A 36-year-old lady with type three Female Genital Mutilation (Infibulation) – its long-term complications: a case report and literature review

Abstract

Abstract Background:Female genital mutilation comprises all procedures involving the partial or total removal of female external genitalia or other injury to the female external organs, whether for religious, cultural or other non-therapeutic reasons. The impact of female genital mutilation is diverse, including physical, social and psychological impact. We report a case of a 36-year-old woman with type three female genital mutilation who did not seek medical treatment due to lack of awareness that there was no treatment for it, and use this case as an entry point to comprehensively review literature regarding long-term complications associated with female genital mutilation and its impact on women’s quality of life. Case presentation: We present a case of a 36-year-old woman with type three female genital mutilation who had presented with difficulty with urination since childhood. She had difficulty with menstruation since her menarche, and she had never had sexual intercourse. She never sought treatment, but recently went to hospital after she heard of a young lady who had the same problem in her neighborhood who was treated surgically and got married. On external genitalia examination, there was no clitoris, no labia minora, and labia majora were fused to each other with a healed old scar between them. There was a 0.5 cm by 0.5 cm opening below the fused labia majora near to the anus through which urine was dribbling. De-infibulation was done. Four months after the procedure, she was married and at that moment she was pregnant. Conclusion: The physical, sexual, obstetrics and psychosocial consequences of female genital mutilation are neglected issues. The improvement of women’s socio-cultural status in combination with planning programs to enhance their information and awareness as well as trying to change the cultural and religious leaders’ viewpoints regarding this procedure is essential to reducing female genital mutilation and its burden on women’s health. Cognitive behavioral therapy is also recommended to treat psycho-social disorders in both girls and women.