Genital findings in adolescent girls referred for suspected sexual abuse.
BACKGROUND
Sexual abuse is a common problem affecting adolescent girls, but the frequency of medical findings in this population has not been specifically described.


OBJECTIVE
To describe the frequency of specific genital findings in a group of pubertal girls who had experienced probable or definite sexual abuse.


METHODS
Patient series, medical chart and photograph review.


METHODS
Specialty referral clinic for abused children. PATIENTS AND SELECTION: Referred sample of female patients, examined between January 1, 1987, and June 30, 1994, with Tanner genital stages 3, 4, or 5, who reported a history of penile-vaginal penetration, had colposcopic photographs taken, and were determined, by means of a previously described classification system, to have experienced probable or definite abuse.


METHODS
None.


RESULTS
The study included 204 girls, aged 9 to 17 years (mean, 13 years); race or ethnicity was Mexican American in 57%, white in 34%, and other in 9%. Abnormal genital findings were documented in 32% of patients overall but were more common when the girls had reported bleeding at the time of the assault (50% vs 26%; P = .004, chi 2 analysis), or when the examination occurred within 72 hours of the last episode of abuse (69% vs 26%; P < .001, chi 2 analysis). Transections of the hymen were unusual (8%), but notches in the hymen were more common (25%).


CONCLUSIONS
Normal or nonspecific results of genital examinations are commonly found in adolescents who have been sexually abused, unless the abuse was very recent. Further studies are needed to document the healing of genital injuries in victims of acute assault and the frequency of hymenal findings in nonabused, non-sexually active adolescents.
Adams
J A
JA
Division of Adolescent Medicine, University of California, San Diego, USA.
Knudson
S
S
D000293:Adolescent; D001003:Anal Canal / Q000473:pathology*; D002648:Child; D002650:Child Abuse, Sexual / Q000145:classification / Q000175:diagnosis*; D003127:Colposcopy; D016002:Discriminant Analysis; D005260:Female; D005836:Genitalia, Female / Q000473:pathology*; D006801:Humans; D010781:Photography; D010808:Physical Examination; D011627:Puberty; D012017:Referral and Consultation; D012189:Retrospective Studies; D013997:Time Factors