Deinfibulation for treating urologic complications of type III female genital mutilation: A systematic review.
BACKGROUND
Women and girls who have undergone type III female genital mutilation (FGM) may suffer urologic complications such as recurrent urinary tract infections, obstruction, stones, and incontinence.


OBJECTIVE
To assess the effectiveness of deinfibulation for preventing and treating urologic complications in women and girls living with FGM.


METHODS
The following major databases were searched from inception to August 2015: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, SCOPUS, Web of Science, and ClinicalTrials.gov without language restrictions.


METHODS
Randomized controlled studies (RCTs) or observational studies with controls were considered.


METHODS
We screened the results of the search independently for potentially relevant studies and applied inclusion and exclusion criteria for the full texts of the relevant studies.


RESULTS
No RCTs were found. We found three case reports and a retrospective case review, all of which were excluded.


CONCLUSIONS
There is no evidence on the use of deinfibulation to improve urologic complications among women with type III FGM. Current clinical practice may be informed by anecdotal evidence from case reports. Appropriate RCTs and observational studies with comparison groups in countries where FGM is common are needed. PROSPERO registration: CRD42015024901.
Calabar Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria.|Renal Unit, Department of Internal Medicine, Faculty of Medicine and Dentistry, College of Medical Sciences, University of Calabar, Calabar, Nigeria.
Emmanuel
E
Effa
Calabar Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria.
Olumuyiwa
O
Ojo
Department of Community Medicine, University of Uyo Teaching Hospital, Uyo, Nigeria.
Austin
A
Ihesie
Calabar Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria.|Department of Pediatrics, College of Medical Sciences, University of Calabar, Calabar, Nigeria.
Martin M
MM
Meremikwu
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002404:Catheterization; D002921:Cicatrix / Q000601:surgery; D019093:Circumcision, Female / Q000009:adverse effects* / Q000145:classification; D005260:Female; D006801:Humans; D012086:Reoperation / Q000592:standards*; D014545:Urinary Calculi / Q000209:etiology / Q000628:therapy*; D014549:Urinary Incontinence / Q000209:etiology / Q000628:therapy*; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000209:etiology; D014844:Vulva / Q000601:surgery
D000900:Anti-Bacterial Agents
Antibacterial agents; Catheterization; Deinfibulation; Female genital mutilation; Incontinence; Urinary tract infections; Urinary tract obstruction