Use of Foley Catheter to Examine Estrogenized Hymens for Evidence of Sexual Abuse

Abstract

An examination technique for the collection of evidence to document physical findings of sexual abuse of children uses a Foley catheter in older girls with estrogenized hymens. The inflated balloon in the distal vaginal vault puts pressure on the hymen, effectively stretching it out and allowing for a more accurate view of the hymen edges. This report demonstrates the results in 2 of 17 adolescent girls who underwent the Foley catheter stretch technique. Patient 1 was a 13-year-old girl who gave a statement of repeated sexual abuse, including penile penetration by an adult male. Patient 2 was a 12-year-old girl who disclosed a single episode of sexual assault 1 year previously. After careful examination, a Foley catheter (14 Fr) was inserted through the hymen orifice and inflated using 40ml of air. Gentle pulling toward the orifice resulted in stretching of the hymenal tissues over the balloon surface of the catheter. After photodocumentation of the anatomy of the hymen edges, the balloon was deflated and removed.