Retrospective Analysis of Clinical Features, Treatment and Outcome of Coital Injuries of the Female Genital Tract Consecutive to Consensual Sexual Intercourse in the Limbe Regional Hospital

Introduction

Nonobstetrical genital injuries are gradually becoming a common cause of genital injuries. Consensual sex has been reported to be a possible cause of this type of injuries, but its contribution to traumatic lesions of the female genital tract is not well known. It has been suggested that injury consecutive to consensual sex can be extensive and life‐threatening.

Aim

The aim of this study was to analyze the clinical features, treatment modalities, and the outcome of injuries to the female genital tract consecutive to a consensual sexual intercourse.

Methods

A retrospective review of records of female patients admitted in our institution with a complaint of genital injury over a 5‐year period. We collected data regarding patient and injury characteristics, findings of the gynecologic examination, modalities of management and final outcome.

Main Outcome Measures

Anatomic location and nature of injury, modalities of management, admission rate and mortality rate.

Results

Forty six cases could be analyzed. Their mean age was 25.6 years. Almost 35% of patients sustained the injury during their first sexual contact. The majority presented with bleeding, often combined with pain. One patient presented with features of peritonitis. During examination, no anatomic lesions could be identified in 16 (34.8%) of patients. When a lesion was present, it concerned mostly the posterior fornix (28.3%) and the lateral vaginal wall (10%). The most frequently described lesion was a laceration. The majority of patients (83%) were treated with suturing under local anesthesia. The admission rate was 28%, and was significantly higher in patients with a laceration of the posterior fornix. No death was recorded.

Conclusions

Coital injuries following consensual sex often present in the form of a life‐threatening condition and young female with no previous sexual experience are particularly exposed. Most lesions can be treated with a simple suture. 

Clinical characteristics recorded in patients with a coital injury in Limbe Regional Hospital

Clinical characteristic	Number	Percentage
Period of abstinence
Never had sex before	16	34.8
Less than 1 month	13	28.2
1–6 months	4	8.7
More than 6 months	7	15.3
Unknown	6	13.0
Main complaint
Genital pain	39	84.8
Bleeding	31	67.4
Lower abdominal pain	18	39.1
Other	7	15.2
Anatomic location of lesion
Posterior fornix	13	28.3
Lateral vaginal wall	5	10.9
Labia minora	3	6.5
Clitoris	2	4.3
Perineum	2	4.3
Posterior fourchette	1	2.2
Multiple	4	8.7
No identifiable lesion	16	34.8

Full article at:   http://goo.gl/CKYZOu

By:  Robert Tchounzou, MD 1 and Alain Chichom‐Mefire, MD 1

¹Faculty of Health Sciences, University of Buea and Regional Hospital Limbe, Limbe, Cameroon

Corresponding author.

*Corresponding Author: Alain Chichom‐Mefire, MD, Genral Surgeon, Faculty of Health Sciences, University of Buea and Regional Hospital Limbe, P.O. Box 25526, Yaounde, Cameroon. Tel: +237 677 530 532; Fax: +237 677 530 532; E‐mail: moc.liamg@erifemohcihc

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