The consequence of FGM depends on the type of operation performed (infibulation clearly has more serious consequences), the ability and experience of the woman performing the operation, the hygienic conditions under which it is performed, and the girl’s health at the time of the operation.
IMMEDIATE CONSEQUENCES
Shock, due not only to the severe pain caused by an operation performed without anesthesia but also to the loss of blood which can continue for several days even when moderate, or to sepsis.
Hemorrhage, the most common and almost inevitable consequence, given that amputation of the clitoris can also involve resection of the dorsal artery. Moreover, even amputation of the labia can cause damage to veins and arteries. Prolonged hemorrhage can cause a girl’s death or lead to long term anemia.
Infections, due to unsanitary conditions, use of unsterilized instruments and the fact that urination and defecation take place over the wound in girls that are bound. In the case of infibulation, an internal explosion of the infection can occur that can affect organs such as the uterus, the fallopian tube and the ovaries, causing chronic pelvic infections and infertility.
Urinary retention lasting eight to ten days. These girls find urination extremely painful due to inflammation of the wound on the vulva. This complication can cause infections of the urinary tract.
Lesions of adjoining tissue such as the urethra, vagina, and perineum. This is also due to the use of unsterilized instruments, the lack of proper illumination during the operation, the lack of anatomic knowledge in the practitioners and the struggling of the patient. More frequent are lesions of the anal and rectal opening with cutting of the anal sphincter and residual incontinence.
Tetanus can be contracted through use of unsterilized equipment.
HIV/AIDS, the HIV/AIDS virus can be transmitted by using the same instruments for many operations.
LONG-TERM CONSEQUENCES
Loss of blood: can take place when the procedure is carried out on an infected wound, for example in the case of repeated infibulations and of re-infibulation after childbirth.
Difficulty in urinating: due to obstruction of the urinary opening and damage to the urinary tube. Urination can be painful and lead to urinary retention, frequent urge to urinate, incontinence and infections of the urinary tract.
Frequent infections of the urinary tract: often due to damage to the lower urinary tract produced by mutilation. Frequent infections of this type are common, especially in infibulated women.
Incontinence: can be caused by damage to the urethra during the operation. Incontinence cause lead to a woman’s being segregated from society.
Chronic pelvic infections: common to infibulated women: The FGM and partial occlusion of the vagina and the urethra increase the probably of infection.
Infertility: due to the infections that can cause irreparable damage to the reproductive organs.
Keloids: thickened, fibrous skin tissue resulting from chronic inflammatory stimulation. These formations often diminish the size of the vaginal opening with serious consequences.
Dermoid cysts: cysts caused by inclusion of a fragment of skin that can develop into a tumor.
CONSEQUENCES TO HEALTH
Neuroma: can develop when the dorsal nerve of the clitoris is cut. The entire genital area becomes hypersensitive and cause intense, permanent pain.
Stones: may occur due to residue of the menstrual flow or by urinary deposits in the vagina and the space behind the tissue created by infibulation.
Fistulae: perforations or lesions between the vagina and the bladder due to damage from FGM or the repetition of defibulation or reinfibulation, sexual relations or difficulty in childbirth. The continuous loss of urine and feces caused by the fistulae can torment these women’s lives and lead to their being rejected by society.
Sexual dysfunction: the most common consequences are pain during intercourse and reduction of sensitivity following the clitoridectomy, but especially as a result of infibulation. Penetration is difficult, if not impossible and in some cases, a second cut is necessary.
Menstrual problems: these often occur due to the partial or total occlusion of the vaginal opening. This can lead to dismenorrhea. Hematocolpus cam result due to menstrual blood stagnating in the vagina for many months. In these cases, swelling of the abdomen caused by the accumulation of menstrual blood, along with the apparent lack of menstruation can lead to suspicion of pregnancy creating many social problems for the girl.
Problems during pregnancy and childbirth: very common in women who have undergone FGM. The resistant scar tissue can prevent dilation of the birth channel and cause an obstructed labor. The woman’s exhaustion during expulsion an lead to urinary inertia and loss of blood which can cause the baby’s death. In addition, the child can suffer from brain damage.
Infibulation can lead to other problems. It is, for instance, almost impossible to conduct a pelvic examination. As a result, it is very difficult if not impossible to evaluate a dangerous pregnancy or diagnose illness. If the opening left after infibulation is very tight, it is also impossible to prevent inflections to the reproductive apparatus. Nor is a pap test possible, meaning that it is impossible to diagnose some tumors.
SEXUAL AND PSYCHOLOGICAL PROBLEMS
Studies on the psycho-sexual effects of the practice are few. The literature however points to the following sexual and prychological complications:
• frigidity
• lack of orgasm due to amputation of the clitoris
• difficulty of penetration due to stiffening of the vagina tissue
• behavior disturbances
• psychosomatic illness
• anxiety
• depression
• nightmares
• psychosis
• frigidity