Vaginal Lacerations

Chapter 91 Vaginal Lacerations



INTRODUCTION



Description: Nonobstetric lacerations of the vaginal wall or introitus are most often the result of sexual trauma (80%, consensual or otherwise).

Prevalence: Uncommon, but specific prevalence is unknown.

Predominant Age: Reproductive (most common at younger than age 25).

Genetics: No genetic pattern.


ETIOLOGY AND PATHOGENESIS



Causes: Intercourse (80%), saddle or water skiing injury, sexual assault, penetration by foreign objects.

Risk Factors: Virginity, vaginismus, postpartum and postmenopausal vaginal atrophy, hysterectomy, alcohol or other drug use.


CLINICAL CHARACTERISTICS



Signs and Symptoms



• Vaginal bleeding (may be profuse and prolonged)

• Acute pain during intercourse (25%, lacerations of the distal vagina or introitus)

• Persistent pain after intercourse (the location of the pain is somewhat dependent on the location of the laceration)


DIAGNOSTIC APPROACH



Differential Diagnosis



• Cervical polyp (as source of bleeding)

• Menstrual bleeding

• Threatened abortion

• Granulation tissue in healing incision (episiotomy, other vaginal surgery)

• Sexual abuse/rape


Associated Conditions: Vaginal atrophy, sexual dysfunction, alcohol or drug use/abuse.


Workup and Evaluation



Laboratory:

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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Vaginal Lacerations

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