Nonobstetrie Lower Genital Tract Trauma

Abstract

In a 4-year-period there were 31 admissions to Nehru Hospital, because of nonobstetric injuries of the female genital tract. This constituted 0.8% of all gynaecological admissions over this period. The injuries were caused by voluntary coitus, automobile accidents and various types of astride injuries. Seven of the 18 patients with noncoital injuries presented with vulval haematomas and all were managed by evacuation under general anaesthesia. Two of the 13 patients with coital injury were admitted with haemorrhagic shock and required initial resuscitation with blood transfusion. The vaginal vault, especially the right and posterior fornices were the frequent sites of coital injury for parous women; on the other hand lower vaginal and introital injuries were caused by first acts of coitus. Except for trivial superficial lacerations with minimal bleeding, primary definitive surgical repair other than vaginal packing was favoured for better healing and to reduce morbidity.

Sexual injuries during consensual sexual activity

“…[6,7] Cinsel yaralanmaların genel jinekoloji pratiğindeki sıklığı muhtelif yayınlarda %0,05 ile %0,7 arasında değişen oranlarda bildirilmiştir. [5,[7][8][9][10] Ancak gerçek sıklığının bildirilenden çok daha fazla olduğu tahmin edilmektedir. [5] Kadınlarda cinsel yaralanmalar sıklıkla izole vajina laserasyonu şeklinde görülmekle beraber izole veya vajina laserasyonu ile birlikte vulva, üretra, mesane ve rektum yaralanmaları da görülebilmektedir.…”

“…[4,12] En sık görülen komplikasyonlar erken dönemde kan nakli, resüsitasyon ve yara yeri enfeksiyonu iken geç dönemde disparoni, yaranın skarla iyileşmesi ve inatçı genital enfeksiyonlardır. [8] Olgularımızda rastlanan komplikasyonlar erken dönemde kan nakli ve enfeksiyon iken geç dönemde disparoni gelişimidir.…”

Non-obstetric vulval hematoma is not so uncommon

“…[1][2][3][4][5][6] It usually constitutes 0.8% of all gynecological admissions, in tertiary and referral hospitals. 7 Unusual etiologies may include automobile accidents, goring by a cow and straddle bicycle seat bar accidents.…”

Bull Gore Injury of the Vagina

“…Arterial embolization has also been tried, with success [11]. The life threatening vaginal injuries almost always need surgical repairs [3,4]. An established protocol provides an organized and a systemic…”

“…Non obstetric traumas to the vagina and the vulva can occur due to variety of reasons like vigorous sexual intercourse [1][2][3][4], an accidental fall on pointed objects in the straddle or the astride positions [4,5], snowboarding [6], bull horn injury [7,8], water skiing [9], jet skiing [10], blunt trauma [11], etc.…”