Genital Trauma Research Articles

Consumer product-related female genital injuries in the USA from 2013 to 2022

BackgroundConsumer product-related genital injuries in females across all age groups are understudied. Existing research focuses primarily on paediatric populations. We aimed to determine characteristics, trends and predictors of hospitalisation.MethodsThe National...

Evaluating Digital Imaging Technologies for Anogenital Injury Documentation in Sexual Assault Cases

Purpose: Photo-documentation is a critical component of care and an indispensable skill for forensic clinicians treating patients who have experienced violence and trauma. This retrospective study examines the frequency and nature of anogenital injuries identified through colposcope digital imaging in comparison to those detected using a high-resolution camera system. Methods: This retrospective, before-and-after study evaluated genital injuries in all adult women (over 16 years old) who presented to a freestanding Nurse Examiner Clinic (NEC) following sexual assault during a 3-year period. The clinic is supervised by forensic clinicians trained in conducting medical-forensic examinations. In 2016-2017, all injuries were documented using the Cooper Surgical Leisegang© colposcope system, while in 2018, injuries were recorded exclusively with a high-resolution camera system. The primary outcome was the frequency of genital findings documented in sexual assault victims from each group. Results: A total of 367 women were evaluated in the "before" period and 180 in the "after" period. Both groups were similar in terms of demographics, assault history, time to examination, alcohol use, and the occurrence of genital injuries (76.1% vs. 74.9%, p = 0.76). However, patients examined with the high-resolution camera system had a significantly higher number of documented anogenital injuries (2.4 vs. 1.8, p < 0.001). This group also had more anogenital abrasions identified (51.1% vs. 27.0%, p < 0.001). The injury patterns between the two groups were not statistically different. Conclusion: Accurate and reliable photo documentation are the key components of forensic medical documentation. Our findings indicate that the detection of anogenital injuries may differ based on the imaging system used.

Anterior deflected urinary stream in female children: description of a unique clinical entity and surgical management.

To investigate the clinical presentation and outcomes for a series of female pediatric patients with severe anterior deflection of the urinary stream (ADUS) who were managed via urethromeatoplasty. This single institution retrospective cohort study used the institutional billing database to identify female patients ≤18 years who received a urethromeatoplasty (CPT 53450) from 2007 to 2022. Patients were included if a substantial anterior deflection of their urinary stream was the primary indication for surgery. Patients were excluded if they were >18 years of age, had a history of prior genital trauma, or underwent surgery for an indication other than a deflected urinary stream. Twenty female patients underwent urethromeatoplasty between 2007 and 2022, with a median age of 3 years old. All patients presented with difficulty aiming the urinary stream during toilet training and demonstrated a web of tissue along the posterior aspect of the urethral orifice. 19/20 patients noted immediate response (i.e., normal, non-deflected urinary stream) after the urethromeatoplasty with no further urinary complaints. There were no post-operative complications within a 90-day period. ADUS is a clinical entity characterized by a web of deflecting tissue at the female posterior urethral meatus that causes severe urinary deflection without other urologic symptoms. This is not well-described in the literature. Surgical correction via urethromeatoplasty is safe and effective.

Traumatic penile amputation managed at Usmanu Danfodiyo University Teaching Hospital Sokoto, Nigeria: a case series

BackgroundTraumatic penile amputation is a rare surgical emergency and a cause of anxiety and psychological distress to patients, spouses, or parents, especially when it occurs in children. Several mechanisms are involved in penile amputation and the management options also vary. We report two cases of penile amputation that our institution handled in the past year to draw attention to the risks associated with firearm confrontations and grinding machines as causes of genital injuries. In a similar vein, we look over the literature for management options.Case presentationIn the first case, a grinding machine resulted in an isolated total penile amputation of a 6-year-old boy. In contrast, the second patient was a 25-year-old man who had bilateral testicular injuries and near-total penile amputation as a result of gunshot injury as part of polytrauma. Both patients had a history of profuse bleeding from the penile stump associated with severe pain. Both patients were resuscitated and subsequently underwent emergency wound debridement and stump refashioning/meatoplasty. The first patient had a satisfactory outcome and was discharged home on follow-up visits while the second patient died from overwhelming sepsis with pulmonary embolism as a differential.ConclusionPenile injuries may increase in tandem with civilian firearm-related incidents. Similarly, grinding machines are an important cause of penile injuries. In emergencies, wound debridement followed by stump refashioning is an appropriate treatment option.

Role of genetic variations and protein expression of β-Microsemino protein in intrauterine insemination outcome of unexplained infertile men: A case-control study.

Intrauterine insemination (IUI) is often the first-line treatment for unexplained infertility. -Microsemino protein (MSMB) is an abundant protein in seminal plasma that has an inhibitory effect on spontaneous acrosome reaction. The present study aimed to evaluate MSMB gene variations and protein expression on IUI success rate in unexplained infertile men. A case-control study was performed on 100 unexplained infertile Iranian men referred to the Royan Institute, Tehran, Iran for IUI (50 men with IUI positive result [IUI+], and 50 men with IUI negative result [IUI-]). Couples with female infertility factors (such as hormonal disorders, infrequent menstrual period, abnormality in uterus, fallopian tubes, or ovaries) and men with infections of the male accessory glands, hypogonadotropic hypogonadism, clinical varicocele, retractile testis, genital trauma, drug use, or concurrent hormonal treatment Y chromosome microdeletions, and abnormal karyotype were excluded from the study. The polymerase chain reaction sequencing was performed for the promoter and the coding regions of MSMB functional domains. To study the protein expression, the total protein of sperm was extracted, and sandwich enzyme-linked immunosorbent assay was performed. 4 variations were detected (rs12770171, rs10993994, rs2075894, and rs4517463). None of them showed significant differences between the IUI+ and IUI- groups. The mean value of protein expression did not show any differences between the groups. In conclusion, there is no association between genetic variations of promoter and coding regions of MSMB functional domains as well as its expression with IUI success in unexplained infertile men.

Audit of Genito-Anal Injuries in male and female sexual abuse cases - A retrospective study.

Background: Sexual assault is a global issue wherein timely examination of sexual assault victims by medico-legal officers and an understanding of the characteristics and factors influencing their injuries have a crucial impact on medico-legal evidence collection and its use in the court. Genital injury findings improve the level of justice for victims, but the lack of injury does not negate the possibility of sexual violence incurred on the victim. The following study describes in great detail the different factors associated with injury characteristics and the medico-legal importance of all these factors. Methodology: It was a retrospective descriptive study conducted at the Forensic Medicine Department of King Edward Medical University, Lahore, Pakistan. All the cases included that fulfill the predefined inclusion criteria were included. A record chart was designed, and six years’ data was recorded in it from the medical records of the medico-legal clinic. It was entered and edited manually. Methods used to prevent data entry errors included double entry and validation following data entry Difference of proportions between variables, where appropriate, has been calculated by Pearson Chi-Square test and Fischer Exact test at 95% confidence interval. Data were analyzed using SPSS v23. All procedures performed in this study involving human participants were following the ethical standards of the institutional and/or national research committee and the Helsinki declaration. Results: Genito anal injury was present in 28.2% cases and was absent in 71.8% cases. Most of the victims were aged 11 to 15 years. The most common injury in the victims was a tear. In females, the most common injury site was the vagina, while the perianal area was the most injured site in males. There was a significant relation (p<0.05) between type and site of injury, gender, site of injury, and prior sexual intercourse experience and prevalence rate of injury. Conclusion: This study concludes that the presence of injuries in the Genito anal area is suggestive of sexual assault and provides useful court evidence.

Genital Injury - Female

Genital Injury - Female

Genital Injury - Male

Genital Injury - Male

Storage of evidence and delayed reporting after sexual assault: Rates and impact factors on subsequent reporting

BackgroundSexual assault (SA) is alarmingly prevalent, yet reporting rates remain disproportionately low. Forensic examinations (FE) play a crucial role in both immediate medical care and evidence collection, yet many victims/survivors may not report the crime initially, leading to the loss of vital forensic evidence. The storage of evidence “Option 3″ care alternative provides post-SA care including FE without initial police involvement. MethodsThis is a cross-sectional study analysing the attendances of people who chose to store evidence at the Dublin Sexual assault Treatment Unit (SATU) between January 1, 2017 and December 31, 2023. ResultsThere were 238 storage of evidence FEs (‘Option 3’) performed during the study period, which represented 12.8 % of all FEs. The majority identified as female (89.1 %), with an average age of 26.6 years. 31.9 % attended within 24 h of the incident, and 51.3 % self-referred. Most assaults occurred over weekends (64.7 %), with alcohol consumption reported in 82.2 % of cases and drug-facilitated SA concerns in 20.2 %. Genital injuries were present in 17.9 % of females and 19 % of males.Those that availed of storage of evidence (compared with those who initially reported to the police) were significantly more likely to have consumed alcohol (p < 0.001) and the assault was more likely to have occurred indoors (p = 0.002). There was no significant difference in care option choice for those ‘unsure’ of the assault occurrence (p = 0.353).Among storage of evidence cases, 20.2 % subsequently reported to the police, with females more likely to report (p = 0.02), while people who were uncertain whether an assault had occurred were less likely to report (p = 0.04). Genital injury (p = 0.822), victim-assailant relationship (p = 0.465), assault location (p = 0.487), and substance consumption (p = 0.332) did not significantly affect subsequent reporting rates. ConclusionsThe availability of storage of evidence has afforded people the opportunity to access prompt, responsive SATU care including collection of forensic evidence which may have significant evidential value. This approach provides further opportunity for comprehensive detection of a crime, even if reporting to the police is delayed.

Phantom sensation in genital gender-affirming surgery: a narrative review.

To review findings related to phantom genital sensation, emphasizing phantom sensation in the transgender and gender diverse (TGD) population. We discuss prevalence, presentation and potential implications for sensory outcomes in genital gender-affirming surgery. There is a high prevalence of phantom genital sensations in the TGD population. The prevalence varies by body part, approaching 50% in the most frequently reported transgender phantom - the phantom penis. Unlike genital phantoms that occur after trauma or surgery which are often painful, transgender phantoms are typically neutral and often erogenous in experience. Phantom sensation in the TGD population can be an affirming experience and important part of sexual well being and embodiment. Recent studies have begun to characterize the prevalence and presentations of phantom genital sensations in TGD people, informing our evolving understanding of the sensory experiences of the transgender and gender diverse population. Targeting integration of these centrally-mediated phantom genital sensations with the peripherally generated sensation from genital stimulation may represent one potential avenue to improve sensation and embodiment following genital gender-affirming surgical procedures. Additionally, emerging techniques in modern peripheral nerve surgery targeting phantom pain may offer potential treatment options for painful phantom sensation seen after cases of genital surgery or trauma.

The Epidemiology and Outcomes of Perineal and Genital Burn Injury in Low- and Middle- Income Countries: A Global Burn Registry Study

IntroductionThe epidemiology, care, and outcomes of perineal and genital burns (PG) in high-income countries have been previously described, but an analysis of this topic in LMICs has yet to be performed. We use the World Health Organization’s Global Burn Registry to fill this gap. MethodsThe GBR was searched from inception to November 2023 to identify all burn patients, excluding cases from high-income countries. Demographics and mechanism of injury were retrieved. Primary outcomes were length of hospital stay (LOHS), surgical intervention, discharge with physical impairment, and mortality. A multivariate regression analysis was performed controlling for burnt total body surface area (TBSA), age, sex, inhalation injury, mechanism of burn and care center characteristics. ResultsOf 9041 patients identified, 1213 (13.4 %) had PG burns with 136 (1.6 %) isolated to the PG region. PG patients had higher TBSA (p < 0.001) and more inhalation injury (p < 0.001). They had better access to rehabilitation and lower access to theater space for burns (p < 0.001). Multivariable analysis showed that PG patients had longer LOHS (p = 0.001), greater mortality (p < 0.001), were less likely to undergo surgery (p = 0.01) or be discharged home with physical impairment (p = 0.03). ConclusionSimilarities and differences exist between high- and low/middle-income countries in terms of the patterns of injury, care, and recovery in patients with PG burns. The longer LOHS and higher mortality among PG patients, previously reported in high-income countries, are verified. This highlights the importance of greater vigilance when caring for such patients.

Combat-Genital Injury in UK Male Military Veterans: A Pilot and Feasibility Study Exploring Long-Term Psychosocial and Sexual Experiences and Support Needs

During the most recent conflicts in Iraq and Afghanistan, genital injuries were reported among male personnel at rates higher than previous conflicts. To date, research has focused predominantly on immediate medical management with limited published research exploring the long-term psychosocial and sexual impacts of combat-genital injury. This pilot study, therefore, aimed to explore the psychosocial and sexual health outcomes, experiences and support needs of military veterans who sustained combat-genital injuries and to assess the feasibility of conducting further research on this topic. A cross-sectional online survey design was used, comprising open and closed questions. Recruited through opportunity and snowball sampling, 11 eligible male UK veterans who had sustained a combat-genital injury completed the survey between March and July 2021. The results indicate that participants experienced long-term challenges related to their genital injury including low self-esteem, sexual function difficulties, and fertility concerns. The findings provide preliminary evidence of unmet long-term psychosocial, sexual, and fertility support needs among UK veterans with combat-genital injury. Further research is required to better understand the psychosexual wellbeing of combat veterans who have sustained physical injuries more broadly and to determine how best to provide psychosexual support to those who may benefit.

Variation in perceptions of genital ablation between aspiring eunuchs and individuals with paraphilic sexual fantasies

Abstract Background Although uncommon, some individuals assigned male at birth (AMAB) seek voluntary genital ablative procedures, and others fantasize about it. Aim To learn more about the views of genital ablation and injuries in those who aspire to be castrated as compared with those who only fantasize about it. Methods A survey was run on the Eunuch Archive internet community. Content analysis was conducted on the responses of 342 AMAB individuals with castration fantasy but no desire for actual surgery (fantasizers) vs 294 AMAB individuals who expressed a desire for genital ablation (aspiring). Outcomes Study outcomes were responses to open-ended questions about genital ablations and injury. Results Aspiring individuals were more likely to perceive a “physical appearance benefit” from orchiectomy, but fewer could recall how they first learned about the procedure. Some reasons that aspiring persons gave for desiring an orchiectomy included “achieving preferred self” and “health reasons.” Fantasizers, in contrast, worried about the potential side effects of orchiectomy, and more believed there to be no benefit to it. Clinical Implications Psychiatrists and other clinicians need to understand their patients’ views on genital ablation to properly diagnose and provide the best personalized care. Strengths and Limitations Strengths include a large sample of respondents. Limitations include the accuracy of the anonymous survey data. Conclusions This study demonstrates divergent interests on genital ablation among AMAB individuals who have not had an any genital ablation yet have intense interest in the topic.

Kupi II Congress and Results of Religious Views on Contemporary Women's Issues in the Perspective of Islamic Anthropology

This paper is a study related to the Indonesian Women's Ulama Congress (KUPI) and its religious views through an Islamic feminist anthropology approach. This is because the discussion on KUPI hasn’t been captured through this approach. In fact, by this approach, the problems surrounding women can be seen in more depth and detail. By using primary data from observations and secondary data from literature reviews, the results found that KUPI or the Indonesian Women's Ulama Congress is a women's organization in Indonesia that brings together various individual backgrounds to study women's problems based on Islamic teachings that are mutabadil. Through discussions, halaqoh and religious meetings, the first KUPI congress in Cirebon produced three religious views while the second congress in Jepara produced five religious views and several recommendations regarding the protection of women from religious extremism, forced marriages, dangers of pregnancies due to settlement, genital injuries, and issues environment. KUPI activities are cultural in nature. Participants who come from various backgrounds bring facts and data in the field to be interacted with in order to realize human reason, mind and power which then shape culture and find an Islamic religion that is moderate, gender fair and provides human welfare.

107 Genital Burn Injuries: A Nationwide Analysis of Patient Outcomes

107 Genital Burn Injuries: A Nationwide Analysis of Patient Outcomes

Sexual assault of the older person: Attendances to the Republic of Ireland's sexual assault treatment unit network

BackgroundSexual assault (SA) poses a threat to all areas of contemporary society. Although older individuals represent a vulnerable demographic, a considerable gap exists in the literature regarding the context in which older individuals experience SA. This study aims to provide a comprehensive description of older individuals' attendances at the Sexual Assault Treatment Unit (SATU) network in the Republic of Ireland. MethodsA 7-year national cross-sectional study was performed to analyse the attendances of older people (≥65 years old) to the SATU network, and to compare them with younger attendances (<65 years old), with a more in-depth subset analysis of Dublin SATU attendances. ResultsDuring the study period, there were 6478 attendances to the SATU network, of which 0.93 % (n = 60) were older people. These included 59 females and 1 male, with the average age of 76.05 years ± 8.16. Forensic examinations were performed in 81.7 %, with the majority seeking assistance within 7 days (80 %). Comparison of older (≥65 years) and younger (<65 years) attendees revealed older individuals were more uncertain whether a sexual assault had occurred (35.5 % vs. 14.4 %, p < 0.001) but more likely to report the incident to the police (78.3 % vs. 64.3 %, p = 0.02). Assault by a person in authority was significantly more common in older age groups (11.7 % vs. 1.8 %, p < 0.001). Older individuals were significantly more likely to be assaulted in their own home (33.3 % vs. 21.5 p < 0.03) or in ‘other-indoors' settings (e.g. nursing home/hospital) (43.3 % vs. 23.4 % p < 0.001). They were less likely to be assaulted in the assailant's home (5.0 % vs. 22.9 %, p < 0.001) or outdoors (5.0 % vs. 19.7 %, p = 0.004).In our subset analysis of 19 cases, 73.7 % occurred in healthcare facilities, 63.2 % had dementia, and 42.1 % were care dependent. Genital injuries were present in 44.4 % of patients and extra-genital injuries in 22.2 %. ConclusionUnique patterns are evident in sexual assault experienced by older people, underscoring the necessity for tailored interventions and effective support systems for reporting and addressing this vulnerable demographic. This is especially crucial in healthcare environments, where a notable proportion of cases occur, frequently involving individuals with dementia and requiring care assistance.

PREVALENCE OF SEXUAL VIOLENCE AND RELATIONSHIP BETWEEN ACCUSED AND VICTIM CASES ATTENDED IN ONE STOP CRISIS MANAGEMENT CENTER OF CENTRAL NEPAL

Background: Sexual violence is a global public health issue, drawing more concern compared to other forms of violence. Evidence indicates that adolescents face an increased risk of encountering both physical and sexual violence. Despite this, there is a scarcity of nationally representative research on sexual violence in Nepal, hindering the development of informed interventions. This paper seeks to determine the prevalence of sexual violence and relationship between accused and the victim cases attended in one stop crisis management center of central Nepal. Methods: A retrospective cross-sectional study was carried out in the department of Forensic Medicine of College of Medical Sciences in Bharatpur, Chitwan, Nepal, from January, 2023 to January 2024. Ethical approval was taken from institutional review committee of College of Medical Sciences, Bharatpur, Chitwan. Data was entered and analyzed by using descriptive statistical tools in SPSS-16. Results: The prevalence of sexual violence was 41.97% (with 95% CI as 36.31% to 47.62%). Out of 123 sexual violence cases majority (40.65%) of them were in the age group less than 14years followed by 38.21% in the age group 15-18 years. Majority of the victim were female (99.2%) by gender and Janajati (52.8%) by ethnicity. majority (78.9%) were victim of forcefully sexual intercourse. Most of the accused person (20.3%) were stranger followed by boyfriend (17.9%). Conclusions: The prevalence of sexual violence is almost half among all type of violence. Majority of the victim were Adolescence girls and they were from janajati. One out of ten victim had present of body injuries while two out of ten had genital injuries. Most of the accused person were known person (boyfriend, Neighbors, Uncle and cousin). The statistically significant variables were age and gender.

Factors associated with postpartum hemorrhage in selected Southern Oromia hospitals, Ethiopia, 2021: an unmatched case-control study.

Around one-fourth of maternal deaths worldwide are attributed to hemorrhage. One of the prevalent types of maternal hemorrhage is postpartum hemorrhage. In spite of this, there is very little data on postpartum hemorrhage. Thus, the intention of this study was to determine factors associated with postpartum hemorrhage among mothers who gave birth in the selected Southern Oromia hospitals in Ethiopia. An institutional-based, unmatched case-control study was employed on a sample of 333 (83 cases and 250 controls) mothers who gave birth from March 1-30, 2021. Standardized and pretested check-lists were used to retrieve data from patients' cards, delivery registration, and operation registration logbooks. Epi Data Version 3.1 was used to enter data, while SPSS Version 25 was used for analysis. Multi-variable logistic regressions were used to identify the determinants of postpartum haemorrhage with a 95% confidence interval and p-value less than 0.05. Mothers who have no antenatal care follow-up (AOR = 1.94, 95% CI = 1.03, 3.64), had pre-partum anemia (AOR = 5.68, 95% CI = 3.13, 10.32), hypertensive disorder during pregnancy (AOR = 3.3, 95% CI = 1.13, 9.64), intrauterine fetal death (AOR = 4.21, 95% CI = 1.68, 10.58), and genital tract trauma during delivery (AOR = 3.23, 95% CI = 1.52, 6.89) were found as determinants of postpartum haemorrhage. The study showed that factors such as lack of antenatal care, pre-partum anemia, pregnancy-related hypertension, intrauterine fetal death and genital tract trauma during delivery were responsible for postpartum hemorrhage. The early introduction of antenatal care services for all mothers plays a crucial role in reducing postpartum hemorrhage.

A Review on Male Infertility and Herbal Medicine: Complementary and Alternative Therapies in Animal Models

Various factors contributing to male infertility include genetic determinants, hormonal/neurological imbalance, erectile/libido disorders, genital tract injuries, and toxic/ischemic testicular injuries. Herbs increase sperm count and quality parameters, as well as sexual performance in infertile men, through various mechanisms. For this purpose, efforts were made to investigate effective plants in treating infertility, focusing on those studied in animal research. In this review, we explored the latest findings from animal studies on the therapeutic applications of medicinal plants in male infertility. Based on MeSH keywords, 250 animal studies investigating the effects of herbs on male infertility were reviewed, 72 of which were selected after removing duplicated and unrelated articles. The search was conducted in the Scientific Information Database, the World Health Organization database, Web of Science, Science Direct, Iranmedex, Cochran Library, PubMed, and Google Scholar. The mechanisms underlying the therapeutic effects of herbs on male infertility caused by hormonal disorders, oxidative stress, cytokines, inflammatory pathways, as well as erectile and libido disorders were discussed. Aphrodisiac, spermatogenesis-inducing compounds, antioxidants, anti-inflammatory agents, and androgenic compounds, including anthocyanins, proanthocyanidins, ginsenosides, protodioscin, quassinoids, sesquiterpenes, diosgenin, phyto-oestrogens, thymoquinone, and bajijiasu, in these plants increase male fertility by affecting the hypothalamic-pituitary-gonadal axis and improving sperm’s functional parameters and fertility indices in relation with seminiferous tubules.

Sexual abuse in late postmenopausal women: Complete posterior colporrhexis with intestinal evisceration.

Genital injuries from sexual intercourse in late postmenopause (senium) are rare in clinical practice and may result from sexual abuse. I present a medically and judicially completed case as a contribution to forensic gynaecological literature where an 82-year-old women suffered extensive and life-threatening injury (complete posterior colporrhexis with intestinal evisceration) when she was raped (20 years ago) by a young perpetrator.