Traumatic injuries of the female external genitalia and their association with urological injuries

H B Goldman, C B Idom, R R Dmochowski
Journal of Urology 1998, 159 (3): 956-9

PURPOSE: To date trauma to the female external genitalia has been incompletely characterized. At our institution a large number of such patients have been identified and many had associated urological injuries. We characterize these injuries and their association with urological injuries.

MATERIALS AND METHODS: We reviewed the charts of all female patients presenting with trauma to the genitalia unrelated to parturition between 1991 and 1996. Type and mechanism of injury, associated injuries and blood transfusion requirements were noted. Vaginal injuries were classified as complex (greater than 3 cm., multiple or involving deeper structures) or simple (all others).

RESULTS: We identified 20 women a mean 20.7 years old with traumatic injuries to the genitalia, including motor vehicle accidents in 6, injury from consensual intercourse in 5, sexual assault in 4 and other penetrating injuries in 5. There were 15 patients with vaginal injuries (complex in 8 and simple in 7) and vulvar injuries in 5. Six of the 20 women (30%) had associated urological injuries (urethra in 1, bladder in 4, ureter in 1 and kidney in 3) [corrected], including 3 associated with blunt trauma (all complex vaginal injuries) and 3 associated with penetrating trauma (simple vaginal or vulvar injuries).

CONCLUSIONS: Traumatic injury to the female genitalia unrelated to parturition is more common than previously reported. Of the women with such injuries 30% have coexisting urological injuries. Thus, it is important to assess completely all women who present with external genitalia trauma for possible coexisting urological injury.

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