VULVAR INJURIES INCLUDING SEXUAL ABUSE

Female genital injury is not infrequent, and it includes vulvar and vaginal injury and is classified as external, internal and anal, based on the location. Non-sexual injuries are usually accidental or intentional and are caused by blunt or penetrating trauma or by burns or contact with caustic agents. Intrapartum genital trauma is common but usually mild and heals quickly, except in rare cases. Female genital mutilation is a rare cause seen in certain regions. Sexual trauma involves injury to the posterior fourchette, hymen, labia minora and fossa navicularis. Ecchymosis, edema and tears are commonly seen. Forced penetration leads to more severe injury. Evaluation of a genital injury case should be focused on ruling out intentional non-sexual injury and sexual abuse. Management involves rest, analgesics, antibiotics and surgical repair in certain indicated cases.