Nonobstetrics vulvovaginal injuries: mechanism and outcome.
OBJECTIVE
The aim of this study is the evaluation of mechanisms and outcome of nonobstetrics vulvovaginal injuries (VVI).


METHODS
Medical documentation on 17 VVI recorded during the 1998-2005 period was analysed. The analysis included age, mode of injury infliction (accidental, intracoital, rape), treatment, and VVI outcome. Pregnant women and obstetrics peripartal and postpartal VVI were excluded from this study, and there was no sexual assault VVI in children and young girls in this period.


RESULTS
There were five young girls, all of them raped by the straddle mechanism, five adolescents (aged <25), and five postmenopausal women. Two postmenopausal women were raped by young men. Straddle accident due to fall from bicycle was recorded in three, fall onto a metal object in two, and athletic injury by a foreign object, cow's horn, and kitchen knife in one patient each. Intracoital injuries, mostly rupture of the posterior fornix, were recorded in six patients. Revision and primary suture of the wound were performed in 16 patients, whereas 1 patient underwent laparotomy and revision of the vaginal stump due to intestinal prolapse after vaginal rupture.


CONCLUSIONS
Besides primary operative management of the wound, the patient should receive broad-spectrum antibiotic and antitetanic prophylaxis in cases of accidental and penetrating injuries (foreign object, cow's horn, kitchen knife). In case of suspect mechanism of infliction, VVI in a child require careful inspection because of the potential forensic implications (rape, abuse).
Habek
Dubravko
D
Department of Obstetrics and Gynecology, School of Medicine, Zagreb University, Sveti Duh Hospital Zagreb, Sveti Duh 64, HR-10000 Zagreb, Croatia. dubravko.habek@os.t-com.hr
Kulas
Tomislav
T
D000059:Accidents; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001642:Bicycling / Q000293:injuries; D003075:Coitus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017698:Postmenopause; D011902:Rape; D014621:Vagina / Q000293:injuries*; D014844:Vulva / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000209:etiology* / Q000601:surgery; D014950:Wounds, Penetrating / Q000209:etiology* / Q000601:surgery