Vaginal trauma at sexual intercourse in Ilorin, Nigeria. An analysis of 36 cases

Over a six-year period (1982-1987), 36 cases of vaginal trauma at sexual intercourse managed in the gynaecological unit of the University of Ilorin Teaching Hospital are presented. The serious nature of this accident is stressed. The frequent involvement of the posterior fornix of the vagina, accounting for 50% of the cases is shown. Perforation of the pouch of Douglas with possible intestinal prolapse, and involvement of the urinary bladder resulting in vesicovaginal fistula are not common in Ilorin. The predisposing factors like rough coitus, first sexual intercourse, puerperium, surgical alteration of the vagina, peno-vaginal disproportion and multiparity are discussed. The importance of adequately preparing the women emotionally and physically for coitus, a matter which certain males tend to ignore, is emphasized. The necessity for thorough digital as well as speculum examination in all cases of vaginal bleeding is made. There was no death recorded, while the morbidity was mainly hypovolaemic shock with haemorrhagic anaemia.