Medical dangers of female circumcision.

Female circumcision is practiced in some parts of Africa the southern part of the Arabian Peninsula Malaysia and Indonesia. 95% of a sample of 2000 Egyptian women were circumcised an operation attended by a high incidence of complications: immediate and late physical and psychosexual minor and serious even fatal. The causes are the type of operation and the operator. In a mild form the prepuce of the clitoris only is removed with the posterior larger parts of the labia minora. An extensive operation common to Sudan consists of removal of the whole clitoris the whole of the labia minora and part of the labia majora. Complications common with pharaonic or Sudanese circumcision include painful scarkeloid formation labial adhesions cysts of the clitoris vulval disfigurement vaginal calculi tight circumcision infertility and urinary complications. Psychosexual complications include a feeling of reduced feminity; diminished desire for coitus; diminished coital frequency; dyspareunia apareunia or vaginismus; lack of orgasm; anal intercourse; depression and psychotic states; and social problems. With infibulation come obstetric complications. Vaginal examination during labor may be difficult; catheterization of bladder is difficult; second stage of labor is delayed; tearing or splitting of the circumcison scar is unavoidable; injury of the vagina cervix and fetal scalp; and soft-tissue obstruction by the vulval skin diaphragm contributes to the production of a vesicovaginal fistula.