Genital lesions complicating female genital cutting in infancy: a hospital-based study in south-east Nigeria.
BACKGROUND
Despite the global outcry against female genital cutting (FGC), the practice continues in many African communities. The morbidity of this practice on the girl child deserves more attention.


OBJECTIVE
To determine the genital lesions complicating childhood FGC and the underlying factors that sustain this practice among the Igbos in south-east Nigeria.


METHODS
Prospective evaluation of girls with genital complications of FGC between January 2003 and June 2005 at the Federal Medical Centre, Owerri, south-east Nigeria. The girls' mothers were interviewed at presentation and subsequent visits to determine their perception and attitudes towards FGC.


RESULTS
The average age at presentation was 3.5 years (range 1-5) and the genital cutting procedures were performed 8-90 days after birth. The procedure was undertaken by traditional practitioners in 14 (66.7%) girls and by nurses in 7 (33.3%) girls. Twelve girls (57.1%) had type I genital cutting and nine (42.9%) type II. Inclusion clitoral dermoid cyst and labial fusion were the complications in 13 (61.9%) and eight (38.1%), respectively. Treatment involved complete excision of the cysts and operative division of the labial fusion. Post-operative complications were wound infection (5) and labial adhesion (2). With duration of admission ranging from 3 to 5 days, the average cost of managing each child was $120. Of the girls' mothers, 15 (71.4%) had been educated to secondary level and 17 (80.1%) were aware of the campaign against FGC. Regrettably, all the mothers had genital cutting themselves during childhood and 13 (61.9%) stated that they would like to perpetuate the practice for socio-cultural reasons. Despite this, they all volunteered that FGC is enforced by the child's paternal relations.


CONCLUSIONS
Childhood FGC contributes to appreciable morbidity among girls, a large proportion of whom are not managed in a hospital setting. The cost of managing these complications can be enormous, especially in low-resource settings. Girl child education to tertiary level and the involvement of traditional rulers and local decision-makers in the campaign against FGC might help to eradicate the practice.
Paediatric Surgical Unit, Department of Surgery, Federal Medical Centre, Owerri, Nigeria. soekenze@yahoo.com
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Ezegwui
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D002675:Child, Preschool; D019093:Circumcision, Female / Q000009:adverse effects* / Q000191:economics / Q000523:psychology; D002987:Clitoris; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D003884:Dermoid Cyst / Q000209:etiology / Q000601:surgery; D004522:Educational Status; D005260:Female; D005831:Genital Diseases, Female / Q000191:economics / Q000209:etiology* / Q000601:surgery; D017048:Health Care Costs / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D007223:Infant; D009549:Nigeria; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D000267:Tissue Adhesions / Q000209:etiology; D014846:Vulvar Neoplasms / Q000209:etiology / Q000601:surgery