Female circumcision - (Not) a purely African problem

Introduction: There are three different types of female circumcision: phara onic type, sunna and intermediary circumcision. Female circumcision - also called female genital mutilation (FGM) - is seen more frequently by general practitioners, gynecologists or urologists even in europe because of an in creasing number of immigrating people. The following article points out pos sible complications after circumcision by 39 patients from Sudan and a lite rature review. Method and Material: Between 1986 and 1989 39 patients from four different regions in Sudan were seen because of complications during delivery and aft erwards. Complications during and after delivery and urogynecologic complic ations were noted. Circumcisions and deliveries were performed by tradition al midwives. For the treatment of complications doctors but not the midwive s were involved. The patients' age was between eight and 41 years (median 2 4). All patients except one had been circumcised pharaonically. Results: After circumcision infections, complications during and after deli very by prolonged second stage and sexual malfunction as well as retention of menstrual blood, urinary retention and septicemia are possible. Genital infections are mainly caused by the use of unsterile instruments and techni ques, lack of hygiene and retention of blood. Discussion: Complications after circumcision are frequently seen after deli veries and after the circumcision itself. In Europe there is a growing numb er of circumcised patients who seek medical advice, Especially obstetric pa tients but also urogynecologic patients and in general practice questions a rise concerning treatment or counselling of circumcised women. Information regarding possible treatments by reconstructive surgery demands knowledge o f the different kinds of circumcision.