Table of Contents
What is Genital Trauma
Injury to the GENITALIA (organs and structures of reproduction). Genital trauma may occur as the result of accidental injury, ritual genital mutilation, or SEXUAL ASSAULT and may affect the external or internal genitalia. Genital trauma may result in PAIN, structural damage, impaired genitourinary function, SEXUAL DYSFUNCTION, and INFERTILITY.
Male Genital Trauma
Common forms of genital trauma in young boys are in straddle injuries (such as falling onto the bar of a bicycle), blunt force injuries to the groin (such as being struck with a thrown or kicked ball), and toileting injuries (such as the toilet seat falling onto the PENIS or getting the penis or SCROTUMcaught in the pants zipper.
In older boys and teens, blunt force injuries are more common. Most organized athletic activities and sports require boys to wear a protective cup to guard against such injuries. In adult men, genital trauma may occur as a result of blunt force and during sexual activity that places unusual or excessive pressure on the erect penis or on the scrotum and TESTICLES.
Some people and organizations that oppose routine male infant CIRCUMCISION (surgical removal of the foreskin) view its practice as a form of male ritualistic genital mutilation.
Female Genital Trauma
Straddle-type injuries are common in young girls, though less frequently from bicycles and more often from activities such as gymnastics and horseback riding. Activities that result in the “splits,” whether intentional or accidental, can cause significant bruising and tearing of the external genitals and the PERINEUM (region between the opening of the VAGINA and the ANUS).
Sexual assault is a frequent cause of genital trauma in older girls and women, often resulting from rape (forced, nonconsenting, and violent SEXUAL INTERCOURSE). Health-care providers tend to view most circumstances of female genital trauma with the suspicion that they could represent sexual abuse or assault, in part because it is often the case and in part because the laws in many communities in the United States require them to do so. Hospitals and health-care providers must follow specific procedures to preserve potential evidence when treating sexual assault victims.
Women may experience genital trauma during CHILDBIRTH, particularly with vaginal delivery of a breech presentation (baby born bottom first) or a large baby. Some women have birth-related traumatic tearing of the perineum, and others have episiotomy in an attempt to limit the extent of trauma or enlarge the vaginal opening to allow the baby to pass. The resulting injuries may require surgical repair and sometimes result in long-term complications affecting urinary continence, fecal continence, and pleasure during sexual intercourse.
Female ritual genital mutilation, also called female circumcision, remains common in some cultures despite widespread opposition from the World Health Organization (WHO), Amnesty International, and other health and human rights organizations worldwide. Within such cultures ritual genital mutilation may be a rite of passage, a mark of ownership, or a religious practice conducted in early childhood by nonmedical practitioners, without ANESTHESIA and often under unsanitary conditions. Complications are common and often severe. WHO and other organizations have made it a goal to eliminate ritual genital mutilation worldwide.