Female Genital Mutilation in the Democratic Republic of Congo: Prevalence, Types, Sociodemographic and Cultural Characteristics, and Long‐Term Pelvic Floor Outcomes

INTRODUCTION: In 1999, the prevalence of female genital mutilation (FGM) was 5% in the Democratic Republic of the Congo (DRC). This study aims to assess FGM prevalence and types, describe its demographic and sociocultural characteristics, and evaluate its long-term impact on pelvic floor and sexual function. METHODS: A cross-sectional study was conducted from 2021 to 2023 among 519 adult women living in six provinces of the DRC, selected to represent the country's ethnolinguistic diversity. Pregnant women, those within 6 months of childbirth, survivors of sexual violence, and those with war mutilations were excluded. A questionnaire was designed to collect data, supplemented by a vulvar assessment. The variables were compared using appropriate statistical tests (p < 0.05). RESULTS: The prevalence of FGM was 15.2% (95% CI: 12.2%-18.6%). The prevalence of FGM Types I-II and inner labia elongation (ILE) was 1.7% (95% CI: 0.8%-3.3%) and 13.5% (95% CI: 10.7%-16.7%), respectively. ILE was on average performed at the age of 13.8 years, mainly by women themselves (88.6%), while the circumstances of FGM I-II practice were unknown. ILE was practiced among the Swahili (65.7%) and the Baluba (27.1%), while FGM I-II were practiced among the Bangala (100%). Women with ILE were at higher risk of urinary incontinence (OR: 2.02; 95% CI: 1.17-3.45), dyspareunia (OR: 2.07; 95% CI: 1.08-3.99), and sexual satisfaction disorders (OR: 2.75; 95% CI: 1.34-5.52) than women without FGM. CONCLUSION: FGM is practiced in specific ethnic groups in the DRC, with ILE secondarily leading to long-term effects on pelvic floor and sexual function.