[Ano-genital injuries in female victims of sexual assault]

Sexual assault continues to represent the most rapidly growing violent crime in the USA. Statistics prove a persistent rise in rape incidence with poor conviction rates. This knowledge, along with the vast multitude of emotional sequilae of rape and self-perceived inferior legal status of the involved females results in a high percentage of unreported cases. This presented paper reports of ano-genital trauma in case of sexual assault. Under 2970 victims of sexual assault, examined and treated between 1967-1985 in the Department of Gynecology and Obstetrics Charlottenburg (Free University of Berlin), a percentage of almost 40% was represented by children in the age of 0-14. Therefore, only 1696 patients with complete gynecological examination with correct case history examination for injuries and traces of sperm, infections could be presented. The total rate of injuries was: Perineum 8.4%, vulva 5.4%, vagina 1.8%, pelvis/thighs 14.2%. The highest risk to be injured in case of sexual assault had the age group of victims over 55 years (nearly 50%). The lowest rate of injury has been encountered in the age groups 0-5 years, 6-10 years, 26-35 years: Under 10%. A solitary anal-injury has not been found. Specific training in emergent and chronic care for the victims, both physical and mental, in conjunction with preventive measures to genital infections and pregnancy, are necessary when the gynecologist is involved.