Non-obstetric female genital tract trauma requiring surgical intervention: A 15-year retrospective cohort analysis

Non-obstetric genital tract injuries, though uncommon, can result in significant morbidity. This 15-year retrospective single-centre cohort study included 42 women who underwent surgical intervention for non-obstetric genital injuries at a tertiary center. Consensual sexual activity accounted for 85.7% of cases, and most of these occurred during first intercourse (80.9%). All the intercourse-related injuries were reported as consensual. Vaginal injuries comprised 78.6%; the median tear length was 2 cm. A hemoglobin drop of ≥2 g/dL was observed in 40.0%. For women with sex-related compared to trauma-related injuries, the median age was younger (26.5 vs. 49.0 years, p = 0.045) and the median parity lower (0 vs. 3.5, p = 0.003). The vagina was more often involved in sex-related than trauma-related injuries (83.3 vs. 50.0%, p = 0.065), and the vulvar less often (16.7 vs. 50.0%, p = 0.065). Arab women were generally younger, less frequently postmenopausal, and more often presented with a partner compared with Jewish women. Among sex-related injuries, Arab women more commonly sustained combined vaginal and vulvar injuries, whereas Jewish women presented predominantly with vaginal injuries. The findings highlight the potential importance of trauma-informed, culturally sensitive, and individualized clinical care. However, they should be interpreted with caution given the retrospective design and relatively small sample size.