Genital injuries in a pediatric or adolescent patient can be a result of an accidental injury or from intentional assault. Abrasions, contusions, lacerations and bruising can all result from trauma to the genital area.
The most common genital injuries seen in young girls under the age of 14 years is known as straddle injury to the vulva. This accidental trauma is often caused by common objects such as a bicycle crossbar, the arm of a chair, countertops, diving boards, ledges of pools or bathtubs and playground equipment.
A straddle injury is commonly seen as a fall where the patient straddles an object compressing the soft tissue of the vulva between the object and the underlying bones of the pelvis. Most straddle injuries are non-penetrative injuries and the swelling and bruising is noted on the external region of the genital region.
The need for surgical intervention in adolescent genital trauma is low, but if necessary, can be provided by our OB/GYN specialists. Healing can be found by making use of sitz baths (frequent, shallow, warm baths), and by decreasing physical activity to ensure the area is not re-injured.
Vaginal bleeding and vulvar swelling and bruising can be profuse and the patient's ability to urinate may be compromised if the swelling is near the urethra. Typically, observation and cold compresses are suggested, however, your OB/GYN or urologist will prescribe the best treatment for your individual symptoms.
Penetrating injuries are typically seen as a piercing injury of the genital or urinary organs and/or the anal or rectal tissues. These types of injury are usually more extensive and more commonly involve trauma to the hymen and vagina. These cases require a thorough examination and may need to be performed with assistance from conscious sedation or anesthesia.
Lacerations to the vagina can also be seen as a result of a straddle or penetrating injury. This can occur due to the forceful abduction of the legs, assault or consensual sexual activity.
Although it has been mentioned that genital injuries can be common in children, it is imperative to consider assault or sexual abuse in any child who has suffered a genital injury.
Omaha's only adolescent gynecology clinic at Methodist Physicians Clinic Women’s Center is committed to providing adolescent gynecology services for teens.