Comparison of Genital Injuries in Prepubertal and Pubertal Girls with Sexual Abuse - การบาดเจ็บของอวัยวะเพศในเด็กก่อนวัยรุ่นและวัยรุ่นที่ถูกทารุณกรรมทางเพศ

Abstract

        The objective of this retrospective descriptive study was to compare the frequency and characteristics of genital injuries between pubertal and prepubertal girls who had a history of sexual abuse by penile-vaginal penetration. Medical records of all female patients age 0-18 years evaluated for sexual abuse by the Child Protection Team of the Thammasat University Hospital between January 2004 and December 2007 were reviewed. Clinical characteristics and genital findings including photographs of the patients who had a history of penile-vaginal penetration were collected and analyzed, using descriptive statistics.

         Among 180 patients, 27 prepubertal value girls were 3-10 years old (mean 6.6 years), and 153 pubertal girls were aged 10-18 years old (mean 14.1 years). Overall, the pubertal girls were found to have diagnostic, suspicious, and nonspecific findings of penetrating trauma in 34.0 percent, 42.5 percent, and 23.5 percent, respectively. Whereas, the prepubertal girls were found to have diagnostic, suspicious, and nonspecific findings of penetrating trauma in 22.2 percent, 25.9 percent, and 51.9 percent, respectively. (p-value 0.01). Physical findings that are diagnostic of penetrating trauma include: (1) acute laceration, abrasions, or bruises of the hymen (10.5% in the pubertal girls, 14.8% in the prepubertal girls), (2) absence of hymenal tissue in any portion of the posterior half (5.2% in the pubertal girls, 7.4% in the prepubertal girls), (3) healed hymenal transection (18.3% in the pubertal girls, 0.0% in the prepubertal girls)

         In conclusions, the pubertal girls with a history of penile-vaginal penetration are more likely to have physical findings indicating vaginal penetrating trauma comparing to the prepubertal girls.

Key words: sexual abuse, prepubertal girls, pubertal girls, genital injuries