Liquen escleroso genital pediátrico en niñas: serie de 11 casos / Pediatric genital lichen sclerosus: a case series of 11 girls

Fundamento: El liquen escleroso genital disminuye la calidad de vida de las mujeres; el 10-15% de los casos se dan en prepúberes. Métodos: Estudio descriptivo retrospectivo de las características de las niñas diagnosticadas con liquen escleroso genital en el Hospital Universitario de Navarra (España) entre 2019 y 2022. Resultados: Se diagnosticaron once niñas entre 4 y 14 años. Fue habitual un retraso diagnóstico tras la aparición de las lesiones de hasta dos años; la niña con cuatro años de retraso presentaba una importante alteración arquitectural vulvar. Todas presentaban lesiones escleróticas típicas en genitales, y dos de ellas también tenían afectación en espalda. Seis pacientes eran asintomáticas, el resto refería prurito y/o dolor. El tratamiento con corticoides tópicos de alta/muy alta potencia logró una buena respuesta parcial, sin remisión completa de las lesiones. Conclusión: El diagnóstico precoz de liquen escleroso genital es clave para para iniciar el tratamiento lo antes posible y evitar una alteración estructural genital irreversible.

Background. Genital lichen sclerosus decreases the quality of life of women; 10-15% of cases occur in prepubertal girls. Methods: Retrospective and descriptive study on the characteristics of girls diagnosed with genital lichen sclerosus at the Hospital Universitario de Navarra (Pamplona, Spain) between 2019 and 2022. Results: Eleven girls aged between 4 and 14 year-old were diagnosed. Frequently, diagnostic delays were up to two years after the appearance of the lesions; the girl with a four-year delay showed a significant vulvar architectural alteration. All cases showed the typical sclerotic lesions on the genital area, and two of them also on the back. While six patients were asymptomatic, the rest reported pruritus and/or pain. Treatment with high/very high potency topical corticosteroids achieved a good partial response, without complete remission of the lesions. Conclusion: Early diagnosis of genital lichen sclerosus is key to start early treatment, avoiding irreversible genital structural alteration.(AU)

Comparative prevalence of anogenital injury following sexual assault in women who have had recent consensual sexual contact.

OBJECTIVE: The purpose of this study was to compare the frequency and types of anogenital trauma in rape victims as a function of the time interval between the assault and recent (72 h) consensual sexual intercourse. METHODS: This retrospective cohort trial evaluated consecutive female patients, age 13 years or older, presenting to a community-based nurse examiner clinic (NEC) during a 5-year study period. The NEC facility is staffed by forensic nurses trained to perform medical-legal examinations using colposcopy with nuclear staining and digital imaging. Eligible patients were classified into five different groups based on the time interval from the last consensual intercourse to the forensic examination (none, 0-24 h, 25-48 h, 49-72 h, 73-96 h). Patient demographics, assault characteristics, and injury patterns were recorded using a standardized classification system. RESULTS: A total of 947 cases of sexual assault met the inclusion criteria and were divided into five groups. The age range was 13 to 87 years (mean, 23.9 years); 78% were examined within 24 h following sexual assault. The five study groups were comparable in terms of demographics, assault history, and incidence of non-genital injuries. The overall frequency, type, or location of anogenital injury did not vary significantly between groups (p > 0.5). CONCLUSION: This is the first clinical study to systematically compare the prevalence and typology of anogenital injuries in sexual assault victims who have had consensual intercourse within four days before a forensic exam. The frequency, type or location of anogenital trauma did not vary significantly based on the time interval from last consensual intercourse to the forensic examination.

Managing Reproduction Emergencies in the Field: Part 1: Injuries in Stallions; Injury of the External Portion of the Reproductive Tract and Gestational Conditions in the Mare.

Selected emergency conditions of male and female reproductive tracts in horses are described, including injuries affecting the external genitalia of male horses and emergent conditions arising during gestation in mares. Conditions affecting male horses are discussed in the context of breeding stallions, but kicks or other mechanisms of trauma in the groin can also affect geldings. Priapism, paraphimosis, trauma to the scrotum and testicles, and penile injury are discussed. In mares, traumatic vestibular injury, placentitis, hydropsic conditions, prepubic tendon and abdominal wall compromise, and uterine torsion are included. Clinical recognition of the problem, diagnostic procedures, and treatments are summarized.

Prevalence of Adult Female Genital Trauma After Acute Sexual Assault: The Need for a Universal Definition of Genital Trauma.

BACKGROUND: Examination of the adult female genitalia after an acute sexual assault may reveal findings interpreted by the examiner as injuries, which may be linked to later legal outcomes. There is no consistent definition in the literature regarding what findings constitute genital trauma after sexual assault. We studied how the prevalence of genital trauma is impacted by the inclusion/exclusion of various genital findings reported in the literature. METHODS: A retrospective descriptive chart review of the sexual assault forensic records from a provincial regional sexual assault treatment center was conducted over a 4-year period and included 67 female patients, 12 years old and over, who reported being sexually assaulted in the previous 72 hours and received a complete forensic examination. We studied the prevalence of genital trauma, using eight definitions of trauma, as well as the percentage of each type of genital finding within this population. RESULTS: The prevalence of genital trauma in this population ranged from 52%, the majority, to 31% of women, depending on the definition of trauma utilized. Forty-one percent of the findings, the greatest number overall, were redness. Bruises, abrasions, and tears (lacerations), the components of blunt force trauma, accounted for 4%, 15%, and 14% of the findings, respectively. INTERPRETATION: A universal definition of what findings constitute genital trauma after acute sexual assault is required if the examiner, as expert witness, is to compare findings in a given case with the broader literature and assist the court in ensuring an informed process of decision making.

It's a woman's thing: gender roles sustaining the practice of female genital mutilation among the Kassena-Nankana of northern Ghana.

INTRODUCTION: The practice of female genital mutilation (FGM/C) in traditional African societies is grounded in traditions of patriarchy that subjugate women. It is widely assumed that approaches to eradicating the practice must therefore focus on women's empowerment and changing gender roles. METHODS: This paper presents findings from a qualitative study of the FGM/C beliefs and opinions of men and women in Kassena-Nankana District of northern Ghana. Data are analyzed from 22 focus group panels of young women, young men, reproductive age women, and male social leaders. RESULTS: The social systemic influences on FGM/C decision-making are complex. Men represent exogenous sources of social influence on FGM/C decisions through their gender roles in the patriarchal system. As such, their FGM/C decision influence is more prominent for uncircumcised brides at the time of marriage than for FGM/C decisions concerning unmarried adolescents. Women in extended family compounds are relatively prominent as immediate sources of influence on FGM/C decision-making for both brides and adolescents. Circumcised women are the main source of social support for the practice, which they exercise through peer pressure in concert with co-wives. Junior wives entering a polygynous marriage or a large extended family are particularly vulnerable to this pressure. Men are less influential and more open to suggestions of eliminating the practice of FGM/C than women. CONCLUSION: Findings attest to the need for social research on ways to involve men in the promotion of FGM/C abandonment, building on their apparent openness to social change. Investigation is also needed on ways to marshal women's social networks for offsetting their extended family familial roles in sustaining FGM/C practices.

Discriminating between consensual intercourse and sexual assault: Genital-anal injury pattern in females.

BACKGROUND: Assessment of genital-anal (GA) injuries following sexual assault promotes health and assists prosecutors to build a case. The pattern of injuries may help differentiate between consensual and non-consensual intercourse, bolster the survivors' credibility, and increase prosecutions in sexual assault cases. OBJECTIVES: To identify the constellation of G-A injury-related characteristics that most effectively discriminated between consensual sexual intercourse and sexual assault in females when controlling for intercourse-related variables. METHODS: We employed a comparative study with two groups: a prospective cohort group with consensual participants and a group derived from an existing sexual assault registry. In the prospective cohort, we performed a sexual assault forensic examination at baseline and following consensual sexual intercourse with females ≥21 years. We compared their injury patterns to the injury records of females ≥21 years who were sexual assaulted. RESULTS: We enrolled a sample of 834 females: 528 consensual (63.3%) participants and 306 non-consensual (36.7%) registry cases. After controlling for race/ethnicity, age, and time between intercourse and examination, logistic regression analyses showed that the presence of an external genital tear increased the odds of non-consensual intercourse more than two times (adjusted odds ratio [AOR] = 2.70, 95% CI = 1.28-5.56). Logistic regression analyses also showed that the odds of non-consensual sexual intercourse were significantly greater with a lower prevalence and frequency of external and internal genital redness, lack of condom use and lubrication, and presence of anal penetration. Latent class analysis identified high and low G-A injury prevalence subgroups among both consensual and non-consensual samples. One subset of results emerged that may be indicative of non-consensual as compared to consensual intercourse: a higher prevalence of external genital and anal tears. CONCLUSION: External genital tears occurred more frequently in the non-consensual sample and increased the odds of non-consensual intercourse more than two times. Anal tears, swelling, and ecchymosis and anal penetration were markers for non-consensual intercourse and should increase suspicion for lack of consent.

Insights into preventing female genital mutilation/cutting in Sri Lanka: a qualitative interpretative study.

BACKGROUND: FGM/C is a cultural practice associated with adverse health outcomes that involves the partial or complete removal of the external female genitalia or injury to the genitalia. FGM/C is a form of violence against women and girls. There are no laws that specifically outlaw FGM/C in Sri Lanka and no national prevalence data. There is a lack of evidence about this practice to inform prevention efforts required to achieve the Sustainable Development Goal (SDG) target 5.3.2, which focuses on the elimination of all harmful practices, including FGM/C. METHODS: We undertook a qualitative interpretative study to explore the knowledge and perceptions of community members, religious leaders and professionals from the health, legal and community work sectors in five districts across Sri Lanka. We aimed to identify strategies to end this practice. RESULTS: Two-hundred-and twenty-one people participated in focus group discussions and key informant interviews. A template analysis identified five top-level themes: Providers, procedures and associated rituals; demand and decision-making; the role of religion; perceived benefits and adverse outcomes; ways forward for prevention. CONCLUSIONS: This study delivered detailed knowledge of FGM/C related beliefs, perceptions and practitioners and provided opportunities to develop an integrated programming strategy that incorporates interventions across three levels of prevention.

Sexual Abuse as a Cause of Prepubertal Genital Bleeding: Understanding the Role of Routine Physical Examination.

Although accidental trauma is the most common mechanism for genital bleeding, sexual abuse should be considered when the patient is prepubertal and/or a vague history of bleeding is provided. Prepubertal female genital exams should be completed routinely; this clinical technique is critical for pediatricians to assess pubertal progression, to identify pathologies or differences in sexual differentiation, and to narrow a broad differential diagnosis of bleeding. Physical evidence of sexual abuse on exam is rarely found, and therefore the diagnosis relies on a child's disclosure. Physicians should be cognizant of barriers to patient disclosure. In this commentary we aim to provide general pediatricians and trainees with a framework for evaluating genital/vaginal bleeding in prepubertal girls, by discussing the following: (1) the importance of a complete anogenital exam in generating a differential diagnosis; and (2) the possibility of sexual abuse as an etiology with recognition that the disclosure process is complex.

Similarity and Differences in Sexual Violence Against Adolescents and Adult Women: The Need to Focus on Adolescent Victims.

STUDY OBJECTIVE: To explore whether there are differences in characteristics, clinical findings and management in cases of sexual violence in adolescent and adult women. DESIGN: Retrospective study. SETTING: SVSeD-Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. PARTICIPANTS: Female victims of sexual violence aged 10 years and older. Two study groups were analysed: an adolescent group and an adult group. INTERVENTIONS: None; this was an observational study. MAIN OUTCOME MEASURES: Characteristics of the perpetrator, time spent between the episode of sexual violence and the access to SVSeD, presence of genital and/or extragenital injuries; tests for sexually transmitted diseases, spermatozoa research; and toxicological screening; RESULTS: Adolescent victims of sexual violence requested help later than the adult victims. The majority of the perpetrators were well known to the victims in both groups. In both groups, we observed genital injuries in 1 of 3 patients. We found a strong association between the presence of genital injuries and a positive screening test for sexually transmitted diseases, in particular with regard to the adolescent victims. CONCLUSION: Adolescents' delayed disclosure of sexual violence may affect the ability to properly manage these crimes. Prevention programs and public awareness campaigns should be implemented to highlight the importance of a prompt disclosure after sexual assault has occurred. Gynecologists should be made increasingly aware of this delicate issue, to better assist victims of sexual violence, especially adolescent victims.

Lesions of the sheep reproductive system found in a slaughterhouse in the state of Bahia, Brazil / Lesões do sistema reprodutor em ovelhas de abatedouros frigoríficos no estado da Bahia

The present study aimed to evaluate and diagnose pathologies of the reproductive system of slaughtered sheep in slaughterhouses in the state of Bahia since there are few data on the subject as well as it is important to note the diagnosis of these diseases to apply appropriate control and prophylaxis measures. The research was carried out in slaughterhouses in the state of Bahia according to the "Serviço de Inspeção Federal" and "Serviço de Inspeção Estadual" for sheep slaughter. From July 2018 to February 2019, visits and monitoring of 1,072 slaughtered sheep were carried out. The animals came from 22 municipalities in the state of Bahia, aged from six to 18 months. During slaughter, the sheep reproductive systems were sectioned for evisceration and lesion collection. Additionally, epidemiological surveys related to origin, age, and race were obtained. For bacteriological examination, collections were performed with sterile scalpel slides and swabs in Stuart medium sterile tubes and refrigerated in a thermal box. For histopathological analysis, fragments were fixed in 10% formaldehyde and routinely processed for histology, stained with Hematoxylin and Eosin (HE). A study of the sheep's main pathological changes in slaughterhouses in the state of Bahia was carried out, in which 1.072 genital systems were evaluated, and 211 alterations were identified. The most affected reproductive organs were the ovaries (65.3%), followed by the uterus (29.4%) and uterine tubes (5.3%). In the ovaries, the most frequent lesion was a follicular cyst (34.1%); in the fallopian tubes, the cysts represented 3.3% of the lesions, and in the womb, endometritis was observed in 9% of the animals. Other pathologies identified in the ovaries were: luteinized cyst (2.3%); cystic granulosa cell tumor (0.5%); benign lesion (0.5%); agenesis unilateral (0.5%), in addition to other changes of little clinical significance, such as corpus luteum cysts (11.8%) and paraovarian cysts (15.6%). In the fallopian tubes, hydrosalpinx was observed (1%), as well as adenoma (0.5%), agenesis (0.5%), and cysts (3.3%). Uterine lesions included hydrometra (2.3%); Cystic Endometrial Hyperplasia (CEH), abscess, and pyometra (1.4% each); adenomyosis, womb sera petechiae, and total segmental aplasia (1% each); two pregnant uterus, in early pregnancy, presented pyometra (0.9%), however, no change was observed in the fetuses; and uterine polyp (0.5%). Ectopic pregnancy with fetal maceration (0.5%) was observed; vaginitis occurred in 0.5% of the animals, and endometrial melanosis in 8.5%. The high incidence of follicular cysts and endometritis are characterized as diseases that reduce the reproductive efficiency in herds, causing infertility and economic losses in production.(AU)

O objetivo do presente trabalho foi avaliar e diagnosticar alterações do sistema reprodutor de ovelhas abatidas em abatedouros frigoríficos no estado da Bahia. A pesquisa foi realizada em abatedouros frigoríficos do estado da Bahia com Serviços de Inspeção Federal e Estadual no abate de ovinos. No período de julho de 2018 a fevereiro de 2019 foram realizadas visitas e acompanhamento do abate de 1.072 ovelhas. Os animais eram provenientes de 22 municípios do estado da Bahia, com idade entre 6 a 18 meses. Durante o abate, na evisceração foram seccionados os sistemas reprodutores das ovelhas para avaliação e coleta das lesões. Adicionalmente foram obtidos inquéritos epidemiológicos relacionados à procedência, idade e raça. Para o exame bacteriológico, as coletas foram realizadas com lâminas de bisturi estéreis e swabs em tubos estéreis com meio Stuart e refrigeradas em caixa térmica. Para análise histopatológica, os fragmentos foram fixados em formol a 10% e processados de forma rotineira para histologia e corados pela hematoxilina e eosina (HE). Entre 1.072 sistemas genitais avaliados, identificou-se 211 alterações. Os órgãos do sistema reprodutor mais acometidos foram os ovários (65,3%), útero (29,4%) e tubas uterinas (5,3%). Nos ovários, a lesão mais frequente foi o cisto folicular (34,1%); no útero a endometrite (9%) e nas tubas uterinas, os cistos representaram (3,3%). Outras lesões identificadas nos ovários foram: cisto luteinizado (2,3%); tumor de células da granulosa (0,5%); adenoma (0,5%); agenesia unilateral (0,5%), além de outras alterações de pouco significado clínico, como cistos paraovarianos (15,6%) e corpo lúteo cístico (11,8%). Nas tubas uterinas observou-se, além dos cistos tubo-ovarianos (3,3%), hidrossalpinge (1%), adenoma (0,5%) e agenesia (0,5%). As lesões uterinas foram endometrite (9%), hidrometra (2,3%); hiperplasia endometrial cística, abscesso e piometra (1,4% cada); adenomiose, petéquias na serosa do útero e aplasia segmentar (1% cada); dois úteros gravídicos, em início de gestação, apresentaram piometra (0,9%), porém os fetos não apresentaram alterações; e pólipo uterino (0,5%). Observou-se uma gestação ectópica com maceração fetal (0,5%); a vaginite ocorreu em 0,5%, e melanose endometrial em 8,5%. Destaca-se a elevada incidência de cistos foliculares e endometrite que são doenças que reduzem a eficiência reprodutiva dos rebanhos, provocando infertilidade e perdas econômicas na produção.(AU)

Female pediatric and adolescent genitalia trauma: a retrospective analysis of the National Trauma Data Bank.

PURPOSE: Pediatric genitalia injury represents 0.6% of all pediatric trauma. It is crucial for providers to understand whether pediatric patients are at risk for violent mechanisms, such as rape, assault, or other abuse. Therefore, we sought to perform a large database analysis of pediatric and adolescent female genitalia trauma, comparing mechanisms of injury (i.e., sexual abuse) and need for operative intervention between adolescent and pediatric cohorts. METHODS: The National Trauma Data Bank was queried (years 2007-2015) for female patients ≤ 16 years old with external genitalia (vaginal or vulvar) trauma. Two groups were compared: pediatrics (< 12 years old) and adolescents (12-16 years old). RESULTS: Out of 303,992 female patients, 3206 (1.1%) were identified to have genitalia trauma with the majority being pediatric patients (92.1%) and with injury to the vagina (62.6%). Pediatric patients with vaginal injury were less likely to be victims of rape (4.1% vs. 17.3%, p < 0.001) and assault (2.1% vs. 7.2%, p < 0.001) but more likely to be victims of other abuse (9.5% vs. 3.4%, p = 0.003). More of the adolescent patients with vaginal trauma required repair (58.7% vs. 43.2%, p < 0.001). Pediatric patients with injury to the vulva were less likely to be victims of rape (0.7% vs. 2.8%, p = 0.01) and motor vehicle accidents (4.2% vs. 11.0%, p < 0.001). CONCLUSION: Genitalia trauma occurs in 1.1% of pediatric and adolescent trauma cases with the vagina being more commonly injured compared to the vulva. Adolescent patients with vaginal injuries were more likely to be victims of rape and assault and required repair more often, while those with vulvar injuries were more likely due to motor vehicle accidents. Health care providers must be aware of these at-risk populations and the differences between them to identify female victims of violence and provide resources to assist with recovery.

Pubic hair grooming practices in KwaZulu-Natal, South Africa: prevalence, side effects and association with sexually transmitted infections.

Pubic hair grooming is common in many countries, but little is known about this practice in Africa. Grooming has been positively associated with self-reported sexually transmitted infections (STIs). This study aimed to investigate the prevalence and safety of pubic hair grooming in two South African settings. In KwaZulu-Natal province, 1218 women participating in the Evidence for Contraceptive Options and HIV Outcomes Trial completed an interviewer-administered questionnaire on pubic hair grooming practices, and were tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and herpes simplex virus type 2 (HSV-2). Pubic hair removal was reported by 705 (58.2%) of women. Common areas for grooming were the pubis (n = 616, 99.4%), vagina/perineum (n = 529, 85.3%) and inner thigh (n = 255, 41.1%). Half (n= 361, 51.4%) removed some or all of their pubic hair at least monthly and 59 (8.4%) once a week or more often. Common side effects reported included itching (n = 439, 77.1%) and pimples and blisters (n = 249, 43.9%). A quarter (n = 173, 24.5%) of groomers had a positive result for either or both of CT and NG compared to a fifth (n = 98, 19.4%) of non-groomers (p-value < 0.033). There was no difference between the groups for HSV-2. After adjusting for age and having more than one sex partner, groomers were significantly more likely to have CT or NG than non-groomers (OR: 1.31; 95% CI: 1.19-1.45). Similarly, those who experienced hair removal-related complications had 1.26 times the odds of testing positive for CT or NG (95% CI: 1.03-1.54). The practice of pubic hair removal is common and reporting of side effects is high in this population. These injuries could put women at a higher risk of STIs.

Asphyxia Homicides in Finland, 1983-2012.

Finland has one of the highest homicide rates in Western Europe, and almost every tenth homicide is caused by asphyxiation. Reliable statistics, a strict legislation, and an exceptionally high medico-legal autopsy rate formed a base for a nationwide analysis of asphyxia homicides (n = 383) during 30 years. The cases were identified through multiple records, and all the forensic pathology case files were studied in detail. In more than one out of five cases, there were indications of staging, and the homicide was revealed first at autopsy in close to one in ten cases. The vast majority of the homicides took place in private locations and involved persons known to each other. Every third victim was an intimate partner, and every tenth a child. Almost half of the victims died from manual strangulation, one in three from ligature strangulation. Smothering, choking, neck compression with a firm object, and thoracic compression were more rare methods. Drownings were excluded from this study material. Of all the victims, 7% had no observable external injuries. Petechiae were recorded in approximately in 61%, laryngohyoid fractures in 47%, and vocal cord hemorrhages in 16% of the cases. Every tenth female victim had genital injuries. Toxicological analyses were performed in close to all of the cases, and almost three out of four victims tested positive for blood alcohol. The various aspects of the demographics and autopsy findings covered in this study contribute reliable and accurate data to further strengthen the spectrum of observable medico-legal characteristics of asphyxia homicides.

Genital Hair-Thread Tourniquet Syndrome.

BACKGROUND: Hair-thread tourniquet syndrome is a rare disorder that occurs when a hair or other fiber becomes wrapped around an appendage, resulting in swelling, pain, or even loss of the appendage. Some cases affecting the female genitals have been reported. CASE: The case of a 10-year-old girl with a 3-day history of genital pain is presented. During examination, a hair tourniquet was found at the base of a swollen and painful clitoris. The hair was removed under deep sedation, producing immediate relief. SUMMARY AND CONCLUSION: The most important concern in genital hair-thread tourniquet syndrome is a high index of suspicion and prompt resolution in order to save the affected tissue. It should be considered on the differential diagnosis for all girls with vulvar swelling and indication of pain.

Current Management of Gynecologic Trauma.

INTRODUCTION: To date, there are few reports describing the management of traumatic gynecologic injuries leaving physicians with little guidance. OBJECTIVE: Describe the injury patterns and the preferred management of these injuries. METHODS: A retrospective cohort study was performed using the National Trauma Data Bank (NTDB) from years 2011 to 2013. Female patients age 16 years and older with internal gynecologic injuries were identified based on diagnosis codes. Demographics, associated diagnoses and procedure codes were compiled for the cohort. RESULTS: 313 patients met inclusion criteria. The mechanism of injury was blunt in 236 (75%) patients, penetrating in 68 (21%), and other in 9 (4%). The mean Injury Severity Score was 16.6 ± 14.6. Mean age was 34 ± 21 years old. 226 (74.8%) patients had an ovarian and/or fallopian tube injury, 71 (25.2%) had a uterine injury, 8 (3%) had both, and 8 (3%) had injury to the ovarian or uterine vessels only. Of the 226 patients with ovarian and/or fallopian tube injury, 11(5%) underwent repair and 10 (4%) underwent salpingo-oophorectomy. Of the 71 uterine injuries, 15 (21%) underwent repair and 5 (7%) required a hysterectomy. CONCLUSIONS: Most traumatic internal gynecologic injuries result from blunt mechanism. Currently, these injuries are largely managed non-operatively. When surgery was performed, ovarian and uterine repair was more common than salpingo-oophorectomy and hysterectomy. Prospective large-scale studies are needed to establish a standard of treatment for the management of gynecologic trauma and to assess both short and long term outcomes and fertility rates.

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

Genital injury has a forensic relevance after a sexual assault and it has been discussed and investigated among professionals who work in this field. To analyze the studies published in the last decades, the present review examines different factors that may influence this finding, first clarifying terms of the forensic field, such as the peculiarity of the legal medical examination, and the distinction of the terms "legal" and "anatomical" vagina. Finally, it analyses if it is possible that the existence of these injuries in victims explain the lack of consent in sexual contact, and to clarify the meaning of the absence of injuries.

Genital injuries: Are they telling us something about sexual violence?

Abstract Genital injury has a forensic relevance after a sexual assault and it has been discussed and investigated among professionals who work in this field. To analyze the studies published in the last decades, the present review examines different factors that may influence this finding, first clarifying terms of the forensic field, such as the peculiarity of the legal medical examination, and the distinction of the terms "legal" and "anatomical" vagina. Finally, it analyses if it is possible that the existence of these injuries in victims explain the lack of consent in sexual contact, and to clarify the meaning of the absence of injuries.