Variability in findings of anogenital injury in consensual and non-consensual fisting intercourse: A systematic review.
Fisting is an uncommon and potentially dangerous sexual practice. This is usually a homosexual activity, but can also be a heterosexual or an autoerotic practice. A systematic review of the forensic literature yielded 14 published studies from 8 countries between 1968 and 2016 that met the inclusion/exclusion criteria, illustrating that external anogenital (anal and/or genital) trauma due to fisting is observed in 22.2% and 88.8% (reported consensual and non-consensual intercourse, respectively) of the subjects, while internal injuries are observed in the totality of the patients. Establishing the reliability of the conclusions of these studies is difficult due to a lack of uniformity in methodology used to detect and define injuries. Taking this limit into account, the aim of this article is to give a description of the external and internal injuries subsequent to reported consensual and non-consensual fisting practice, and try to find a relation between this sexual practice, the morphology of the injuries, the correlation with the use of drugs, and the relationship with assailant, where possible. The findings reported in this paper could be useful, especially when concerns of sexual assault arise.
Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Sciences, "Sapienza" University of Rome, Rome, Italy. Electronic address: simone.cappelletti@uniroma1.it.
Simone
S
Cappelletti
Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Sciences, "Sapienza" University of Rome, Rome, Italy.
Mariarosaria
M
Aromatario
Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Sciences, "Sapienza" University of Rome, Rome, Italy.
Edoardo
E
Bottoni
Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Sciences, "Sapienza" University of Rome, Rome, Italy.
Paola Antonella
PA
Fiore
Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Sciences, "Sapienza" University of Rome, Rome, Italy.
Vittorio
V
Fineschi
Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Sciences, "Sapienza" University of Rome, Rome, Italy.
Natale Mario
NM
di Luca
Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Sciences, "Sapienza" University of Rome, Rome, Italy.
Costantino
C
Ciallella
D001003:Anal Canal / Q000293:injuries*; D003106:Colon / Q000293:injuries; D005260:Female; D005554:Forensic Medicine; D006225:Hand; D006801:Humans; D007413:Intestinal Mucosa / Q000293:injuries; D008297:Male; D010502:Perineum / Q000293:injuries; D011902:Rape; D012007:Rectum / Q000293:injuries; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000150:complications; D014621:Vagina / Q000293:injuries*
Anogenital injury; Fisting; Injuries; Sexual assault; Sexual practice; Trauma