title: [Assessment of a multidisciplinary care for 169 excised women with an initial reconstructive surgery project].
abstract: OBJECTIVE
  To assess the benefits of a multidisciplinary care among excised women with an initial surgery project and identify the reasons for discarding surgery.
  
  
  METHODS
  Descriptive and retrospective study performed between the 1st of January 2006 and the 31st of December 2011 at the Armand Trousseau Hospital, Paris. All excised patients went through consultations with a mid-wife, a sexologist, a psychologist, a gynaecologist-obstetrician and, for some of them, underwent a clitoral reconstructive surgery.
  
  
  RESULTS
  One hundred and sixty-nine patients were included: among them, 61 patients (36%) were operated and 108 patients (64%) have given spontaneously to surgery, 32% being reinforced by consultation. Ninety-one on 111 patients (82%) respondents were satisfied with their care pathway. The main motivation was to support identity for 39 patients operated (64%) while improving sex prevailed for 56 non-operated patients (52%). The study evidenced an improvement of the functional and sexual life quality after surgery: 17% experienced an orgasm versus 2% before surgery, 56% reported an increase in their libido and 41% a decrease in dyspareunia.
  
  
  CONCLUSIONS
  Clitoral reconstructive surgery with multidisciplinary care tends to improve the functional and sexual life quality of excised patients, though it is not always necessary. Some of the patients discard their initial project of reconstructive surgery as in some of the cases, a multidisciplinary care only seems sufficient.
authors.affiliation: Service de gynécologie-obstétrique, hôpital Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France. Electronic address: hildemerckelbagh@yahoo.fr.
authors.forename: H-M
authors.initials: HM
authors.lastname: Merckelbagh
authors.affiliation: Service de gynécologie-obstétrique, hôpital Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France.
authors.forename: M-N
authors.initials: MN
authors.lastname: Nicolas
authors.affiliation: Service de gynécologie-obstétrique, hôpital privé Paul-D'Egine, 4, avenue Marx-Dormoy, 94500 Champigny-sur-Marne, France.
authors.forename: M-P
authors.initials: MP
authors.lastname: Piketty
authors.affiliation: Service de gynécologie-obstétrique, hôpital Lariboisière, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
authors.forename: J-L-B
authors.initials: JL
authors.lastname: Benifla
mesh_terms: D000293:Adolescent; D000328:Adult; D002987:Clitoris / Q000601:surgery*; D004414:Dyspareunia / Q000601:surgery; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008875:Middle Aged; D009948:Orgasm; D010297:Paris; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000523:psychology; D012189:Retrospective Studies; D019529:Sexuality
keywords: Chirurgie clitoridienne; Clitoral surgery; Excision; Multidisciplinarité; Multidisciplinary care; Trauma; Traumatisme