Management of female genital trauma

Abstract

The management of female genital trauma is complex and should be performed by a well-trained team of health care professionals. It is important to remember that many female genital injuries will cause not just physical injury, but also significant psychological and emotional distress that may lead on to future physical dysfunction. The approach of any health care professional in the immediate diagnosis and management of females with a genital injury must be aimed at getting the best and most appropriate care to the patient as soon as possible. It is also important to remember that many of these injuries are the result of crimes and careful documentation is required so as not to remove or invalidate evidence that may later be required by the courts. This article is aimed at non-specialist healthcare providers who may find themselves faced with a female genital trauma patient. It will cover the range of injuries and conditions that should be expected and describes the treatment that should be given for the best possible physical and psychological outcomes. At all times it should be remembered that the patient should be assessed and resuscitated in accordance with recognised ATLS protocols.

Genital trauma in prepubertal girls and adolescents

“…If the injury is not severe, the child may be examined in an outpatient setting without sedation. If the child or adolescent is severely injured or unable or unwilling to allow an adequate examination to be accomplished, light conscious sedation or general anesthesia may be required [1,2].…”

Vulvovaginal Laceration and Pelvic Fracture With Symphisiolysis

“…Most of postpartum vulvovaginal lacerations will not cause long term complications, however severe lacerations are associated with a higher incidence of longterm pelvic floor pain, dyspareunia, dysfunction, and embarrassment. Lower urogenital tract trauma cases are challenging as there are psychological factors that contribute to long-term complications (Hall & Brown, 2009). An understanding of anatomy, diagnosis, management and complications is essential for optimal outcomes of genital trauma (Merritt, 2008).…”