Colposcopy to establish physical findings in rape victims

Conventional rape examination protocols have been poor in yielding genital findings (10% to 30% typically). We report our experience with a revised protocol employing colposcopy to perform genital examinations of victims and to document findings.

Physical examinations were performed on rape victims seen by San Luis Obispo County's Suspected Abuse Response Team between 1985 and 1990, and the results were reviewed for this study.

Of 131 patients seen within 48 hours and who experienced penile penetration, 114 (87%) had positive findings. Colposcopic magnification allowed examiners to characterize these findings as acute mounting injuries, typically seen at 3, 6, and 9 o'clock on the posterior fourchette and consisting chiefly of lacerations, ecchymosis, and swelling.

An examination protocol that includes colposcopy may be the most reliable means to document and characterize genital findings in rape victims and to evaluate whether findings may be linked to a reported sexual assault.