Prevalence, clinical characteristics and management of female genital mutilation in paediatric and adolescent patients: a retrospective cohort analysis from a clinic in Vienna, Austria

OBJECTIVE: To enhance paediatric gynaecological knowledge of female genital mutilation (FGM) within European hospital settings. DESIGN AND SETTING: A retrospective study was conducted of girls aged 0-18 years who were referred to the Children and Victim Protection Center (CAVPC) of the Medical University of Vienna-a tertiary care hospital-on suspicion of FGM between 2014 and 2024. MAIN OUTCOME MEASURES: Registry data from the CAVPC were analysed, and baseline characteristics were described. The primary outcome was the annual prevalence of FGM cases. Secondary outcomes included the type and setting of the procedure, age at FGM, country of performance, presenting symptoms and management strategies. RESULTS: Over 10 years, the centre recorded a median of 3.2 suspected cases annually (range 0-7), with peaks in 2017-2018, a decline during 2019-2020-likely due to COVID-19 restrictions-and a rise again in 2023-2024 (p=0.03). FGM was confirmed in 77.1% of referrals, most commonly among Somali girls (80%) with a median age at examination of 11 years (range: 3-15 years). Procedures had exclusively occurred in the country of origin, typically in non-medical settings at a median age of 7 years (range: 4-9 years). WHO Types I and III predominated; 75% of Type III cases required defibulation for chronic complications. CONCLUSIONS: These findings emphasise the urgent need for centres with specialisation in paediatric gynaecology with surgical expertise in FGM. Broader European data are required to strengthen healthcare responses and to improve outcomes for affected girls and young women.