TRAUMATIC INJURIES OF THE FEMALE EXTERNAL GENITALIA AND THEIR ASSOCIATION WITH UROLOGICAL INJURIES

Purpose: To date trauma to the female external genitalia has been inco mpletely characterized, At our institution a large number of such pati ents have been identified and many had associated urological injuries. We characterize these injuries and their association with urological injuries. Materials and Methods: We reviewed the charts of all female patients presenting with trauma to the genitalia unrelated to parturit ion between 1991 and 1996. Type and mechanism of injury, associated in juries and blood transfusion requirements were noted, Vaginal injuries were classified as complex (greater than 3 cm., multiple or involving deeper structures) or simple (all others). Results: We identified 20 women a mean 20.7 years old with traumatic injuries to the genitalia, including motor vehicle accidents in 61 injury from consensual interco urse in 5, sexual assault in 4 and other penetrating injuries in 5. Th ere were 15 patients with vaginal injuries (complex in 8 and simple in 7) and vulvar injuries in 5. Six of the 20 women (30%) had associated urological injuries (urethra in 1, bladder in 1, ureter in 1 and kidn ey in 1), including 3 associated with blunt trauma (all complex vagina l injuries) and 3 associated with penetrating trauma (simple vaginal o r vulvar injuries). Conclusions: Traumatic injury to the female genita lia unrelated to parturition is more common than previously reported. Of the women with such injuries 30% have coexisting urological injurie s. Thus, it is important to assess completely all women who present wi th external genitalia trauma for possible coexisting urological injury .