Pediatric female genital trauma or injury

What is a pediatric female genital trauma or injury?

Straddle injuries are the most common genital trauma in females. They occur when a child sustains an injury from falling on an object that is being straddled (playground equipment, bike, arm of chair, bathtub side, etc.).

Most cases of genital trauma occur accidentally and involve bruising, swelling and/or minor cuts on their outer labia that heal within a few days. Even minor cuts in this area can cause significant bleeding because of rich blood supply. The vagina and urethra are protected by the labia and are generally not harmed in these cases.

If the child falls on a blunt or sharp object, penetrating injuries to the vagina can occur. These injuries can be mild or serious and often require rapid examination by a doctor. Rarely, genital trauma can be a sign of abuse.

What are the signs and symptoms of pediatric female genital trauma or injury?

Genital trauma related to straddle injuries may include:

• Bleeding
• Bruising
• Mild to moderate pain or discomfort
• Redness
• Swelling

Genital trauma sustained by falling on a sharp or blunt object – or other severe genital injuries – may include:

• Abrasions
• Blood in urine
• Bruising – including inside the vagina
• Dizziness
• Nausea/vomiting
• Moderate to severe pain
• More significant vaginal bleeding
• Problems with urination
• Vaginal discharge

How is a pediatric female genital trauma or injury diagnosed?

Your child’s doctor will ask about your daughter’s symptoms and how the trauma occurred. The doctor will then conduct a thorough physical examination to look at the vulva, perineum and lower vagina. This can typically be done while the patient is awake; however, in cases where a more thorough (i.e. internal) exam is necessary, the patient may need to be sedated to perform a better examination.

Your doctor may perform additional tests including:

• Ultrasound or x-ray - if there is concern about internal trauma
• Vaginal discharge sample - to check for infection

How is a pediatric female genital trauma or injury treated?

For genital trauma (especially straddle injuries), treatment may include:

• Sitz baths
• Cool compresses
• Over-the-counter pain medication
• Reduced physical activity
• Antibiotics, if infection is present
• Surgery – in rare cases – for significant trauma

Injuries to the vulva and perineum usually heal very well and will likely have no long-term consequences.