Simple surgery repairs genital mutilation. (Deinfibulation).

NASHVILLE, TENN. -- About 2 million girls and women worldwide undergo female genital mutilation each year, and some of them may eventually present to U.S. physicians.

Relatively simple gynecologic surgery can repair many of these infibulations. Counseling of the patient is another important part of treatment, and a woman who is not a relative is often needed to help translate the counseling session, Dr. Gwinnett Ladson said during the annual meeting of the National Medical Association.

Surgical repair of the mutilation, "deinfibulation," can be offered to either pregnant or nonpregnant women. Although it is safest and easiest to do a repair before labor, pregnancy is often a time when a woman can have a repair and avoid some of the social stigma of deinfibulation, said Dr. Ladson, an ob.gyn. at Meharry Medical College in Nashville.

Treatment starts with assessing the mutilation, including the extent of damage and whether keloids, neuroma, or fistula are present. The patient should also be assessed for emotional and psychiatric problems. General anesthesia during the repair helps to avoid the psychological trauma of flashback experiences.

Four types of mutilation exist. The least extensive is type I, or sunna, and involves removal of the clitoral hood, the tip of the glans, and a small portion of the labia minora. ...