Genital injuries acute evaluation and management

Lopez, Heather; Focseneanu, Mariel; Merritt, Diane F.

doi:10.1016/j.bpobgyn.2017.09.009

Cited by 22 publications

(14 citation statements)

References 48 publications

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“…However, if the EGOI is not managed properly, the female patients may have chronic discomfort, dyspareunia, infertility or fistula formation. 18 Male patients should be tracked to avoid testis loses due to hematoma and undetermined ruptures in the long term.…”

Section: Discussionmentioning

confidence: 99%

External genital injuries in childhood: obey the rules and detect the unseen

Tuncer¹,

Embleton²,

User³

et al. 2018

Int Surg J

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Background: This paper evaluates the patients with external genital organ injuries (EGOI) and the suitability of the Onen’s genital injury scoring (GIS) for the management of such patients.Methods: This is a cross-sectional study. Patients with the complaints of EGOI were retrospectively explored regarding to age, sex, trauma type, hospitalization time, classification of injury type, presence of additional pathologies and treatment methods. After the injury types are classified by using the Onen’s GIS, we investigated the sufficiency of this scoring method for our treatment modalities.Results: A total of 57 patients, 19 females and 38 males, were diagnosed as EGOI. These patients were classified with Grades (G) by using the Onen’s GIS (G1: 42, G2: 7, G3: 5, G4: 2, and G5: 1 patient.). The Grade 5 patient had a colostomy. The external anal sphincters of two patients were repaired to avoid incontinence in the future. The other patients received either medical or non-specific surgical treatments for their injuries. A G3 patient with testicular hematoma had testicular atrophy in the following year. There was no mortality in the present series.Conclusions: The EGOI at childhood ranges from minor derma-abrasion to complete tears of anorectum which requires colostomy. Onen’s GIS ensures better management.

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Section: Discussionmentioning

confidence: 99%

External genital injuries in childhood: obey the rules and detect the unseen

Tuncer¹,

Embleton²,

User³

et al. 2018

Int Surg J

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“…Traumatic injury to the female genital tract includes external injuries to the labia, vulva or vagina, urethra and anus and internal injuries to the bony pelvis, bladder, bowels and reproductive organs [ 1 ]. Obstetric complications are the most common cause of female urogenital trauma, although non-obstetric causes are not unusual.…”

Section: Introductionmentioning

confidence: 99%

Bladder rupture due to urogenital tract trauma caused by ox horn injury in a patient with pelvic organ prolapse: a case report

Mengistu

Molla

2020

J Med Case Reports

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Introduction Genitourinary tract trauma caused by ox horn injury in the presence of pelvic organ prolapse (POP) is an extremely rare phenomenon and associated with devastating morbidity. Case presentation A 50-year-old multiparous postmenopausal woman from rural northwest Ethiopia presented with the primary complaint of urinary incontinence 6 days after she suffered ox horn injury to her prolapsed genitalia. She had stage 3 pelvic organ prolapse with the leading point being the cervix. The anterior vaginal and posterior bladder walls were disrupted with visible draining of the left ureter. The wound was dirty and edematous with whitish discharge. She was admitted to the urogynecology ward and provided with wound care until the infection subsided. Apical prolapse suspension was performed using right sacrospinous fixation, and bladder repair was carried out 6 weeks following the prolapse suspension. She recovered well and was continent when discharged. Conclusion Ox horn injury involving the female lower urogenital tract in the presence of POP is extremely rare. Late presentation after sustaining injury is associated with increased risk of morbidity and long hospital stay, and treatment requires multistage surgery.

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“…However, the vulva and vagina are susceptible to hemorrhage due to their rich blood supply by branches of the internal pudendal artery [3]. The etiology of non-obstetric VVT includes sports-related injuries (bicycle related being the most common), straddle injuries, midline splitting injuries (such as falls during in-line skating), crush injuries, penetrating injuries (including gunshot wounds), burns, animal/human bites, and non-accidental trauma such as sexual assault, rape, or abuse [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…There appears to be a paucity of data regarding nonobstetric VVT as many studies combine obstetric-related injuries with traumatic injuries [4,6]. The majority of previous non-obstetric VVT studies focus on the pediatric population as the incidence is higher, which is attributed to the decreased labial fat pads that provide lesser protection [4]. Additionally, the majority of reports on adult VVT are small single-center studies, often reported as a case-series [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Analysis of non-obstetric vaginal and vulvar trauma: risk factors for operative intervention

et al. 2019

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Vaginal and vulvar trauma may occur accidentally or because of an act of violence. Due to its rarity, little is known about risk factors effecting need for operative intervention. We sought to perform a large descriptive analysis of adult non-obstetric vulvovaginal trauma (VVT) and elucidate risk factors for requiring operative intervention. A retrospective analysis of the National Trauma Data Bank was performed between 2007 and 2015. Patients ≥ 16 years old with vaginal or vulvar trauma were identified. Risk factors for surgical intervention were identified using a multivariable logistic regression analysis. From 2,040,235 female patients, 2445 (< 0.2%) were identified to have VVT with the majority being injury to the vagina (68.6%). In patients with injury to the vagina, age > 65 (OR = 0.41, CI 0.26-0.62, p < 0.001), Injury Severity Score > 25 (OR = 0.66, CI 0.50-0.86, p = 0.01) and victims of rape (OR = 0.39, 95% CI 0.26-0.57, p < 0.001) were less likely to require operative intervention. In patients with injury to the vulva, age > 65 (OR = 0.45, CI 0.21-0.94, p = 0.02), victims of rape (OR = 0.26, CI 0.08-0.87, p = 0.01) and gunshot violence (OR = 0.10, CI 0.02-0.59, p = 0.02) were less likely to require operative intervention, but those with a concomitant injury to the vagina were more likely to require operative intervention (OR = 2.56, CI 1.63-4.03, p < 0.001). Injuries to the vagina or vulva occur in < 0.2% of traumas. Interestingly, in both vulvar and vaginal trauma, older age, and involvement in rape were associated with lower risk for operative intervention. A combined injury to the vagina and vulva increases the need for operative intervention.

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Genital injuries acute evaluation and management

Cited by 22 publications

References 48 publications

External genital injuries in childhood: obey the rules and detect the unseen

External genital injuries in childhood: obey the rules and detect the unseen

Bladder rupture due to urogenital tract trauma caused by ox horn injury in a patient with pelvic organ prolapse: a case report

Analysis of non-obstetric vaginal and vulvar trauma: risk factors for operative intervention

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