Vaginal Injuries Following Consensual Sexual Intercourse and Trauma- A Case Series (original) (raw)
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Coital Laceration in Shock: A Case Report
SSRN Electronic Journal, 2019
Background: Coital lacerations vary from minor self-limiting vaginal injury with minimal bleeding, which do not require medical attention to life-threatening tear with severe bleeding which could progress to haemorrhagic shock and death if not promptly managed. Case presentation: A 19-year-old senior secondary school student who presented to the gynaecological emergency unit with coital laceration in shock. She was resuscitated, and had repair in theatre. Conclusion: Coital laceration is usually mild. It could be life-threatening in severe cases. Prompt diagnosis and management of severe cases will reduce the morbidity and mortality associated with it.
Female Genital Injury Following Consensual and Nonconsensual Sex: State of the Science
Journal of Emergency Nursing, 2012
Introduction: Nurses who evaluate patients following sexual assault are often faced with the task of identifying genital injuries and providing legal testimony regarding the nature of the injuries. Following a 2000 Virginia State court decision, sexual assault nurse examiners have had to struggle to answer the questions, "Are the genital injuries consistent with the patient's history?" and "Are the genital injuries consistent with sexual assault?" Methods: A search of the relevant scientific literature was conducted. Sources were examined and reviewed to identify what is presently known about adult female genital injuries associated with either consensual or nonconsensual sexual intercourse. Results: Female genital injuries occur with both consensual and nonconsensual sexual contact. Although some studies suggest that differences in injury patterns, types, or locations may exist, the data do not unequivocally confirm these findings. Discussion: Currently, the presence or absence of genital injury should not be used to render an opinion regarding consent to sexual intercourse. Further research is necessary to determine if injury patterns can indeed distinguish consensual from nonconsensual sex.
Genital injuries acute evaluation and management
Best Practice & Research Clinical Obstetrics & Gynaecology, 2018
Genital trauma may result in external injuries to the labia, vulva or vagina, urethra and anus and internal injuries to the bony pelvis, bladder, bowels and reproductive organs. Worldwide, the most common cause of genital trauma in reproductive age women is injury sustained during childbirth, but in this chapter we will focus on accidental genital injuries as well as those arising from sexual violence, and female genital mutilation. While genital injuries alone rarely result in death; if not properly managed, chronic discomfort, dyspareunia, infertility, or fistula formation may result. Clinicians need to be able to recognize these injuries and provide initial management, and assure that the patient's mental, emotional and physical needs are addressed.
Perineal-Vaginal Injuries in Children: Accident or Abuse?
Journal of Forensic Sciences, 2010
A large number of conditions have been mistaken for abuse. Differentiating accidental injuries from inflicted injuries is important in the management of injured children. In this work, the authors describe two cases of accidental perineal-vaginal injury in children. In case 1, a 4-year-old girl suffered a vaginal tear caused by violent stretching during play; in case 2, a 3-year-old girl had minor lacerations of labia minora and majora. The intervention of a multi-specialist team including a forensic pathologist and forensic psychiatrist was the key factor in being able to exclude abuse by third parties in the described cases.. This leads to the appropriate recommendations to be adopted in the forensic medicine setting.
Patterns of accidental genital trauma in young girls and indications for operative management
Journal of Pediatric Surgery, 2010
Background/purpose: The aim of this study was to define the injury patterns of accidental genital trauma (AGT) in female patients and examine the indications and outcomes of operative intervention. Methods: Review of patients younger than 16 years with AGT from 1980 to 2007 excluding sexual-and obstetric-related injuries. Results: One hundred sixty-seven patients met the criteria. Mean (±SEM) age was 6.9 (0.2) years. There were 70.5% straddle injuries, followed by nonstraddle blunt injuries (23.5%) and penetrating injuries (6.0%). Injuries to the labia were most frequent (64.0%). Injuries to the posterior fourchette (7.8%) and hymenal disruption (8.4%) were less frequent. There was 87.9% of AGT that was managed expectantly without further sequelae. Twenty patients (12.1%) were managed operatively. Penetrating injuries were more likely to require operative management (P ≤ .03). The operative group was also more likely to have multiple genital injuries (60% versus 25%, P b .01). Proctoscopy, vaginoscopy, and/or cystoscopy were performed in 55% of patients in the operative group. Conclusions: Accidental genital trauma is most commonly caused by straddle-type injuries and is usually amenable to nonoperative management. Hymenal disruption and injuries to the posterior fourchette are uncommon with these types of injuries.
Forensic Emergencies In The Context Of Genital Injuries: A Case Report
Journal of emergency medicine case reports, 2024
A review of gynecological emergency cases shows that traumatic injuries observed in consensual sexual relations, sexual abuse victims or following an abortion, secondary infections, internal organ injuries, and massive bleeding are gynecological forensic cases that may require an emergency approach. In this case; it is aimed to discuss the case of a child who was diagnosed as sexual abuse and reported as a forensic case. In the evaluation of the case of a 15-year-old girl who applied to the emergency service with a history of the foot of a stool entering her vaginal area, it was seen that she had a complaint of active vaginal bleeding but was referred to Child Monitoring Center (CİM) without taking a detailed anamnesis or performing any tests. During the forensic interviews at CİM, on account of the fact that the patient complained of dizziness, an emergency forensic vaginal examination and operation was performed. Active vaginal bleeding, 3 cm transverse laceration, and uterine artery injury were found in the area between the upper cervix and lower uterine segment. Our study aims to contribute to raising awareness about the importance of medical evaluation and healthy anamnesis in the emergency department regarding these issues.
2013
This study aims to determine the incidence, clinical presentation and risk factors to coital MATERIALS AND METHOD A 20 year (1990-2009) retrospective descriptive study of all patients with coital injuries seen patients were obtained from the operation Background: Evidence suggests that coital trauma is a common occurrence in the society but grossly underreported as most of the injuries are minor and self limiting. Objective: To document the pattern of coital trauma. Method: Result: The incidence of coital trauma in this study was 0.34% of the total gynaecological patients seen within the period. The mean age was 19.88+6.75, 45.8% of them were teenagers and 16.7% were prepubertal girls. Alleged rape was the commonest aetiological factor seen Conclusion: Coital injury in the society is not an uncommon occurrence but seldom reported and still poses a great challenge as regards to its prevention. Sex education, counseling and enforcement of stringent penalties to the perpetuators of rape will go a long way in reducing its occurrence.
Retrospective Review of Unintentional Female Genital Trauma at a Pediatric Referral Center
Objectives: Unintentional female genital trauma is a complaint commonly seen and managed through the emergency department. The purpose of this study was to review all unintentional female genital trauma evaluated at The Hospital for Sick Children for 3.5 years to determine the factors associated with gynecologic consultation and need for operative repair. Methods: One hundred five patients were identified by health record coding. Data were extracted to study factors associated with gynecologic consultation and operative repair. Statistical analyses were performed to evaluate the significance of these associations. Surgical choices were also evaluated. Results: Mean age was 5.60 years. Mean time to presentation was 7.05 hours. Straddle injury was the most common mechanism (81.90%), and only 4.76% injuries were penetrating. Of the 105 patients, 48.57% consulted the gynecology section, 19.05% were taken to the operating room, and 6.66% were treated under conscious sedation. Overall, 20.95% required surgical repair. The most common complication was dysuria. Six patients had other injuries, the most common of which were pelvic fractures related to trauma. Factors significantly associated with gynecologic consultation and operative management included older age, transfer to our institution, shorter time to presentation, laceration-type injury, hymenal injury, and larger size of injury. Straddle injuries were significantly less likely to be taken to the operating room. When cases were stratified by a surgeon, there were no significant differences in management. Conclusions: Unintentional female pediatric genital traumas most commonly result from straddle injuries. Most injuries are minor, and in this cohort, only 48.57% received gynecologic consultation and 19.05% required operative management. Future prospective studies would be useful to better evaluate the efficacy of surgical choices.
This study aims to determine the incidence, clinical presentation and risk factors to coital MATERIALS AND METHOD A 20 year (1990-2009) retrospective descriptive study of all patients with coital injuries seen patients were obtained from the operation Background: Evidence suggests that coital trauma is a common occurrence in the society but grossly underreported as most of the injuries are minor and self limiting. Objective: To document the pattern of coital trauma. Method: Result: The incidence of coital trauma in this study was 0.34% of the total gynaecological patients seen within the period. The mean age was 19.88+6.75, 45.8% of them were teenagers and 16.7% were prepubertal girls. Alleged rape was the commonest aetiological factor seen Conclusion: Coital injury in the society is not an uncommon occurrence but seldom reported and still poses a great challenge as regards to its prevention. Sex education, counseling and enforcement of stringent penalties to the perpetuators of rape will go a long way in reducing its occurrence.