title: Female genital injuries resulting from consensual and non-consensual vaginal intercourse.
abstract: OBJECTIVE
  The purpose of this study was to compare the incidence of genital injury following penile-vaginal penetration with and without consent.
  
  
  METHODS
  This study compared observations of genital injuries from two cohorts.
  
  
  METHODS
  Participants were drawn from St. Mary's Sexual Assault Referral Centre and a general practice surgery in Manchester, and a general practice surgery in Buckinghamshire.
  
  
  METHODS
  Two cohorts were recruited: a retrospective cohort of 500 complainants referred to a specialist Sexual Assault Referral Centre (the Cases) and 68 women recruited at the time of their routine cervical smear test who had recently had sexual intercourse (the Comparison group).
  
  
  METHODS
  Presence of genital injuries.
  
  
  RESULTS
  22.8% (n=00, 95% CI 19.2-26.7) of adult complainants of penile-vaginal rape by a single assailant sustained an injury to the genitalia that was visible within 48h of the incident. This was approximately three times more than the 5.9% (n=68, 95% CI 1.6-14.4) of women who sustained a genital injury during consensual sex. This was a statistically significant difference (a<0.05, p=0.0007). Factors such as hormonal status, position during intercourse, criminal justice outcome, relationship to assailant, and the locations, sizes and types of injuries were also considered but the only factor associated with injury was the relationship with the complainant, with an increased risk of injury if the assailant was known to the complainant (p=0.019).
  
  
  CONCLUSIONS
  Most complainants of rape (n=500, 77%, 95% CI 73-81%) will not sustain any genital injury, although women are three times more likely to sustain a genital injury from an assault than consensual intercourse.
authors.affiliation: Academic Unit of Obstetrics and Gynaecology, University of Manchester, Manchester Academic Health Science Centre, St. Mary's Hospital, Hathersage Road, Manchester M13 0JH, UK. iain.mclean@cmft.nhs.uk
authors.forename: Iain
authors.initials: I
authors.lastname: McLean
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Roberts
authors.forename: Cath
authors.initials: C
authors.lastname: White
authors.forename: Sheila
authors.initials: S
authors.lastname: Paul
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D003075:Coitus; D003288:Contusions / Q000473:pathology; D005260:Female; D005836:Genitalia, Female / Q000293:injuries* / Q000473:pathology; D058869:Gynecological Examination; D006801:Humans; D022125:Lacerations / Q000473:pathology; D008875:Middle Aged; D011902:Rape; D012189:Retrospective Studies