Sexual Assault Forensic Examination in adult and child cases: Is Colposcopy Really Necessary?

Abstract

Sexual assault is a complex situation with medical, psychological, and legal aspects. Victims should be examined by a specially trained medico-legal examiner to collect evidence and avoid multiple examinations. The use of colposcopy in child and adult sexual assault cases is becoming increasingly more widespread however; it is still not a routine aspect of all examinations in most countries. The present study aimed to evaluate the importance of using the colposcope in the examination of the sexual assault cases admitted to the violence against women and child clinic in the Forensic Medicine Authority in Egypt. The study included (150) cases, divided into two groups according to age: Group A (1 to 18 years) (124) male and female children and Group B (19-40 years) (26) females. -General, then local examination with the naked eye and colposcopy had been performed. Internal genitalia was examined by using disposable plastic Casco in adult non-virgin victims only. -Vaginal and anal swabs were collected for the detection of seminal stains. The results of the colposcopic examination revealed a significant difference in both negative and positive results when compared to the other methods of examination (naked eye, swabs, and clothes examination). Colposcopic magnification power with high resolution and illumination light permits to discover microtrauma which may not be discovered with a normal examination by naked eyes. Colposcope seems to be an important noninvasive tool for the examination of children and adults when sexual abuse is suspected. Its documentation could allow for supervision, teaching, and second opinions in an ethically difficult setting. The colposcopic examination should be introduced to all forensic departments in Egypt to be used as a routine aspect of all sexual assault examinations. Future studies are recommended to be conducted on a national scale. Keywords: Sexual assault; Colposcope; Toluidine blue dye; Examination