Patterns of accidental genital trauma in young girls and indications for operative management

Iqbal, Corey W.; Jrebi, Nezar; Zielinski, Martin D.; Benavente-Chenhalls, Luis A.; Cullinane, Daniel C.; Zietlow, Scott P.; Moir, Christopher R.; Ishitani, Michael B.

doi:10.1016/j.jpedsurg.2010.02.024

Cited by 47 publications

(21 citation statements)

References 6 publications

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“…3,5 Straddle-type injuries are reported as the most common (70.5%-81.9% of cases reported) but are least likely to require gynecological evaluation or operative intervention. Penetrating injury and injury above the labia (eg, hymenal injuries) were more likely to require operative intervention.…”

Section: Commentmentioning

confidence: 99%

“…Overall, the majority of accidental female genital trauma did not require general anesthesia or operative intervention (80.9%-87.9%). 3,5 These 2 studies, although informative, were single institution studies. A recent publication using a national inpatient and ED database verified that pediatric female genital trauma rarely requires operative intervention by demon-strating that 90% of patients were discharged from the ED, 4.2% underwent invasive diagnostic evaluation, and 8.9% required surgical repair.…”

Section: Commentmentioning

confidence: 99%

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Pediatric Genital Injury: An Analysis of the National Electronic Injury Surveillance System

Casey¹,

Bjurlin²,

Cheng³

2013

Urology

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Objective To describe the characteristics of pediatric genital injuries presenting to United States emergency departments (EDs). Methods A retrospective cohort study utilizing the U.S. Consumer Product Safety Commission (CPSC) National Electronic Injury Surveillance System (NEISS) from 1991-2010 to evaluate pediatric genital injuries was performed. Results Pediatric genital injuries represented 0.6% of all pediatric injuries with the incidence of injuries rising through the period studied, 1991-2010. The mean age at injury was 7.1 years old and was distributed 56.6% girls and 43.4% boys. A total of 43.3% had lacerations and 42.2% had contusions/abrasions. The majority of injuries occurred at home (65.9%), and the majority of patients (94.7%) were treated and released from the hospital. The most common consumer products associated with pediatric genital trauma were: bicycles (14.7% of all pediatric genital injuries), bathtubs (5.8%), daywear (5.6%), monkey bars (5.4%), and toilets (4.0%). Conclusion Although pediatric genital injuries represent a small proportion of overall injuries presenting to the ED, genital injuries continue to rise despite public health measures targeted to decrease childhood injury. Our results can be used to guide further prevention strategies for pediatric genital injury.

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Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Pediatric Genital Injury: An Analysis of the National Electronic Injury Surveillance System

Casey¹,

Bjurlin²,

Cheng³

2013

Urology

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“…In cases of accidental genital trauma, the hymen and vagina are usually spared and the most common mode of pediatric trauma is a straddle injury. Two recent reports of unintentional genital injury in young girls are comparable in this regard (Table 1) [3,4].…”

Section: Causes Of Injuriesmentioning

confidence: 79%

Genital trauma in prepubertal girls and adolescents

Merritt¹

2011

Current Opinion in Obstetrics &Amp; Gynecology

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Genital injuries whether accidental or intentional need to be reported with standardized terminology to allow for comparisons between reported outcomes. Motor vehicle accidents associated with pelvic fractures may result in bladder or urethral trauma. Adverse long-term psychosocial behaviors may be sequelae of child sexual abuse. FGM is willful damage to healthy organs for nontherapeutic reasons, and a form of violence against girls and women. Healthcare providers should counsel women suffering from the consequences of FGM, advise them to seek care, counsel them to resist reinfibulation, and prevent this procedure from being performed on their daughters.

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“…Most commonly occurring in primary school ages (4–11 years), in contrast to most patterns of injury almost as many girls have been reported as boys, although sadly this may reflect a number of cases of misdiagnosed sexual abuse . Falling astride on bicycle or scooters appear the most common cause of injury, with rope swings, toilet seats and sides of a bath tub also well recognised . A clear, well documented history of the event, any urinary difficulties or haematuria and appropriate clinical examination remain the cornerstone of appropriate management.…”

Section: Straddle Injuriesmentioning

confidence: 99%

“…). Persistent bleeding and deeper or extensive lacerations will require operative intervention, with general anaesthesia, theatre lighting, loupe magnification and optimal exposure assisting repair with absorbable sutures . Whilst the severity of the injury may only be appreciated following an examination under anaesthesia, between 50 and 91% of cases may be safely managed without operative intervention with an excellent outcome …”

Section: Straddle Injuriesmentioning

confidence: 99%

Trauma hazards in children: An update for the busy clinician

Holland

Soundappan

2017

J Paediatrics Child Health

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Trauma and injury continue to be common in children and remain an important cause of mortality and morbidity. Legislation mandating the use of helmets for all cyclists appears to have been effective in reducing the incidence and severity of head and facial injuries, with no clear evidence of a reduction in cycling usage or activity. Straddle injuries, whilst uncommon and generally minor, require careful clinical assessment as they may be associated with urethral trauma. Quad bikes remain highly dangerous with continuing reports of deaths in child riders due to their inherent lack of stability: a ban on their use by children would seem the most effective solution. The popularity of mobile devices and toys, coupled with the development of higher voltage, lithium button batteries have seen a surge in the number of cases and subsequent complications from ingestion. The problems seen in children following ingestion of high-powered, rare earth magnets in the late 1990s and 2000s has now receded due to legislation introduced in 2012. Inhaled, typically organic foreign bodies remain a diagnostic challenge with rigid bronchoscopy still the most effective diagnostic and therapeutic modality. Corrosive ingestion, now seen much less commonly, continues to be a potentially devastating injury when occurring as a result of caustic soda. Recent publicity concerning the problem of childhood drowning highlights the need for constant parental vigilance, the limitations of pool fencing and the importance of community cardiopulmonary resuscitation training, together with repeated education of the risk of rips when swimming in the sea.

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Patterns of accidental genital trauma in young girls and indications for operative management

Cited by 47 publications

References 6 publications

Pediatric Genital Injury: An Analysis of the National Electronic Injury Surveillance System

Pediatric Genital Injury: An Analysis of the National Electronic Injury Surveillance System

Genital trauma in prepubertal girls and adolescents

Trauma hazards in children: An update for the busy clinician

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