%) in number had in-depth interviews. All the participants had knowledge of FGM and its practice. Rural health workers are getting more involved. ‘Female Genital Crushing’ is replacing actual cutting. The participants all agreed there is no benefit and the practice should stop. Conclusion: Female Genital Mutilation is secretly practiced and is getting replaced by “Female Genital Crushing” perpetrated by rural health workers as well as mothers, fathers, traditional birth attendants and the peer group playing a major role with low knowledge of the Law against Female genital mutilation.
文摘Background: The practice of female genital cutting as a cultural obligation is widespread in Kenya but there is little consensus about its effects on health. Some of the health risks associated with female genital cut range from minor and short-term to major and long-term effects including pain, bleeding, infections, and, in the extreme, death. Female genital cut is widespread among the Kisii but there is no adequate information about how it is currently practised and the value people attach to it. Objective: The objective was to establish the value of female genital cut as well as the health risks associated with the practice among the Kisii community of western Kenya. Methods: This was a cross-sectional study, which employed a mixed method approach to generate both quantitative and qualitative data. The quantitative data were obtained from a randomly selected sample of 373 respondents while quantitative data were generated from focus group discussions as well as key informants interviews. Results: The Kisii consider female genital cut a cultural identifier inherited from past generations and whose main value is a rite of passage from girlhood to womanhood. Majority (63%) had heard of the health risks associated with female genital cut including transmission of infections, excessive bleeding and pain. But most of the community did not seem to know the long-term health consequences associated with female genital cut. Even though knowledge on the campaigns to eradicate the practice was found to be wide spread, the community’s response toward the campaigns was less than positive. Conclusions: The authors conclude that female genital cut continues to persist in this community because of its value as a rite of passage, which currently has no substitute. This cultural demand by far outweighs the health risks associated with female genital cut, which are being mitigated through medicalization of the practice. For intervention programmes to succeed a more culturally sensitive campaign that is acceptable or appropriate alternative rite of passage is required.
文摘Objective: The aim of this study is to evaluate the acute and long-term effects of female genital mutilation (FGM) among women in Sharkia Governorate. Method: This was a cross-sectional descriptive study carried out in Zagazic University Hospital (ZUH) over a two years period from January 2012 to January 2014. The overall sample consisted of 1500 women. An interview was utilized to collect the necessary data. The questionnaires were administered face to face, in Arabic language. Four open and 25 close-ended questions were used to collect socio-demographic data of the sample: women’s experience about the circumcision, occurrence of health hazards after circumcision, and sexual effects on married women. Intention of all women (circumcised or not) to circumcise?their daughters was also documented. Results: This study revealed that the prevalence of FGM in?Sharkia Governorate was about 85.5%. The majority of circumcised women were Muslims (94.4%), married (87.9%), housewife (81.4%), illiterate or with low education level (45.5% and 38.5% respectively) and from rural areas (82.2%). The most common types of FGM were type I (49.2%) and type II (50.8%). The most common motive of FGM was the religious cause (46.6%). The majority of circumcised women (59%) denied the occurrence of any acute complication. The reported acute complications in this study were bleeding (19.6%), urine retention (2.3%), infection (6.3%) and difficult walking (12.8%). The majority of circumcised women (86%) denied the occurrence of any problems at labor related to circumcision. The reported problems at labor in this study were narrowing of introitus (8.4%), laceration (0.7%) and bleeding (4.9%). In this study, 74.6% of circumcised women believed that there was no effect of circumcision on their sexual satisfaction and 92.1% of circumcised women believed that there was no effect of circumcision on their husband’s sexual satisfaction. Approximately 16% of circumcised women complained of dyspareunia and believed that it was related to circumcision. Conclusion: Female circumcision is deeply rooted in our community and laws alone will not eradicate it. Moreover, this approach may drive it underground. Increased media coverage, statements by ministers, religious leaders and non-governmental organizations may lead to increased discussion of the topic at a local level. Spreading the message by means of pictures, song and drama as well as economic development will be more effective.
文摘Background: Female Genital Mutilation/Cutting (FGM/C) often has lifelong negative consequences for a woman’s physical and mental health but is still practiced in some parts of Kenya including Kajiado County. We aimed to estimate the current prevalence as well as the socio-cultural beliefs and power relations that are in favor of or against the practice in Kajiado, Kenya. Methods: A mixed method cross-sectional study was conducted in Kajiado County. The study targeted: women of reproductive age (15 to 49 years);community health volunteers (CHVs);opinion leaders;health care workers;officials from the ministries of Education, Health, Culture, Gender and Social Services;Community Health Assistants (CHAs);Traditional Birth Attendants (TBAs);teachers;morans and adolescent boys and girls aged 10 to 24 years. Data were collected both quantitatively through a household questionnaire and qualitatively through the focus group discussions and key informant interviews. Factors influencing Female Genital Mutilation/Cutting (FGM/C) were classified as either social, cultural beliefs or economic. Results: From the study, quantitative results revealed that the prevalence of FGM/C in Kajiado County was 91%, with most of them (96.7%) practicing type 2 (excision) circumcisions. From the interviews, girls undergo the cut as a rite of passage to womanhood and thus a prerequisite for marriage. It is also believed that girls who are uncircumcised cannot be helped by TBAs in delivery. It is believed that their blood is poisonous and can cause bad omen to whoever comes in contact with dirty blood. Additionally, it is believed that girls go through the cut to avoid conflict and natural phenomena;for instance, drought and outbreaks of diseases that kill many people. Finally, it is a practice that earns respect for the parents of the girls and incentives as dowry to the father of the girl. TBAs that perform FGM/C get paid in cash and kind. Conclusion: Female genital mutilation/cutting practice in Kajiado County is still high. Efforts to end the practice will need to have an integrated approach to include all the players. Suggested alternatives to the cut must, therefore, be inclusive so as to address the myths/beliefs, misconceptions, socio-cultural and economic factors in favor of the vice. The alternatives must be inclusive for the beneficiaries, supporters, and practitioners.
文摘Female genital mutilation (FGM) is partial or total excision of female external genitalia or other deliberate injury to the female genital organs for non-therapeutic purpose. It is cultural and traditional practice. Female genital mutilation may result in immediate complications such as severe pain and bleeding and long-term complications such as: psychological, psychosexual, trauma, infertility, urinary and genital complications.
文摘Introduction: Female Genital Mutilation (FGM) is a public health problem. There are 100 to 140 million girls and women who suffer every year in the world [1]. The aim of this study is to improve the medical care and reduce complications of FGM at the Regionalhospital of N’zérékoré, to determine their frequency, and to evaluate the maternal-fetalprognosis. Methods: The study was conducted at the Regional Hospital of N’zérékoré. This was a cross-sectional, descriptive and analytic study of 6 months, from 1 September 2016 to 28 February 2017, including all pregnant women admitted for childbirth who had a complication of female genital mutilation. Results: A total of 1295 women gave birth in the service, of which 1204 women were women with female genital mutilation. Given a frequency of 92.97%, of these 1204 mutilated women, 223 presented obstetrical complications during their delivery, a proportion of 17.22%. They were mostly young patients, mostly housewives who were not in school. Type II FGM was the most common (53.06%). Obstetric complications were dominated by complicated perinatal tears (54.08%), and hemorrhages (40.81%). The catch was dominated by perineorrhaphy. Conclusion: The frequency of FGM was 92.97% and that of their obstetric complications 17.22%. Most were house-wives, not in school. There was FGM type II. The abandonment of FGM would reduce maternal and perinatal morbidity and mortality.
文摘Background: Female genital mutilation (FGM) or female circumcision is all procedures involving partial or total removal of the external female genital organ or other injuries to the female genital organ whether for cultural or any other non-therapeutic reasons. Female genital mutilation causes numerous complications. Four in such cases multiplies obstetric complications. The aim of this study was to identify obstetric complications due to FGM. Patients and Material: We conducted a comparative prospective case-control study for three months, from January 1st to March 31st, 2014 in the maternity of N’Djamena Mother and Child. It focused on identifying neonatal and/or maternal complications during childbirth due to FGM. The study population consisted of pregnant women at term admitted for delivery labor. All parturients had to present the same sociodemographic and clinical profiles. A history of FGM was the main distinguishing criterion. Results: During the study period, we recorded 312 births to women with genital mutilation, among 1905 deliveries, representing a prevalence of 16.4%. One hundred ninety-one cases of circumcised women responding to the inclusion criteria were selected. Most of these women were between the ages of 20 and 29. The extreme age group was 15 and 39 (with a mean of 24.5 years). FGM was significant in age group over 20 years (Khi2 = 10.8;OR = 2.6 [1.4 - 4.9];P = 0.001). The type II of FGM which removed a part of the clitoris and the adjacent labia minora represented 64.40% patients in the group of women with FGM. Perinea laceration was the frequent maternal complication among parturient with FGM (Khi2 = 9.8;OR = 2.2 [1.4 to 3.6];P = 0.0007). FGM type III was associated with a high proportion of maternal complication (Khi2 = 11.2;OR = 7.3 [1.97 - 31.6];P = 0.0001). Still births were significantly higher in the group of parturient with FGM (11.5%, P = 0.015). Conclusion: Female genital mutilation is a common cultural practice in our country;it contributes to worsening maternal and fetal complications.
文摘Background: Current evidence has focused on the complications of female genital mutilation/cutting (FGM/C) types 2 and 3, and there is a gap in the knowledge of the complications of FGM/C types 1 and 4, which are often considered milder forms of cutting. Case Presentation: A 23-year-old Somali woman with FGM/C was referred for chronic clitoral pain and superficial dyspareunia after several inconclusive gynecological examinations. Her clitoris was found to be entrapped under the scar of the cut clitoral hood. We surgically lysed the scar and reconstructed a prepuce. At the two-month follow-up, the patient reported no pain and physiologic sexual response. Conclusion: Clitoral pain and dyspareunia after FGM/C can be due to the incarceration of the clitoral glans. Treatment is surgical lysis of the scar.
文摘<p> <b><span style="font-family:Verdana;">Introduction: </span></b><span style="font-family:""><span style="font-family:Verdana;">Female genital fistula (FGF), remains a world concern, especially in low developed country. Obstructive (blocked) delivery labor is his principal cause, sometimes by pelvic surgery (urogenital or obstetrical, rectal) more rarely by congenital urogenital malformation, excision, pelvic neoplasm, pelvic radiotherapy. We were interested in iatrogenic FGF treated in the special referral fistula center. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">We report 35 cases of iatrogenic female genital fistula. Are included only cases by urogenital surgery, excision in the National Referal Center of Obstetrical Fistula. Were not included cases happened by over 12 hours blocked delivery labor, caustic destruction, pelvic cancer pelvic infection and those with incomplete file. The epidemiologic, clinical and therapeutic information were studied. All ethical protocols were respected. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">CNRFO recorded 743 cases of female genital fistula from May 23 2013 to May 23 May 2018 within 35 iatrogenic cases (4.71%). Patients were 19 - 29 years old (42.85%), average age 35 years old, extremes 19 - 60 years, without occupation (82.86), grand multiparous 48.57%, with a mean of 4 previous deliveries. The principal constancies were hysterectomies 71.43%, caesarean section 17.14%, genital excision 11.42%, and cystocele cure 11.42%. The anatomical finds were soft vagina tissue 97.14% uretero-vaginal fistula 45.71% (2 cases post Caesarean, 14 cases post hysterectomy), vesico-vaginal 31.43% (all post hysterectomy), ureteral 11.42% (all post caesarean), 1 vesico-uterine 5.71% (case post caesarean), 1 case after a cystocele cure, 2 uretro-vaginal 11.42% secondary of genital excision. Treatment was ureteral reimplantation (18/31) cases by abdominal way, fistulorraphy (12/31) and 1uretroplasty by vaginal, 4 cases treated with transurethral bladder probe. 30 were cured by fistulas surgery, 1 urinary tress incontinency and 1 not closed, and 4 of transurethral bladder probe were cured. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The female genital fistula is sometimes the consequence of Caesarean, hysterectomy, gynecological surgery, urologic surgery and some traditional practices.</span></span> </p>
文摘Female genital mutilation/cutting(FGM/C)is a harmful traditional practice with severe health implications among women and girls.This study determined whether knowledge reduced the practice of female genital mutilation and identified the socio-demographic factors that predicted the practice of female genital among parents in Ekiti State,Nigeria.A cross-sectional quantitative research method was employed among 600 selected parents in the three senatorial districts of Ekiti-State,Nigeria between March and June 2019.A pretested structured questionnaire was used to collect data.Our analysis revealed that 468(78%)of the respondents believed that the practice was high as against 132(22%)who said the practice was low.Female is two times more likely to practice FGM than male(OR=1.614,B=0.479,p<0.05,CI=1.088-2.394).Respondents with low knowledge were significantly 11 times likely to practice female genital mutilation compared with respondents with high knowledge(OR=10.597,B=2.361,p<0.05,CI=6.813-16.483).Those who lived in rural areas were two times significantly(OR=1.690,B=0.525,p<0.05,CI=3.246-13.197)likely to practice female genital mutilation than the urban dwellers.The study concluded that respondents’knowledge,location(urban/rural),sex,age,and ethnicity were strong predictors of the practice of FGM/C in Ekiti-State,Nigeria.With these findings in mind,the community institutions would play a great role in changing the community through spreading information about the health implications of FGM/C for the practice to be drastically reduced.
文摘Female genital mutilation (FGM) is still a topical practice in several African regions or countries. They constitute a violation of human rights, in particular because of their harmful consequences for the health of the people who suffer them and are the source of various complications. We report a case of FGM complications in the form of total coalescence of the labia majora with a small hole from which urine flows permanently. The management was a disinfubilation with suturing of the edges and urethral reimplantation and the evolution was favorable with complete healing after two (2) weeks.
文摘With advances in the standards of living and public perceptions,female genital cosmetic surgery is becoming a new hot topic in the field of plastic surgery,gaining considerable interest recently among beauty seekers and professionals alike.However,the needs of beauty pursuers seem to be exuberant but vague;on the other hand,practitioners who have received strict professional training are still desperately needed.Additionally,interestdriven marketing and promotion render the field prone to chaos,resulting in widespread attention and concerns regarding the scientificity,safety,effectiveness,and necessity of the performance of multiple treatment procedures.Extensive survey of the relevant literature was performed,and several beauty seekers as well as surgeons with working experience of pertinent techniques were consulted,in order to examine the current status and future developments of this field.
文摘OBJECTIVE To analyze the clinical characteristics,pathologic diagnosis,treatment and prognosis of amelanotic melanoma in the female genital tract(AMFGT).METHODS The medical records of 6 patients with AMFGT between 1991 and 2006 in our hospital were reviewed.RESULTS Of these cases,4 were preliminarily misdiagnosed as chorioepithelioma,sarcoma,adenocarcinoma or lymphoma.Two patients were determined to have AMFGT preoperatively after positive immunohistochemical staining for both S-100 protein and HMB-45.Specimens removed from all 6 cases were tested for immunohistochemical staining,as well as H&E histochemical stains.S-100 and vimentin were both positive in all patients,and HMB-45 was positive in 3 out of 5 patients.Four patients recurred(at 6,6,12 and 19 months) a er primary treatments.Three patients died(at 13,18 and 19 months) a er the initial diagnosis.CONCLUSION Because of an absence of pigmentation AMFGT is extremely difficult to diagnose.Combined immunohistochemical staining,such as the S-100 protein,HMB-45 and vimentin etc,is important in the evaluation of AMFGT.Correct diagnosis plays a crucial role in the treatment of this disease.
基金supported by grants from the National Key Research and Development Program(No.2018YFC1002103)The Chinese Medical Association(No.16020520668)+1 种基金the Natural Science Foundation of Hubei Province(No.2017CFB752)Key Projects of Science and Technology Research and Development Plan of Jingmen City(No.2019YFZD044).
文摘Objective:This study aims to offer an update assessment of the knowledge of Chinese oncologists on female fertility preservation,and identify the determinants that influence the implementation of fertility preservation.Methods:A total of 713 Chinese oncologists with different specialties completed the online self-report questionnaire to assess their understanding of fertility risks in cancer treatment,knowledge on female fertility preservation,and perceptions on the barriers in referring patients for fertility preservation.Results:Although most oncologists were familiar with fertility risk in cancer treatment,half of them lacked the knowledge for reproduction and preservation methods.In the multivariable model,oncologists in a hospital with a specialized reproductive institution,positive precaution for fertility risk,and fertility preservation discussion with patients were significantly correlated with the possibility of fertility preservation referral.Conclusions:The intervention targets based on the update evaluation and identified influencing determinants will be helpful for all the oncofertility researchers,oncologists and institutions in future efforts for well-established female fertility preservation services.
文摘Background Women’s health in resource-limited settings can benefit from the integrated management of high-burden diseases,such as female genital schistosomiasis(FGS)and human papilloma virus(HPV)-related cervical cancer.In schistosomiasis-endemic countries such as Madagascar,data on FGS and HPV prevalence are lacking as well as preventive measures for both conditions.This study aims to estimate the prevalence of FGS and HPV in rural Madagascar,and to examine associated risk factors to identify opportunities for improving women’s health.Methods After initial community outreach activities,interested women aged 18-49 years were recruited consecutively in 2021 at three primary health care centers in the district of Marovoay.FGS was detected by colposcopy.Colposcopy images were double-blind reviewed by two independent specialists.A Luminex bead-based assay was performed on cervical vaginal lavage specimens for HPV typing.Crude(CPR)and adjusted prevalence ratios(APR)of associations between selected factors and FGS and HPV positivity were estimated using univariable and multivariable binary Poisson regression with 95%confidence intervals(CIs).Results Among 500 women enrolled,302 had complete information on FGS and HPV diagnosis,and were thus eligible for analysis.Within the sample,189(62.6%,95%CI:56.9-68.1)cases of FGS were detected.A total of 129 women(42.7%,95%CI:37.1-48.5)tested positive for HPV.In total,80 women(26.5%,95%CI:21.6-31.8)tested positive for both conditions.No association was observed between FGS and HPV positivity,while previous pregnancy(APR=0.65,95%CI:0.43-0.78)and older age(APR=0.59,95%CI:0.42-0.81)are showing a negative association with HPV infection compared to no previous pregnancy and younger age groups.Conclusions The results of the study show that FGS and HPV are highly prevalent in rural Madagascar.The concurrent prevalence of these two conditions requires urgent adaptations of public health strategies to improve women’s health,such as integrated services at primary level of care.
基金This study was supparted in paut by the Shanghai Medi cal Leading Speciality(No 993025).
文摘To study the clinicopathologic features and immunoprofile of angiomyofibroblastoma (AMF) with emphasis on differential diagnosis Methods Seven vulvar, two vaginal and one perineal angiomyofibroblastomas were evaluated by light microscopy and immunohistochemistry The immunohistochemical studies were performed on paraffin embedded sections using the standard ABC method with a panel of antibodies Results Angiomyofibroblastoma predominantly occurred in middle aged women in the genital region, especially in the superficial area of the vulva Clinically, most of the tumors presented as slowly growing painless masses and were often diagnosed as Bartholin’s gland cysts Histologically, the tumors were all well circumscribed and characterized by alternating hypocellular and hypercellular areas with abundant thin walled blood vessels The tumor cells were bland and spindle shaped or epithelioid and tended to concentrate around the vessels or cluster in small nests Immunohistochemically, the tumor cells expressed vimentin and estrogen receptor protein in all 10 cases and desmin in 9 cases Three cases showed weak or focal immunoreactivity to alpha smooth muscle actin and muscle specific actin All ten patients were treated by local excision Follow up showed a benign course with no signs of recurrence Conclusions Angiomyofibroblastoma is a distinctive neoplasm that has a propensity to occur in the female genital tract Recognition of this entity is important to avoid misdiagnosis with other vulvar angiomyxoid
