Genital Injuries: Are They Telling us Something about Sexual Violence?

Orellana-Campos, Carolina

doi:10.1055/s-0040-1701465

Cited by 5 publications

(7 citation statements)

References 37 publications

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“…In the literature, evidence of genital injuries after sexual offenses ranges from 6% 10 to 87% 11 . This may be attributed to differences in the patient inclusion criteria used in the different studies, the definition of genital injuries, and the delay in seeking medical assistance, as well as the study method 12 , 13 , 14 . Transient evidence (skin redness, swelling) is not systematically recorded 12 , 15 , and may be missed if there is a prolonged delay since the time of the offense.…”

Section: Discussionmentioning

confidence: 99%

“…This may be attributed to differences in the patient inclusion criteria used in the different studies, the definition of genital injuries, and the delay in seeking medical assistance, as well as the study method 12 , 13 , 14 . Transient evidence (skin redness, swelling) is not systematically recorded 12 , 15 , and may be missed if there is a prolonged delay since the time of the offense. In contrast to studies showing that significantly more genital injuries were detected in women examined within 72 hours of a sexual offense 16 , 17 , 18 , we were unable to confirm this in our cohort.…”

Section: Discussionmentioning

confidence: 99%

“…The absence of genital injuries does not generally preclude a sexual offense 12 . Conversely, the presence of genital injuries does not prove that a sexual offense took place, since injuries may also occur after consensual sexual intercourse 17 .…”

Section: Discussionmentioning

confidence: 99%

“…In der Literatur variiert der Nachweis genitaler Verletzungen nach Sexualdelikten zwischen 6% 10 und 87% 11 . Dies lässt sich durch Unterschiede bezüglich der Einschlusskriterien der Patientinnen in die Studien, der Definition von genitalen Verletzungen, der Latenz zur Tatzeit und der Untersuchungsmethode erklären 12 , 13 , 14 . Flüchtige Befunde (Hautrötungen, Schwellungen) werden in manchen Studien nicht systematisch erfasst 12 , 15 und können sich bei längerer Latenz einer späteren Nachweisbarkeit entziehen.…”

Section: Diskussionunclassified

“…Dies lässt sich durch Unterschiede bezüglich der Einschlusskriterien der Patientinnen in die Studien, der Definition von genitalen Verletzungen, der Latenz zur Tatzeit und der Untersuchungsmethode erklären 12 , 13 , 14 . Flüchtige Befunde (Hautrötungen, Schwellungen) werden in manchen Studien nicht systematisch erfasst 12 , 15 und können sich bei längerer Latenz einer späteren Nachweisbarkeit entziehen. Im Gegensatz zu Studien, die zeigen konnten, dass bei Frauen, die innerhalb von 72 Stunden nach einem Sexualdelikt untersucht wurden, signifikant mehr genitale Verletzungen detektiert werden konnten 16 , 17 , 18 , konnten wir dies in unserem Kollektiv nicht bestätigen.…”

Section: Diskussionunclassified

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Frequency of Injuries to Women after Sexual Offense – Relevance of a Gynecology Examination

Klasen

Meyer

Anders

et al. 2022

Geburtshilfe Frauenheilkd

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Introduction Up to a third of women worldwide report having experienced an act of sexual violence during their lifetime. The emergency gynecology department is often the first port of call for affected individuals. The aim of the current study was to evaluate the importance of gynecology examinations for women after a sexual offense and to evaluate the pattern of injuries sustained. Methods This study is a retrospective single center analysis of the gynecology and forensic examination reports of all women examined for a suspected sexual offense in the central emergency department of a university hospital between 2013 and 2017 (n = 692). We evaluated genital and extragenital injury patterns, age, offender profile, time of offense, and substance use, as well as the administration of post-coital contraception and post-exposure prophylaxis for HIV. Results The affected individuals had a mean age of 26 (12 – 91 years). Almost 75% of affected individuals presented within 24 hours of the reported sexual offense. Extragenital injuries were detected in 78.6% of patients and genital injuries in 28.5%. Overall, 20.1% of the women reported complete memory loss and 18.7% partial memory loss of the actual event. Risk factors for memory lapse were the consumption of alcohol and/or the (possibly non-consensual) administration of other substances acting on the central nervous system. A history of alcohol consumption by the victim (hazard ratio [HR] 1.95; 95% confidence interval [CI] 1.21 – 3.12, p = 0.006) and younger victims aged between 25 – 49 years (HR 1.75; 95% CI 1.07 – 2.85, p = 0.025) were associated with the occurrence of extragenital injuries. However, if the perpetrator was someone who was known to the affected individual, fewer extragenital injuries were sustained (HR 0.60; 95% CI 0.36 – 0.99, p = 0.046). Reports of genital injuries, associated with an older age of affected individuals and indications of anal penetration, resulted in more frequent administration of post-exposure prophylaxis (29.1% vs. 19.5%, p < 0.012) and hepatitis B (active) vaccination (40% vs. 28.5%, p < 0.028). Conclusion Emergency gynecology examinations form a fundamental component of the medical care and the assessment of affected women after a sexual offense, since almost a third of victims sustain injuries to the genital region. In addition to a detailed complete physical examination and expert forensic documentation of physical and genital injuries, victims should also be offered psychological support which is easy for them to access.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Diskussionunclassified

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Frequency of Injuries to Women after Sexual Offense – Relevance of a Gynecology Examination

Klasen

Meyer

Anders

et al. 2022

Geburtshilfe Frauenheilkd

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Differences in patterns of sexual assault among female victims preceding and during the COVID-19 pandemic: an analysis of encounters in an emergency department

Klasen,

Teltrop,

Belau

et al. 2023

Forensic Sci Med Pathol

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The aim of this study was to evaluate how the COVID-19 pandemic may have impacted the number and patterns of sexual assault victims within a German metropolitan city. A retrospective single center analysis of the gynecology examination reports of all women presenting to the emergency department of a university hospital after a sexual offense between 03/2013 and 02/2021 (n = 1167). Comparison of the first year of the pandemic 03/2000-03/2021) to previous years (03/2017-02/2020) and comparison of periods of government-imposed social distancing (03/12/2020-05/23/2020 and 10/23/2020-02/28/2021) with corresponding periods of pre-pandemic years. The overall number of sexual assault cases did not change during the first year of the COVID-19 pandemic. However, during the stay-at-home orders, the number of women presenting to the emergency department decreased by 38% (n=45 vs. 72). Fewer victims filed a police report during the pandemic (49.5% vs. 73.9%, p<0.001) and the lockdown period (50% vs. 76.5%, p<0.001). Less genital injuries after sexual assault were detected during the pandemic (14.3% vs. 25.2%, p<0.02), but there was an increase of illegal substance abuse (19.5% vs. 9.3%, p<0.003). During the stay-at-home orders fewer victims reported alcohol consumption (42.4% vs. 62.5 %, p<0.023). Despite the decrease in sexual offense related police reports, the number of sexual assault cases remained consistent, and the usage of illegal drugs increased during the COVID-19 pandemic. These findings represent the importance of providing support to sexual assault victims, as well as the implementation of preventative measures, especially in times of crisis.

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Acute concomitant injury and intoxication in complainants of recent sexual assault: A review

Luong¹,

Parkin²,

Cunningham³

2022

Journal of Forensic and Legal Medicine

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Genital Injuries: Are They Telling us Something about Sexual Violence?

Cited by 5 publications

References 37 publications

Frequency of Injuries to Women after Sexual Offense – Relevance of a Gynecology Examination

Frequency of Injuries to Women after Sexual Offense – Relevance of a Gynecology Examination

Differences in patterns of sexual assault among female victims preceding and during the COVID-19 pandemic: an analysis of encounters in an emergency department

Acute concomitant injury and intoxication in complainants of recent sexual assault: A review

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