Pediatric Female Genital Trauma

Pediatric Female Genital Trauma

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Summary

Genital trauma is defined as any injury to the female genital area – including the labia, vulva and/or vagina. Most cases of genital trauma occur accidentally and involve bruising, swelling and/or minor cuts that heal within a few days. Even minor cuts in this area can cause significant bleeding because of rich blood supply.

Expanded Overview

Straddle injuries are the most common genital trauma in females. They occur when a child sustains an injury from falling on an object that is being straddled (playground equipment, bike, arm of chair, bathtub side, etc.). Girls usually get a bruise or small cut on their outer labia. The vagina and urethra are protected by the labia and are generally not harmed in these cases.

If the child falls on a blunt or sharp object, penetrating injuries to the vagina can occur. These injuries can be mild or serious and often require rapid examination by a doctor. Rarely, genital trauma can be a sign of abuse.

Symptoms

Related to straddle injuries may include:

  • Bleeding
  • Bruising
  • Mild to moderate pain or discomfort
  • Redness
  • Swelling

Sustained by falling on a sharp or blunt object – or other severe genital injuries – may include:

  • Abrasions
  • Blood in urine
  • Bruising – including inside the vagina
  • Dizziness, nausea/vomiting
  • Moderate to severe pain
  • More significant vaginal bleeding
  • Problems with urination
  • Vaginal discharge

Tests and Diagnosis

Your child’s doctor will ask about your daughter’s symptoms and how the trauma occurred. The doctor will then conduct a thorough physical examination, and may perform additional tests including:

  • Pelvic exam (may have to be conducted under anesthesia in young children)
  • Ultrasound or X-ray, if there is concern about internal trauma
  • Vaginal discharge sample – to check for infection

Treatment

For genital trauma (especially straddle injuries), treatment may include:

  • Sitz baths
  • Cool compresses
  • Over-the-counter pain medication
  • Reduced physical activity
  • Antibiotics, if infection is present
  • Surgery – in rare cases – for significant trauma

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