External genital injuries in girls
Natalia I. Pavlenko , Andrey V. Pisklakov , Irina I. Chuyan
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care ›› 2022, Vol. 12 ›› Issue (1) : 31 -40.
External genital injuries in girls
BACKGRAUND: The treatment of girls with genital trauma is an urgent problem because of the increased frequency in cases in recent years. This study examines the treatment effectiveness in girls with various types of genital trauma.
MATERIALS AND METHODS: Case histories of 126 girls aged one to 17 years with external genital organ injuries and treated from 2016 to 2020 were studied. They included 120 (95%) patients with mechanical injuries and six (5%) girls with intravaginal electrochemical burns. The types of injuries, clinical picture, diagnostic methods, methods of surgical interventions, and treatment outcomes were studied.
RESULTS: The data obtained as a result of the analysis showed an increase in the number of injuries of the external genital organs in girls by 2.2 times, with a predominance of victims aged two to 10 years (69%). The structure of injuries was dominated by mechanical damage (95%) due to domestic and street injuries. Most injuries were localized in the external genital area, and deeper injuries accounted for 7.9%. Massive bleeding with the development of severe posthemorrhagic anemia was noted in 4.2% of cases. Surgical treatment was performed in 80.8% of cases. In cases of combined injuries with the rectum (2%), operations were performed jointly with surgeons. Mortality and postoperative complications were not observed. In six patients, one finger and five disc batteries, which caused electrochemical burns, were found and removed from the vagina. The treatment control of these injuries was performed with dynamic vaginoscopy. For more than six months, four girls had pronounced cicatricial changes.
CONCLUSION: Therapeutic tactics for mechanical injuries have shown effectiveness due to the absence of complications and a short hospital stay. The rehabilitation of patients with electrochemical burns requires further study since two-thirds of them have long-lasting cicatricial changes.
genital trauma / genital injury / vaginoscopy / electrochemical burns / scarring process / rehabilitation / children / girls
| [1] |
Casey J, Bjurlin M, Cheng E. Pediatric genital injury: an analysis of the National Electronic Injury Surveillance System. Urology. 2013;82(5):1125–1130. DOI: 10.1016/j.urology.2013.05.042 |
| [2] |
Casey J., Bjurlin M., Cheng E. Pediatric genital injury: an analysis of the National Electronic Injury Surveillance System // Urology. 2013. Vol. 82. No. 5. P. 1125–1130. DOI: 10.1016/j.urology.2013.05.042 |
| [3] |
Merritt DF. Genital trauma. Pediatric and adolescent reproductive health. 2016;(1):64–80. (In Russ.) |
| [4] |
Меррит Д.Ф. Травмы гениталий // Репродуктивное здоровье детей и подростков. 2016. № 1. С. 64–80. |
| [5] |
Adamyan LV, Sibirskaya EV, Moksyakova EG. Problemy travm polovykh organov u devochek i devushek goroda Moskvy. Optimizatsiya taktiki lecheniya. Moskovskaya meditsina. 2016;(S1):69–70. (In Russ.) |
| [6] |
Адамян Л.В., Сибирская Е.В., Моксякова Е.Г. Проблемы травм половых органов у девочек и девушек города Москвы. Оптимизация тактики лечения // Московская медицина. 2016. № S1. С. 69–70. |
| [7] |
Bakal U, Sarac M, Tartar T, et al. Twenty years of experience with perineal injury in children. Eur J Trauma Emerg Surg. 2016;42(5):599–603. DOI: 10.1007/s00068-015-0576-y |
| [8] |
Bakal U., Sarac M., Tartar T., et al. Twenty years of experience with perineal injury in children // Eur J Trauma Emerg Surg. 2016. Vol. 42. No. 5. P. 599–603. DOI: 10.1007/s00068-015-0576-y |
| [9] |
Takei H, Nomura O, Yusuke Hagiwara Y, Inoue N. The Management of Pediatric Genital Injuries at a Pediatric Emergency Department in Japan. Pediatr Emerg Care. 2021;37(2):73–76. DOI: 10.1097/PEC.0000000000001489 |
| [10] |
Takei H., Nomura O., Yusuke Hagiwara Y., Inoue N. The Management of Pediatric Genital Injuries at a Pediatric Emergency Department in Japan // Pediatr Emerg Care. 2021. Vol. 37. No. 2. P. 73–76. DOI: 10.1097/PEC.0000000000001489 |
| [11] |
Merritt D. Genital trauma in the pediatric and adolescent female. Obstet Gynecol Clin North Am. 2009;36(1):85–98. DOI: 10.1016/j.ogc.2009.01.003 |
| [12] |
Merritt D. Genital trauma in the pediatric and adolescent female // Obstet Gynecol Clin North Am. 2009. Vol. 36. No. 1. P. 85–98. DOI: 10.1016/j.ogc.2009.01.003 |
| [13] |
Savaş A, Efesoy O, Cayan F, Cayan S. Sexual injuries during consensual sexual activity. Ulus Travma Acil Cerrahi Derg. 2012;18(6):519–523. DOI: 10.5505/tjtes.2012.47347 |
| [14] |
Savaş A., Efesoy O., Cayan F., Cayan S. Sexual injuries during consensual sexual activity // Ulus Travma Acil Cerrahi Derg. 2012. Vol. 18. No. 6. P. 519–523. DOI: 10.5505/tjtes.2012.47347 |
| [15] |
Adamyan LV, Koltunov IE, Sibirskaya EV, et al. Injuries of external genital organs in girls and young females. Russian Journal of Pediatric Surgery. 2018;22(2):99–101. (In Russ.) DOI: 10.18821/1560-9510-2018-22-2-99-101 |
| [16] |
Адамян Л.В., Колтунов И.Е., Сибирская Е.В., и др. Травмы наружных половых органов у девочек и девушек // Детская хирургия. 2018. Т. 22, № 2. С. 99–101. DOI: 10.18821/1560-9510-2018-22-2-99-101 |
| [17] |
Mukwege D, Alumeti D, Himpens J, Cadière G. Treatment of rape-induced urogenital and lower gastrointestinal lesions among girls aged 5 years or younger. Int J Gynaecol Obstet. 2016;132(3):292–296. DOI: 10.1016/j.ijgo.2015.07.034 |
| [18] |
Mukwege D., Alumeti D., Himpens J., Cadière G. Treatment of rape-induced urogenital and lower gastrointestinal lesions among girls aged 5 years or younger // Int J Gynaecol Obstet. 2016. Vol. 132. No. 3. P. 292–296. DOI: 10.1016/j.ijgo.2015.07.034 |
| [19] |
Iqbal C, Jrebi N, Zielinski M, et al. Patterns of accidental genital trauma in young girls and indications for operative management. J Pediatr Surg. 2010;45(5):930–933. DOI: 10.1016/j.jpedsurg.2010.02.024 |
| [20] |
Iqbal C., Jrebi N., Zielinski M., et al. Patterns of accidental genital trauma in young girls and indications for operative management // J Pediatr Surg. 2010. Vol. 45. No. 5. P. 930–933. DOI: 10.1016/j.jpedsurg.2010.02.024 |
| [21] |
Roland D, Lewis G, Rowlands R, et al. Female perineal injuries in children and adolescents presenting to a paediatric emergency department. Emerg Med J. 2016;33(1):73–75. DOI: 10.1136/emermed-2014-204259 |
| [22] |
Roland D., Lewis G., Rowlands R., et al. Female perineal injuries in children and adolescents presenting to a paediatric emergency department // Emerg Med J. 2016. Vol. 33. No. 1. P. 73–75. DOI: 10.1136/emermed-2014-204259 |
| [23] |
Shweta Nayak S, Witchel S, Sanfilippo J. Vaginal foreign body: a delayed diagnosis. J Pediatr Adolesc Gynecol. 2014;27(6):e127–129. DOI: 10.1016/j.jpag.2013.10.006 |
| [24] |
Shweta Nayak S., Witchel S., Sanfilippo J. Vaginal foreign body: a delayed diagnosis // J Pediatr Adolesc Gynecol. 2014. Vol. 27. No. 6. P. e127–129. DOI: 10.1016/j.jpag.2013.10.006 |
| [25] |
Yang X, Sun L, Ye J, et al. Ultrasonography in detection of vaginal foreign bodies in girls: a retrospective study. J Pediatr Adolesc Gynecol. 2017;30(6):620–625. DOI: 10.1016/j.jpag.2017.06.008 |
| [26] |
Yang X., Sun L., Ye J., et al. Ultrasonography in detection of vaginal foreign bodies in girls: a retrospective study // J Pediatr Adolesc Gynecol. 2017. Vol. 30. No. 6. P. 620–625. DOI: 10.1016/j.jpag.2017.06.008 |
| [27] |
Merritt D. Genital trauma in children and adolescents. Clin Obstet Gynecol. 2008;51(2):237–248. DOI: 10.1097/GRF.0b013e31816d223c |
| [28] |
Merritt D. Genital trauma in children and adolescents // Clin Obstet Gynecol. 2008. Vol. 51. No. 2. P. 237–248. DOI: 10.1097/GRF.0b013e31816d223c |
| [29] |
Sibirskaya EV, Karapetyan EA, Moksyakova EG, et al. Analysis of the prevalence of genital trauma in girls and young women. Complicated during prolonged presence of a foreign body in the vagina (a clinical example). Russian journal of human reproduction. 2021;27(3):44–48. (In Russ.) DOI: 10.17116/repro20212703144 |
| [30] |
Сибирская Е.В., Карапетян Э.А., Моксякова Е.Г., и др. Анализ распространенности травм половых органов у девочек и девушек. Осложненное течение длительного нахождения инородного тела во влагалище (клинический пример) // Проблемы репродукции. 2021. Т. 27, № 3. С. 44–48. DOI: 10.17116/repro20212703144 |
| [31] |
Dowlut-McElroy T, Higgins J, Williams K, Strickland J. Patterns of treatment of accidental genital trauma in girls. J Pediatr Adolesc Gynecol. 2018;31(1):19–22. DOI: 10.1016/j.jpag.2017.07.007 |
| [32] |
Dowlut-McElroy T., Higgins J, Williams K., Strickland J. Patterns of treatment of accidental genital trauma in girls // J Pediatr Adolesc Gynecol. 2018. Vol. 31. No. 1. P. 19–22. DOI: 10.1016/j.jpag.2017.07.007 |
| [33] |
McCann J, Miyamoto S, Boyle C, Rogers K. Healing of nonhymenal genital injuries in prepubertal and adolescent girls: a descriptive study. Pediatrics. 2007;120(5):1000–1111. DOI: 10.1542/peds.2006-0230 |
| [34] |
McCann J., Miyamoto S., Boyle C., Rogers K. Healing of nonhymenal genital injuries in prepubertal and adolescent girls: a descriptive study // Pediatrics. 2007. Vol. 120. No. 5. P. 1000–1111. DOI: 10.1542/peds.2006-0230 |
| [35] |
Huppert J, Griffeth S, Breech L, Hillard P. Vaginal burn injury due to alkaline batteries. J Pediatr Adolesc Gynecol. 2009;22(5):133–136. DOI: 10.1016/j.jpag.2008.10.009 |
| [36] |
Huppert J., Griffeth S., Breech L., Hillard P. Vaginal burn injury due to alkaline batteries // J Pediatr Adolesc Gynecol. 2009. Vol. 22. No. 5. P. 133–136. DOI: 10.1016/j.jpag.2008.10.009 |
| [37] |
Semaan A, Klein T, Vahdad MR, et al. Severe vaginal burns in a 5-year-old girl due to an alkaline battery in the vagina. J Pediatr Adolesc Gynecol. 2015;28(5):e147–148. DOI: 10.1016/j.jpag.2014.12.001 |
| [38] |
Semaan A., Klein T., Vahdad M.R., et al. Severe vaginal burns in a 5-year-old girl due to an alkaline battery in the vagina // J Pediatr Adolesc Gynecol. 2015. Vol. 28. No. 5. P. e147–148. DOI: 10.1016/j.jpag.2014.12.001 |
| [39] |
Nakib G, Calcaterra V, Pelizzo G. Longstanding presence of a vaginal foreign body (battery): severe stenosis in a 13-year-old girl. J Pediatr Adolesc Gynecol. 2017;30(1):e15–e18. DOI: 10.1016/j.jpag.2016.08.015 |
| [40] |
Nakib G., Calcaterra V., Pelizzo G. Longstanding presence of a vaginal foreign body (battery): severe stenosis in a 13-year-old girl // J Pediatr Adolesc Gynecol. 2017. Vol. 30. No. 1. P. e15–e18. DOI: 10.1016/j.jpag.2016.08.015 |
| [41] |
Gross I, Riera A. Vaginal Foreign Bodies: The potential role of point-of-care-ultrasound in the pediatric emergency department. Pediatr Emerg Care. 2017;33(11):756–759. DOI: 10.1097/PEC.0000000000001304 |
| [42] |
Gross I., Riera A. Vaginal foreign bodies: the potential role of point-of-care-ultrasound in the pediatric emergency department // Pediatr Emerg Care. 2017. Vol. 33. No. 11. P. 756–759. DOI: 10.1097/PEC.0000000000001304 |
| [43] |
Yi S, Wang X, Jin L, et al. Clinical analysis for 156 cases of vaginoscopy in young girls and adolescent girls. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2019;44(9):1030–1034. DOI: 10.11817/j.issn.1672-7347.2019.190441 |
| [44] |
Yi S., Wang X., Jin L., et al. Clinical analysis for 156 cases of vaginoscopy in young girls and adolescent girls // Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2019. Vol. 44. No. 9. P. 1030–1034. DOI: 10.11817/j.issn.1672-7347.2019.190441 |
| [45] |
Al-Oufi D, Alkharboush HM, Younis ND, Abu-Zaid A. Disk battery as a vaginal foreign body in a five-year-old preadolescent child. Cureus. 2021;13(3):e13727. DOI: 10.7759/cureus.13727. |
| [46] |
Al-Oufi D., Alkharboush H.M., Younis N.D., Abu-Zaid A. Disk battery as a vaginal foreign body in a five-year-old preadolescent child // Cureus. 2021. Vol. 13. No. 3. ID e13727. DOI: 10.7759/cureus.13727 |
| [47] |
Taylor MA, Higginbotham JC. Child sexual abuse exam results in West Alabama. J Child Sex Abus. 2020;29(1):90–111. DOI: 10.1080/10538712.2019.1630881 |
| [48] |
Taylor M.A., Higginbotham J.C. Child sexual abuse exam results in West Alabama // j child sex abus. 2020. 29. No. 1. P. 90–111. DOI: 10.1080/10538712.2019.1630881 |
Pavlenko N.I., Pisklakov A.V., Chuyan I.I.
/
| 〈 |
|
〉 |