Medical Complications of Female Genital Mutilation

Abstract

More than 130 million women are subjected to genital mutilation. Despite increasing efforts to reduce the practice, there are many obstacles to eliminating this 2,000-year-old practice, which is based on strong cultural traditions. As college health clinicians provide care to more international students from countries where female genital mutilation is performed, increased awareness and knowledge of the procedure will enable clinicians to understand and manage its complications. We report a case of obstructive uropathy resulting in hydronephrosis secondary to female genital mutilation and review the medical literature regarding this and other complications of genital mutilation "surgery."

Female Genital Cutting: Implications for Nurses

“…In cultures where FGC is practiced, female virginity remains a vital consideration by males and their families when considering marriage partners. According to Epstein, Graham, and Rimza (2001), the genital scar proves to the prospective husband that the woman has maintained her virginity and has been trained in moral and marital responsibilities.…”

“…Although education, public awareness and legal action have reduced the incidence of FGC, the prevalence remains high, and many women continue to experience the consequences of the procedure. Eradicating a cultural and traditional practice that has existed for more than 2,000 years is complex and delicate (Epstein et al, 2001).…”

“…In some cases, use of a pediatric speculum may facilitate visualization of the cervix with less discomfort (Campbell, 2004 sexual intercourse diffi culties (Little, 2003). A narrow introitus may obstruct passage of menstrual blood resulting in dysmenorrhea and hematocolpos (Epstein et al, 2001). Women who have undergone Type I or II FGC are at less risk for obstetric complications than are women who have undergone Type III FGC.…”

“…Infertility rates of 25 to 30 percent have been reported in women who have experienced FGC, partly due to sexual intercourse difficulties (Little, 2003). A narrow introitus may obstruct passage of menstrual blood resulting in dysmenorrhea and hematocolpos (Epstein et al, 2001).…”

“…Transmission of the human immunodeficiency virus (HIV) during FGC is a concern that has not been documented. The risk exists due to the use of nonsterile and possibly shared instruments in regions of sub‐Saharan Africa where the prevalence of HIV is 20 percent or higher in some areas (Epstein et al, 2001). There are also risks to the woman from sexual intercourse due to the trauma associated with penetration.…”