Such an excision may be as extensive as a vulvectomy. Although the age of circumcision ranges from newborn to adult years, it is primarily a prepubertal custom usually done while the child is held down by a family member. . When one considers the anatomy of the underdeveloped prepubertal female external genitalia, one can begin to understand the difficulties with this procedure, especially since it is commonly done without anesthesia, sterile instruments or visual accuracy. The external genitalia of the prepubertal female are very fragile and miscalculations in this area can be disastrous. Similarly, the clitoris, like the penis, is rich with arteries, veins, lymphatics, as well as sensory and motor nerves.
Urinary retention is often an immediate result of the procedure.
Delayed gynecological complications include hematocolpos, menstrual disorders, vaginal stenosis and future infertility or sterility. The occlusion superior to the imperforate hymen can be a most disastrous complication when a girl presents with an enlarging abdominal mass and apparent amenorrhea, when virginity was the goal of the procedure. The urological complications related to the extent of the adnexal damage from either infection, bleeding or wideness of the excision of the clitoris and adnexal labia. Either incontinence, because of loss of sphincter function, or urethral stenosis and inability to void appropriately can result. The latter will be associated with increased urinary infections because of the relative or complete obstruction.