Vaginal Lacerations

Introduction

• Description: Nonobstetric lacerations of the vaginal wall or introitus are most often the result of sexual trauma (80%; consensual or otherwise); sports and straddle injuries make up most of the rest.

• Prevalence: Uncommon, but specific prevalence is unknown.

• Predominant Age: Reproductive age (most common in females younger than 25 years).

• Genetics: No genetic pattern.

Etiology and Pathogenesis

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

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

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