Hymenal transections in children found by photocolposcopy in suspected sexual abuse cases is associated with a history of bleeding

• Published in: Journal of forensic and legal medicine Vol. 80; p. 102176
• Main Authors: Garfield, Gitte Bech, Schou, Mette Pagh, Lassen, Karin, Leth, Peter Mygind
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.05.2021
• Subjects: Clinical forensic medicine; Hymen; Photocolposcopy; Sexual abuse of children; Hymen; Sexual abuse of children; Clinical forensic medicine; Photocolposcopy
• ISSN: 1752-928X; 1878-7487
• DOI: 10.1016/j.jflm.2021.102176

To investigate the difference in selected variables between children with and without hymenal transection, which is a healed defect that extends through the entire depth of the posterior hymenal membrane to the vaginal wall. All female children from Southern Denmark who were examined by photocolposcopy in a six-year period were included in a retrospective cohort study. Statistical analyses included a chi-square test and a logistic regression analysis. Eighty girls under 15 years of age who were suspected to have been sexually abused were included. Sixteen of the girls had hymenal transections. There was a statistically significant correlation between the presence of hymenal transections and reported fresh bleeding after the assault. Bleeding after an assault could indicate more severe lesions, which might explain why these patients did not heal completely. •80 girls who underwent an investigation with photocolposcopy for abuse showed 21% transections and 6% fresh lacerations or other fresh lesion.•Transections were more frequent in pubertal girls, in multiple episodes, in sexually active, if reported bleeding, if more than a year since abuse.•There was no association with reported pain.•Most of the statistically significant associations disappeared after a binary logistic regression analysis, except for reported bleeding.•Bleeding after a sexual assault could indicate more severe lesions, which might explain why such cases do not heal completely.