Patterns of accidental genital trauma in young girls and indications for operative management.
OBJECTIVE
The aim of this study was to define the injury patterns of accidental genital trauma (AGT) in female patients and examine the indications and outcomes of operative intervention.


METHODS
Review of patients younger than 16 years with AGT from 1980 to 2007 excluding sexual- and obstetric-related injuries.


RESULTS
One hundred sixty-seven patients met the criteria. Mean (+/-SEM) age was 6.9 (0.2) years. There were 70.5% straddle injuries, followed by nonstraddle blunt injuries (23.5%) and penetrating injuries (6.0%). Injuries to the labia were most frequent (64.0%). Injuries to the posterior fourchette (7.8%) and hymenal disruption (8.4%) were less frequent. There was 87.9% of AGT that was managed expectantly without further sequelae. Twenty patients (12.1%) were managed operatively. Penetrating injuries were more likely to require operative management (P <or= .03). The operative group was also more likely to have multiple genital injuries (60% versus 25%, P < .01). Proctoscopy, vaginoscopy, and/or cystoscopy were performed in 55% of patients in the operative group.


CONCLUSIONS
Accidental genital trauma is most commonly caused by straddle-type injuries and is usually amenable to nonoperative management. Hymenal disruption and injuries to the posterior fourchette are uncommon with these types of injuries.
Iqbal
Corey W
CW
Department of Surgery, Mayo Clinic Rochester, Rochester, MN 55905, USA.
Jrebi
Nezar Y
NY
Zielinski
Martin D
MD
Benavente-Chenhalls
Luis A
LA
Cullinane
Daniel C
DC
Zietlow
Scott P
SP
Moir
Christopher R
CR
Ishitani
Michael B
MB
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005836:Genitalia, Female / Q000293:injuries* / Q000601:surgery; D006801:Humans; D007223:Infant; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology / Q000628:therapy