Vaginal trauma is injury to the

vagina In mammals and other animals, the vagina (: vaginas or vaginae) is the elastic, muscular sex organ, reproductive organ of the female genital tract. In humans, it extends from the vulval vestibule to the cervix (neck of the uterus). The #Vag ...

. It can happen during

childbirth Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy, where one or more Fetus, fetuses exits the Womb, internal environment of the mother via vaginal delivery or caesarean section and becomes a newborn to ...

, sexual assault, and accidental occurrences. In adults, the vagina is largely protected from trauma due to the protective function of the

mons pubis In human anatomy, and in mammals in general, the ''mons pubis'' or pubic mound (also known simply as the mons , and known specifically in females as the ''mons Venus'' or ''mons veneris'') is a rounded mass of fatty tissue found over the pubic s ...

and

labia majora In primates, and specifically in humans, the labia majora (: labium majus), also known as the outer lips or outer labia, are two prominent Anatomical terms of location, longitudinal skin folds that extend downward and backward from the mons pubis ...

. This protection is lacking in girls who lack a protective fat layer to protect the vagina. Vaginal trauma can occur when something is inserted into the vagina, for example, a sharp object causing

penetrating trauma Penetrating trauma is an open wound injury that occurs when an object pierces the Human skin, skin and enters a tissue (biology), tissue of the body, creating a deep but relatively narrow entry wound. In contrast, a blunt trauma, blunt or ''non-p ...

. Vaginal trauma can occur as a result of a painful sexual experience or sexual abuse. Vaginal trauma can occur in children as a result of a straddle injury. Most of these, though distressing, are not serious injuries. In some instances, a severe injury occurs and requires immediate medical attention, especially if the bleeding won't stop. Vaginal trauma also occurs during an

episiotomy Episiotomy, also known as perineotomy, is a surgical incision of the perineum and the posterior vaginal wall generally done by an obstetrician. This is usually performed during the second stage of labor to quickly enlarge the aperture, allowing ...

and vaginal childbirth. Avoiding vaginal injuries during childbirth will help to prevent depression, hospital readmissions, and perineal pain.

Signs and symptoms

Signs and symptoms include:

abdominal pain Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given th ...

bleeding Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethr ...

bruising A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. Most bruises occur clo ...

faintness Syncope , commonly known as fainting or passing out, is a loss of consciousness and muscle strength characterized by a fast onset, short duration, and spontaneous recovery. It is caused by a decrease in blood flow to the brain, typically from ...

vaginal discharge Vaginal discharge is a mixture of liquid, cells, and bacteria that lubricate and protect the vagina. This mixture is constantly produced by the cells of the vagina and cervix, and it exits the body through the vaginal opening. The composition, ...

, embedded object in the vagina, genital pain, swelling,

vomiting Vomiting (also known as emesis, puking and throwing up) is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Vomiting can be the result of ailments like food poisoning, gastroenteritis, pre ...

, painful urination, inability to urinate, presence of a

wound A wound is any disruption of or damage to living tissue, such as skin, mucous membranes, or organs. Wounds can either be the sudden result of direct trauma (mechanical, thermal, chemical), or can develop slowly over time due to underlying diseas ...

, report of

sexual abuse Sexual abuse or sex abuse is abusive sexual behavior by one person upon another. It is often perpetrated using physical force, or by taking advantage of another. It often consists of a persistent pattern of sexual assaults. The offender is re ...

, and

blood in the urine Hematuria or haematuria is defined as the presence of blood or red blood cells in the urine. "Gross hematuria" occurs when urine appears red, brown, or tea-colored due to the presence of blood. Hematuria may also be subtle and only detectable with ...

. A

hematoma A hematoma, also spelled haematoma, or blood suffusion is a localized bleeding outside of blood vessels, due to either disease or trauma including injury or surgery and may involve blood continuing to seep from broken capillaries. A hematoma is ...

can form after vaginal trauma. Imaging can identify the presence of the accumulated blood.

Cause

Pregnancy related

During childbirth, vaginal or cervical injuries can occur and will likely require surgery to correct them. The vagina is sometimes injured during the course of labor and perineal tears extend from the vagina to various points of the perineum.

Non pregnancy related

Non-obstetric causes include: sexual assault,
STAT!Ref Online Electronic Medical Library
sup> ubscription required/sup> consensual sex, fracture of the pelvis, foreign object inserted into the vagina, jet ski and water-skiing accidents or blunt force trauma, such as being kicked or kneed in the groin during an athletic competition.

Risk factors

Risk factors include: first episode of consensual intercourse,

breastfeeding Breastfeeding, also known as nursing, is the process where breast milk is fed to a child. Infants may suck the milk directly from the breast, or milk may be extracted with a Breast pump, pump and then fed to the infant. The World Health Orga ...

menopause Menopause, also known as the climacteric, is the time when Menstruation, menstrual periods permanently stop, marking the end of the Human reproduction, reproductive stage for the female human. It typically occurs between the ages of 45 and 5 ...

, and medication

side effect In medicine, a side effect is an effect of the use of a medicinal drug or other treatment, usually adverse but sometimes beneficial, that is unintended. Herbal and traditional medicines also have side effects. A drug or procedure usually use ...

Prevention

A safe environment can be created for young children in addition to keeping small objects out of reach.

Treatment

Treatment begins with a thorough assessment. The presence of someone to provide support during the examination is very beneficial. Such support is especially prioritized in cases of vaginal trauma due to sexual assault. A support person provides emotional support and can help minimize the risk of re-traumatization. Those treating victims employ sexual assault nurse/forensic examiners (SAN/FEs) with specific training to care for those who have experienced rape or sexual assault. They are able to conduct a focused medical-legal exam. If such a trained clinician is not available, the emergency department has a sexual assault protocol that has been established for treatment and the collection of evidence.

References

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Trauma Trauma most often refers to: *Psychological trauma, in psychology and psychiatric medicine, refers to severe mental and emotional injury caused by distressing events *Traumatic injury, sudden physical injury caused by an external force, which doe ...

Trauma types Acute pain Rape Sexual abuse Violence against women Injuries of abdomen, lower back, lumbar spine and pelvis