Association between female genital mutilation type and lower urinary tract symptoms among symptomatic Somali women: a cross-sectional study

Background Female genital mutilation (FGM)/cutting remains highly prevalent in Somalia and is associated with a range of long-term gynaecological and urological complications. However, data on lower urinary tract symptoms (LUTS) and their severity across different FGM types are limited. The aim of this study was to examine the association between FGM type and LUTS among symptomatic care-seeking women with FGM and to evaluate whether symptom severity differed according to FGM type. Design This cross-sectional study included 122 symptomatic women with a history of FGM who presented with LUTS between January and April 2024. Methods Sociodemographic characteristics, FGM type, clinical symptoms, and vaginal and urine culture results were recorded. LUTS severity and associated bother were assessed using the International Consultation on Incontinence Questionnaire–Female Lower Urinary Tract Symptoms Long Form (ICIQ-FLUTS-LF). Comparisons were made between women with FGM types I–II and those with type III. Results The mean age of participants was 31.7±7.6 years. Women with FGM type III had a significantly higher prevalence of positive urine culture growth, history of urinary tract infection (UTI) and prior antibiotic use, and abdominal pain compared with those with types I–II (p<0.05). Median scores for all LUTS domains and corresponding bother scores were significantly higher in women with FGM type III compared with types I–II (all p<0.001), and similar findings were confirmed in regression analyses. Conclusion Among symptomatic care-seeking women with FGM, type III was associated with greater LUTS burden, higher reported history of UTI and greater symptom-related distress compared with types I and II.