Vaginal Injuries - Genital Injuries in Females

Overview, Causes, & Risk Factors

A genital injury to a female is an injury to the reproductive organs of a girl or a woman.

What is going on in the body?

The external genitalia has a rich blood supply. As a result, relatively minor injuries to the area may bleed excessively. This is particularly true when injuries involve the hymen, vagina, or labia. The injury may be the result of childbirth, rough intercourse, sexual assault, or an accident or other trauma.

What are the causes and risks of the condition?

Childbirth is the most likely cause of genital injury. A tear in the vulva or vagina during pregnancy and delivery may occur as a result of:

an episiotomy, which is a cut made in the opening of the vagina during childbirth

tears in the vaginal opening from delivering a large infant

the use of forceps or vacuum suction during childbirth

Accidental injuries can be caused by:

falls

straddle injuries, for example falling on monkey bars, a bicycle bar, or a fence

the amount of body surface area, also called BSA, that is injured\ \the depth of destruction\ \the location of the burn\ ',CAPTION,'Burns');" onmouseout="return nd();">chemical burns or burns from hot objects

pelvic fractures

high-pressure liquid injection, such as from water-skiing or jet-skiing

Injuries related to sex or assault are due to:

rough sex

unusual positions during sex

having sex for the first time

sexual abuse

rape

physical abuse or assault, such as a foreign object forcibly placed into the vagina or anus

child abuse

---

Symptoms & Signs

What are the signs and symptoms of the condition?

If the injury is to the inside of the vagina, the girl or woman may not have any bleeding or pain. Sometimes these internal injuries affect the bladder, rectum, and other organs in the abdomen. Symptoms may include:

pain in the abdomen

pain inside or outside the vagina

bleeding

swelling

redness and swelling within the vagina

cuts or tears anywhere in the genital region

painful urination

inability to urinate

foul smelling discharge

an object embedded in the vagina

feeling faint

bite marks on the genitalia

shock

bruising of the vulva, the outside of the vagina

bleeding under the skin of the vulva

change in the shape of the vaginal lips, vulva, or other areas

---

Diagnosis & Tests

How is the condition diagnosed?

It may be hard to do a pelvic exam in woman or girl who has a genital injury. But without a thorough exam, a healthcare provider may misjudge the extent and severity of the injury. Sometimes the exam is done with the woman or girl under general anesthesia.
Other procedures that may be done include:

cystoscopy, an examination of the bladder

anoscopy, examination of the anus

colonoscopy, examination of the rectum

laparoscopy, examination of the abdomen

exploratory surgery of the abdomen

vaginoscopy, which is a visual examination of the vagina

---

Prevention & Expectations

What can be done to prevent the condition?

Vaginal injuries related to high-pressure water injection can be prevented by wearing protective clothing such as a wet suit while water or jet skiing. Keeping one's feet together when entering the water on a slide will keep water from entering the vagina.
Preventing sexual assault may not be possible, but it is clear that the victim of this brutality should not be blamed. Women should avoid situations that can bring physical or sexual harm, such as:

alcohol or drug use

being in a dangerous environment

having an abusive partner

having group sex

Children should be told that they should not place objects into the vagina. Also, getting rid of sharp objects in the tub that they may fall on can prevent injuries.

What are the long-term effects of the condition?

Genital injuries need to be treated right away to prevent bleeding, complications, and long-term psychological damage. Genital injuries in girls will very likely create a lot of anxiety for the child as well as for her parents.

What are the risks to others?

A genital injury can pose a risk to a fetus if the woman is pregnant. Other risks may occur from some of the secondary effects of genital injury, such as sexually transmitted diseases.

---

Treatment & Monitoring

What are the treatments for the condition?

Treatment varies according to the severity of the injuries. Treatments may include:

ice packs, pressure to stop any bleeding, and bed rest

draining any large areas of blood

suturing of cuts or tears

surgery to repair any damage to other organs

antibiotics

estrogen creams to help the vagina heal

using a urinary catheter, which is a small tube that allows urine to drain from the bladder

counseling after sexual abuse

What are the side effects of the treatments?

Antibiotics can cause stomach upset, rash, allergic reaction, and other side effects. Surgery poses a risk of infection, bleeding, and allergic reaction to anesthesia.

What happens after treatment for the condition?

Bed rest, ice packs, and antibiotics may be needed for some time depending on the extent of the injuries. Not having sex for a while will allow the tissues to heal.

How is the condition monitored?

A woman or girl should notify her healthcare provider if she notices any of the following:

fever

pain or swelling in the affected area

bleeding

nightmares, sleep disorders, depression, or thoughts of suicide after sexual abuse

---

Attribution

Author:Eva Martin, MD
Date Written:
Editor:Smith, Elizabeth, BA
Edit Date:08/22/00
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:07/02/01

Sources

Understanding Your Body, Felicia Stewart, Felicia Guest, Gary Stewart, and Robert Hatcher, 1987
Maternity and Gynecological Care, The Nurse and the Family, Irene Bobak, Margaret Jensen, Marianne Zalar, Mosby Co., 1989

---