Genital injury: Is it significant? A review of the literature

The purpose of this review was to critically evaluate the available literat ure on genital injury in order to facilitate an understanding of its signif icance in relation to sexual offence trials. Wide variation exists in resea rch objectives, study populations and methodology, hindering interpretation considerably. The most valuable research in this field identifies the rang e of normal genital findings and those associated with consensual sexual in tercourse, to enable interpretation of genital Findings in sexual assault v ictims. However, there are, unfortunately, few studies of this nature. Diff iculties arise when examining doctors are not experienced in the genital ex amination of those other than sexual assault victims, limiting their abilit y to draw conclusions about genital injury if it is detected, If the method s of genital examination employed are not the same as those used to examine a wide range of non-sexual assault victims, comparison and thus valuable i nterpretation is further limited. This review of the literature finds that the most appropriate genital exami nations and indeed the most legally valuable as far as interpretation is co ncerned, are done macroscopically by doctors with considerable experience i n the examination of normal, diseased and traumatized genitalia, and a soun d knowledge of the principles of injury interpretation. A deficiency exists in the literature in relation to macroscopic genital examination findings in consensually sexually active women who have been examined by forensicall y trained doctors. This deficiency must be addressed before the medicolegal significance of genital injury relating to sexual assault can be accuratel y interpreted, and before any decision is made to incorporate colposcopy or staining techniques into the routine assessment of sexual assault victims.