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Genital trauma in prepubertal girls and adolescents

Merritt, Diane F.

Current Opinion in Obstetrics and Gynecology: October 2011 - Volume 23 - Issue 5 - p 307–314
doi: 10.1097/GCO.0b013e32834ab544
Adolescent and pediatric gynecology: Edited by Paula J. Adams Hillard

Purpose of review To look critically at recent research articles that pertain to children and adolescents who present with genital injuries.

Recent findings Emerging evidence supports links to long-term psychological sequelae of child sexual abuse. Parents should be educated to instruct their children regarding types of child abuse and prevention. ‘Medicalization’ of female genital mutilation (FGM) by health providers, including ‘cutting or pricking’, is condemned by international organizations.

Summary Genital injuries whether accidental or intentional need to be reported with standardized terminology to allow for comparisons between reported outcomes. Motor vehicle accidents associated with pelvic fractures may result in bladder or urethral trauma. Adverse long-term psychosocial behaviors may be sequelae of child sexual abuse. FGM is willful damage to healthy organs for nontherapeutic reasons, and a form of violence against girls and women. Healthcare providers should counsel women suffering from the consequences of FGM, advise them to seek care, counsel them to resist reinfibulation, and prevent this procedure from being performed on their daughters.

Department of Obstetrics and Gynecology, Pediatric and Adolescent Gynecology, Washington University School of Medicine, Barnes Jewish Hospital, St Louis Children's Hospital and Missouri Baptist Medical Center, St Louis, Missouri, USA

Correspondence to Diane F. Merritt, MD, Professor of Obstetrics and Gynecology, Director Pediatric and Adolescent Gynecology, 660 S. Euclid Avenue, Saint Louis, MO 63110, USA Tel: +1 314 747 1510; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.