... Those men who do manage to penetrate their wives do so often, or perhaps always, with the help of the "little knife". This creates a tear which they gradually rip more and more until the opening is sufficient to admit the penis. Type IV
Type IV is "[a]ll other harmful procedures to the female genitalia for non-medical purposes", including pricking, piercing, incising, scraping and cauterization. It includes nicking of the clitoris (symbolic circumcision), burning or scarring the genitals, and introducing substances into the vagina to tighten it. Labia stretching is also categorized as Type IV. Common in southern and eastern Africa, the practice is supposed to enhance sexual pleasure for the man and add to the sense of a woman as a closed space. From the age of eight, girls are encouraged to stretch their inner labia using sticks and massage. Girls in Uganda are told they may have difficulty giving birth without stretched labia.A definition of FGM from the WHO in 1995 included gishiri cutting and angurya cutting, found in Nigeria and Niger. These were removed from the WHOs 2008 definition because of insufficient information about prevalence and consequences. Angurya cutting is excision of the hymen, usually performed seven days after birth. Gishiri cutting involves cutting the vaginas front or back wall with a blade or penknife, performed in response to infertility, obstructed labour, and other conditions.
Treatment
No treatment is generally required, as bone demineralisation and kidney stones are relatively uncommon in the condition. References


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