A cross-sectional study on pelvic floor symptoms in women living with Female Genital Mutilation/Cutting

Abstract

Background Female Genital Mutilation/Cutting (FGM/C) concerns over 200 million women and girls worldwide and is associated with obstetric trauma and long-term urogynaecological and psychosexual complications that are often under-investigated and undertreated. The aim of this study was to assess the pelvic floor distress and the impact of pelvic floor and psychosexual symptoms among migrant women with different types of FGM/C. Methods This cross-sectional study was conducted between April 2016 and January 2019 at the Division of Gynaecology of the Geneva University Hospitals. The participants were interviewed on socio-demographic and background information, underwent a systematic gynaecological examination to assess the presence and type of FGM/C and eventual Pelvic Organ Prolapse (POP), and completed six validated questionnaires on pelvic floor and psychosexual symptoms (PFDI-20 and PFIQ7 on pelvic floor distress and impact, FISI and WCS on faecal incontinence and constipation, PISQ-IR and FGSIS on sexual function and genital self-image). The participants’ scores were compared with scores of uncut women available from the literature. The association between selected variables and higher scores for distress and impact of pelvic floor symptoms was assessed using univariate and multivariable linear regression models. Results 124 women with a mean age of 31.5 (± 7.5), mostly with a normal BMI, and with no significant POP were included. PFDI-20 and PFIQ-7 mean (± SD) scores were of 49.5 (± 52.0) and 40.7 (± 53.6) respectively. In comparison with the available literature, the participants’ scores were lower than those of uncut women with pelvic floor dysfunction but higher than those of uncut women without such disorders. Past violent events other than FGM/C and forced or arranged marriage, age at FGM/C of more than 10, a period of staying in Switzerland of less than 6 months, and nulliparity were significantly associated with higher scores for distress and impact of pelvic floor symptoms, independently of known risk factors such as age, weight, ongoing pregnancy and history of episiotomy. Conclusions Women with various types of FGM/C, without POP, can suffer from pelvic floor symptoms responsible for distress and impact on their daily life. Trial registration. The study protocol was approved by the Swiss Ethics Committee on research involving humans (protocol n°15-224).

Chronic Vulvar Pain After Female Genital Mutilation/Cutting: A Retrospective Study

“…In a prospective study we recently published, such events were referred by almost half of a sample of 124 participants. 38 As previously observed, 39 age at excision was higher in women with chronic genito-pelvic pain and vulvar pain compared to asymptomatic women in our sample. A higher age at excision could contribute to the pathophysiology of chronic vulvar pain, either psychologically or through biological mechanisms involving age and hormone-related remodeling of genital tissue.…”

Diagnoses and procedures of inpatients with Female Genital Mutilation/Cutting in Swiss university Hospitals: a cross-sectional study

“…Moreover, migrant women in high-income countries often have higher rates of caesarean sections than non-migrants [47]. Communication barriers, economic difficulties, and exposure to violence can result in poor maternal health and/or care quality for some migrants regardless of FGM/C [48][49][50][51][52].…”

Lived experiences and opinions of women of sub‐Saharan origin on female genital mutilation: A phenomenological study

“…Physical complications include chronic pelvic pain, urogenital fistulas, urinary infections or voiding dysfunctions (Zambon et al, 2018). These complications can become chronic and affect their quality of life (Binkova et al, 2021). Mutilated women also suffer from sexual dysfunctions such as lack of sexual desire, arousal and difficulties reaching orgasm (Jacobson et al, 2018).…”