Vaginal postcoital injuries requiring surgical intervention: a case series and literature review

Padoa, Anna; Fishman, Noa Glick; Tsviban, Anna; Smorgick, Noam

doi:10.1038/s41443-020-0234-8

Cited by 5 publications

(9 citation statements)

References 26 publications

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“…Sometimes, the embarrassment of many women makes the anamnesis and, so, the diagnosis more difficult and delayed. The treatment of the vaginal perforation is always surgical, although several approaches have been described [ 2 ]. Many risk factors have been identified in literature, including young age, infections or sexual position [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Postcoital Vaginal Perforation and Evisceration in Women with No Prior Pelvic Surgery: Laparoscopic Management and Systematic Review of the Literature

Stabile

Mordeglia

Romano

et al. 2021

IJERPH

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Objective: to evaluate risk factors, causes, management and surgical therapy of postcoital vaginal perforation and evisceration in women with no prior pelvic surgery. Data sources: We used MEDLINE (PubMed), Scopus, Embase and Web of Science for our research. Our review includes all reports from 1980 to November 2020. The research strategy adopted included different combinations of the following terms: (intercourse) AND (coitus) AND (vaginal perforation). Methods of study selection: we report a case of vaginal evisceration after consensual intercourse in a young and healthy woman. In addition, we performed a systematic review of vaginal perforations with or without evisceration in women without prior surgery or any other predisposing disease. All studies identified were listed by citation, title, authors and abstract. Duplicates were identified by an independent manual screening, performed by one researcher and then removed. For the eligibility process, two authors independently screened the title and abstracts of all non-duplicated papers and excluded those not pertinent to the topic. Tabulation, integration and results: We have followed the PRISMA guidelines. Five manuscripts were detected through the references of the works that had been identified with the research on MEDLINE (PubMed), Scopus, Embase and Web of Science. We found 16 cases between 1980 and 2020. The young age and the virginal status represent the principal risk factors and all the lacerations occurred in the posterior vaginal fornix. The most common surgical technique was the laparotomic approach and, in the remaining cases, the laparoscopic and vaginal route was performed. Conclusions: Post-coital vaginal perforation and evisceration in women with no prior pelvic surgery is a rare condition in the clinical practice and, when it is associated with evisceration it is a surgical emergency. Usually, these injuries are not life-threatening conditions but, a delay in diagnosis, can lead to severe complications. In consideration of the high heterogeneity of the data in the literature, it is essential to define a diagnostic–therapeutic management for the patients with vaginal perforation. With our review, we try to identify the associated risk factors, the best and fastest diagnosis, and the best surgical approach. We believe that a combined vaginal and laparoscopic approach can be the best surgical treatment, useful to diagnose injuries of the abdominal organs and to improve postoperative outcome.

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Section: Introductionmentioning

confidence: 99%

Postcoital Vaginal Perforation and Evisceration in Women with No Prior Pelvic Surgery: Laparoscopic Management and Systematic Review of the Literature

Stabile

Mordeglia

Romano

et al. 2021

IJERPH

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“…Vulvovaginal coital injuries most commonly occur at the extremes of age. [1] The labia majora in adult females is composed of large fat pads that protect the rich vasculature in this region from trauma. Conversely, these fat pads are less well developed in children and adolescents, predisposing them to trauma and haematoma formation.…”

Section: Discussionmentioning

confidence: 99%

“…[11] Introital injuries are commoner in younger, sexnaïve patients, like the index case than deeper vaginal lacerations seen more often in older and sexually experienced women. [1] Injury to the labial branches of the internal pudendal artery, which supply the vulva, can cause significant vulva hematomas. Most vulva haematomas are, however, minor and self-limiting.…”

Section: Discussionmentioning

confidence: 99%

“…Non-obstetric vulvovaginal injuries are rare; they are seen in approximately 1/1,000 gynaecologic emergencies. [1] Of these injuries, vulva haematomas have a reported incidence of 3.7%, accounting for only 0.8% of gynaecologic emergencies. [2] The vulva, being mainly composed of smooth muscle and loose connective tissue, is particularly prone to haematoma formation, owing to its rich vasculature.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Vulva Haematoma following Sexual Assault in an Adolescent Nigerian Girl: A Case Report

Nyeche¹,

Ubom²,

Ikimalo³

2022

Ann Health Res

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Non-obstetric vulva haematomas are uncommon, with an incidence of 3.7% accounting for less than 1% of gynaecologic emergencies. Non-consensual sexual intercourse constitutes the most common aetiology. A 15-year-old adolescent Nigerian girl, who presented to the Gynaecologic Emergency Unit of the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria, with vulva haematoma following sexual assault, is presented. She had surgical management, screening and prophylaxis for sexually transmitted infections, emergency contraception, and psychosocial therapy and was discharged after 24 hours, following an unremarkable postoperative period. This case is being reported to draw attention to the serious global public health problem of adolescent sexual abuse, highlight that though rare, vulva haematomas, which could be life-threatening, can be a complication of sexual assault, and review the literature on its management.

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“…La mayoría de las lesiones observadas son de bajo grado, siendo en su mayor parte hemorragias menores o fisuras que son autolimitadas y no requieren de ninguna intervención 10 . En aquellos casos con traumatismos más profundos o con persistencia del sangrado pueden precisar tratamiento quirúrgico 11 . Se han llegado a describir laceraciones o perforaciones de vagina que han requerido la estabilización hemodinámica y el uso de medidas adicionales 2,12,13 .…”

Section: Lesionesunclassified

Desgarro Perineal con mucosa vaginal íntegra tras primera relación sexual

Morcillo

Soto

Orts

et al. 2020

Rev. chil. obstet. ginecol.

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Las lesiones del tracto genital femenino tras relaciones sexuales son un problema frecuente en las urgencias de ginecología, pero poco estudiado salvo su aspecto médico-legal. Su incidencia es desconocida ya que muchas mujeres no llegan a consultar por miedo o pudor. El reconocimiento precoz de estas lesiones y su correcto tratamiento puede evitar la parición de secuelas que acompañarán a nuestra paciente durante el resto de su vida. Presentamos el caso de una paciente de 18 años con un desgarro perineal con mucosa vaginal íntegra tras su primera relación sexual.

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Vaginal postcoital injuries requiring surgical intervention: a case series and literature review

Cited by 5 publications

References 26 publications

Postcoital Vaginal Perforation and Evisceration in Women with No Prior Pelvic Surgery: Laparoscopic Management and Systematic Review of the Literature

Postcoital Vaginal Perforation and Evisceration in Women with No Prior Pelvic Surgery: Laparoscopic Management and Systematic Review of the Literature

Vulva Haematoma following Sexual Assault in an Adolescent Nigerian Girl: A Case Report

Desgarro Perineal con mucosa vaginal íntegra tras primera relación sexual

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