The procedure is often accompanied by infibulation, or the stitching together of the vulva. This is usually done following the removal of the clitoris, when the woman’s labia major is sewn together, leaving an opening small enough for only urine and menstrual blood to pass through. Prior to marriage, the opening must be enlarged to allow for penetration during intercourse, a process that can take three or more months.
In addition to sexual dysfunction, a clitoridectomy has many long-term effects including incontinence, sterility, increased susceptibility for the AIDS virus, and even death. Medical complications are common since the person who performs the procedure is generally not medically trained, but rather a parent or elderly member of the community. The surgery is usually performed without anesthesia, with a razor, glass shard, or other unsterilized instrument. As a result, tetanus, hemorrhages, and massive scarring can also occur. There are also long-term psychological effects, including depression, anxiety, and reduced self-esteem.
Most women do not choose to undergo a clitoridectomy, as the surgery is typically performed on girls between the ages of four and eight. These girls are usually tied or held down during the procedure. Estimates suggest that approximately 130 million women and girls across the globe have been forced to have the surgery. Now considered a form of violence against women, the clitoridectomy has been banned in many areas of the world. Despite this, however, many cultures continue to practice the procedure.
http://www.wisegeek.com/what-is-a-clitoridectomy.htm
A description of an infibulation
By M.A.S. Mustafa, of Djibouti,
from the thesis of Dr. Alan David
‘The little girl, entirely nude, is immobilised in the sitting position on a low stool by at least three women. One of them with her arms tightly around the little girl’s chest; two others hold the child’s thighs apart by force, in order to open wide the vulva. The child’s arms are tied behind her back, or immobilized by two other women guests. The traditional operator says a short prayer: “Allah is great and Mahomet is His Prophet. May Allah keep away all evils.” Then she spreads on the floor some offerings to Allah: split maize, or, in urban areas, eggs.
Then the old woman takes her razor and excises the clitoris. The infibulation follows: the operator cuts with her raxor from top to bottom of the small lip and then scrapes the flesh from the inside of the large lip. This nymphectomy and scraping are repeated on the other side of the vulva. The little girl howls and writhes in pain, although strongly held down. The operator wipes the blood from the wound and the mother, as well as the guests, “verify” her work, sometimes putting their fingers in. The amount of scraping of the large lips depends upon the “technical” ability of the operator. The opening left for urine and menstrual blood is miniscule.
Then the operator applies a paste and ensures the adhesion of the large lips by means of an acacia thorn, which pierces one lip and passes through into the other. She sticks in three or four in this manner down the vulva. These thorns are then held in place either by means of sewing thread, or with horse-hair. Paste is again put on the wound.
But all this is not sufficient to ensure the coalescence of the large lips; so the little girl is then tied up from her pelvis to her feet: strips of material rolled up into a rope immobilize her legs entirely. Exhausted, the little girl is then dressed and put on a bed. The operation lasts from fifteen to twenty minutes according to the ability of the old woman and the resistance put up by the child.’
http://www.angelfire.com/ar/pilgrim/infibdesc.html