LATE FOLLOW-UP AND FUNCTIONAL OUTCOME AFTER TRAUMATIC REPRODUCTIVE-TRACT INJURIES IN WOMEN

The aim of this study was to assess female reproductive tract injuries and late effects on sexual and reproductive function. This was a revi ew of women presenting to a Level I trauma center with reproductive tr act injuries over 12 years. Thirty-one women (average age, 30 years) w ere divided into coital (19) and noncoital (12) injury groups. One-thi rd of coital trauma presented late, one-fourth was abuse related, and seven women presented in shock. All had vaginal lacerations, and 15 re quired repair. Follow-up in 6 of 19 (32%) women averaged 4.5 years. No ncoital injuries resulted primarily from vehicular trauma, and two-thi rds had associated abdominal injuries. Interventions included: vaginal laceration irrigation/repair (4), salpingectomy (2), ovariectomy (2), repair uterine perforation (1), and emergency cesarean section (2). T he average Injury Severity Score was 25, with two deaths. Follow-up in 6 of 10 (60%) survivors averaged 6.1 years. The combined group has ha d seven subsequent pregnancies, and two women have minor dyspareunia a fter pelvic fracture. Women with coital injuries may develop shock, re quiring rapid resuscitation and operative repair. Noncoital injuries a re often associated with multiple severe injuries and require operativ e intervention. Late sequelae are minimal in both groups, and even sev ere injuries do not preclude normal pregnancy and sexual function.