Female Genital Mutilation - World Health Organization

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FEMALE GENITAL MUTILATION
STUDENT MANUAL
where young girls have been punished for this
condition. Management is as follows:
● Assess the client to identify the problem and type
of FGM.
● If the client has been infibulated, counsel on the
need for opening up.
● If the client has haematocolpos or stones or
stenosis, refer her for surgical intervention under
general anaesthetic. In cases of vaginal stenosis,
surgical intervention may involve dilatation.
Menstrual disorders
Many excised women report severe dysmenorrhoea
with or without menstrual regularity. Possible causes
of this problem are an increase in pelvic congestion
due to infection or other unknown causes, or anxiety
over the state of the genitals, sexuality or fertility.
Management is as follows:
● Try to establish the cause of dysmenorrhoea by
taking a history and performing a clinical
examination of the client’s genitalia.
● Counsel the client to find out how she feels and
support her in dealing with the situation.
● Give antispasmodic drugs to relieve pain.
● If dysmenorrhoea is due to the accumulation of
menstrual flow as a result of infibulation, counsel
the client on the need for opening up.
● If the condition is severe refer to a gynaecologist
for further management.
Ulcers
Vulval ulcers may develop as a result of the
formation of urea crystals in urine trapped under the
scar tissue. Management of this condition is as follows:
● Counsel the client on the need for opening up her
infibulation, and advise her that her vulva should
be kept open thereafter.
● Perform the procedure after getting her informed
consent.
● Apply antibiotics locally with or without 1-%
hydrocortisone cream.
● If the ulcer is chronic and fails to heal, refer client
for surgical excision of the tough fibrous walls.
Documentation of FGM
● Always record FGM type and complications
presented.