Pediatric Female Genital Trauma

What is a Pediatric Female Genital Trauma?

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.

How is a Pediatric Female Genital Trauma 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 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.