Peer-reviewed article
FEMALE GENITAL MUTILATION: AN UNEXPECTED ENCOUNTER
NURUL FATIN IRWANA BINTI ROSLAN ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a case report of a 20-year-old woman who underwent female genital mutilation (FGM) at 2 months old and presented with acute urinary retention caused by scarred tissue from the procedure. The case illustrates Type 3 FGM complications, including fused labia and absence of normal genital structures, which led to internal bleeding and bladder obstruction. The authors highlight that healthcare workers often lack knowledge about FGM recognition and management despite millions of women worldwide being affected. They recommend de-infibulation surgery to treat Type 3 FGM and call for greater awareness among healthcare providers.
Key points
- At least 200 million women living today worldwide have undergone FGM
- Type 3 FGM carries higher complication rates than other types
- The patient's FGM was performed unintentionally at 2 months old by a traditional midwife
- FGM led to acute urinary retention through scarring, fused labia, and haematocolpos (internal bleeding)
- Healthcare workers often lack clinical guidelines and knowledge about FGM recognition and management
Limitations
This is a single case report describing one patient's experience; it cannot establish the frequency of specific complications or effectiveness of treatments across populations. The document provides no comparative data on outcomes or intervention success rates.
Abstract
Introduction: Any non-medical intentional alteration or causes injury to female genital is termed female genital mutilation (FGM). FGM typically performed on young girls between infancy and 15-year-olds. World Health Organization classified FGM into 4 types based on the extend of cutting. Herein, we would like to share a case of a young patient presented with acute urinary retention(AUR) secondary to scarred tissue from an un-intentional Type 3 FGM since young. Case: A healthy 20-year-old nulliparous lady presented with AUR. She has reached menarche at 15-years-old with normal menses flow and currently on day 1 of menses. Her abdomen was soft with palpable bladder. External genitalia examination revealed a fused labia majora with a small holes sizing 0.5cm, unable to visualize urinary meatus. Bedside ultrasound showed haematocolpos measuring 7x9cm. Proceeded with examination under anesthesia revealed scarred tissue extending from clitoris to 4cm above anus with fused labia majora. Separation of the fused labia majora was done however there were absence of clitoris and labia minor. History from patient’s mother, patient was circumcised at 2-months-old by local midwife. It was believed that during the procedure unintentional FGM type 3 was performed. Discussion: At least 200 million women living today worldwide had undergone FGM, however knowledge of FGM is limited among healthcare workers because there are no clinical guidelines that are specifically focused on occurrence of FGM; its recognition, complications and management options. FGM is performed by traditional circumciser, and often leads to early and late complications physically and psychologically. Complication rates vary according to the type of FGM performed and more frequently seen with Type3 FGM. Our patient most probably underwent Type3 FGM which complicated with scarring; this leads to formation of hematocolpus, which subsequently caused AUR owing to the pressure effect to the bladder and urethra. Treatment of FGM Type3 is by de-infibulation. It involves incising the fused labia minora to restore the introitus. Conclusion: FGM might not be an everyday occurrence, awareness should be created in order to built a more respectful and cultural sensitive approach when dealing with the physical and psychological consequences of these patient