Nonobstetrie Lower Genital Tract Trauma

EDITORIAL COMMENT": We accepted this paper for publication to remind readers of the different types of nonobstetric trauma to the lower genital tract. The mechanism of tearing in the upper vagina during coitus is debated; this report does not favour the theory that tearing in the unsupported upper vagina results from levator spasm rather than direct injury (A).
A. Ahnaimugan S, Asuen MI. Coital laceration of the vagina. Aust NZ J Obstet Gynaecol 1980; 20: 180–181.
Summary: In a 4-year-period there were 31 admissions to Nehru Hospital, because of nonobstetrie injuries of the female genital tract. This constituted 0.8% of all gynaecological admissions over this period. The injuries were caused by voluntary coitus, automobile accidents and various types of astride injuries. Seven of the 18 patients with noncoital injuries presented with vulval haematomas and all were managed by evacuation under general anaesthesia. Two of the 13 patients with coital injury were admitted with haemorrhagic shock and required initial resuscitation with blood transfusion. The vaginal vault, especially the right and posterior fornices were the frequent sites of coital injury for parous women; on the other hand lower vaginal and introital injuries were caused by first acts of coitus. Except for trivial superficial lacerations with minimal bleeding, primary definitive surgical repair other than vaginal packing was favoured for better healing and to reduce morbidity.