Female Genital Mutilation in a Nigerian Girl Child: A Case Report

Abstract

Aim: To alert medical practitioners that female genital mutilation (FGM) is still practised, to strengthen awareness of its harmful consequences, and to encourage enforcement of existing laws as a deterrent. Presentation of Case: This case concerns a 2-year-old girl who presented with narrowing of the introitus of one year's duration following female genital mutilation performed as part of a family cultural practice. She had no urinary symptoms or vulval swelling. Examination showed obliteration of the vestibule, with absence of the labia minora and majora, leaving a pinhole opening in the upper vestibule through which the urethra was visible. Discussion: Female genital mutilation is a form of child abuse with no medical benefit. It is practised for reasons that may include cultural and religious beliefs. The procedure may involve the clitoris, with or without removal of the labia minora or majora; in FGM, the vulval tissues are apposed to narrow the vaginal opening, leaving a small passage for urine and menstrual blood. In this case, only a pinhole opening remained after the procedure, although urinary outflow was not affected at presentation. Without appropriate long-term care, the condition may have future sexual, gynaecological, obstetric and psychological consequences. Conclusion: Infibulation and its associated complications remain present in parts of the West African subregion. Greater public and professional awareness of the dangers of this practice is required, together with consistent enforcement of existing laws to deter further cases.