Type I Female Genital Mutilation: A Cause of Completely Closed Vagina

Abstract

Introduction: Female genital mutilation (FGM) ranges in severity from a nick of the clitoris to partial or total removal of the external genitalia. Sexual complications after FGM include sexual dysfunction, difficult intercourse, and dyspareunia. Aim: We report a case of Type I FGM presenting as complete vaginal closure and urinary retention. Methods: A 16-year-old adolescent was referred for obliterated vagina and urinary retention. She had recurrent urinary tract infections, difficulty in voiding, and cyclic hematuria. At the age of 1 year she had been taken by her mother to a pediatric surgeon to have a Type I FGM procedure. On examination, the urethral meatus and vaginal orifices were completely closed by the FGM scar. She underwent uneventful surgical opening of the vagina. Results: A normal vaginal orifice was created and normal flow of urine and menses occurred. Conclusion: Type I FGM can present as complete vaginal closure and urinary retention. Proper diagnosis and treatment are of paramount importance. © 2014 International Society for Sexual Medicine.