DOI: http://dx.doi.org/10.18203/2349-2902.isj20181058

External genital injuries in childhood: obey the rules and detect the unseen

Ahmet A. Tuncer, Didem Baskin Embleton, Nese N. User, Salih Cetinkursun

Abstract


Background: This paper evaluates the patients with external genital organ injuries (EGOI) and the suitability of the Onen’s genital injury scoring (GIS) for the management of such patients.

Methods: This is a cross-sectional study. Patients with the complaints of EGOI were retrospectively explored regarding to age, sex, trauma type, hospitalization time, classification of injury type, presence of additional pathologies and treatment methods. After the injury types are classified by using the Onen’s GIS, we investigated the sufficiency of this scoring method for our treatment modalities.

Results: A total of 57 patients, 19 females and 38 males, were diagnosed as EGOI. These patients were classified with Grades (G) by using the Onen’s GIS (G1: 42, G2: 7, G3: 5, G4: 2, and G5: 1 patient.). The Grade 5 patient had a colostomy. The external anal sphincters of two patients were repaired to avoid incontinence in the future. The other patients received either medical or non-specific surgical treatments for their injuries. A G3 patient with testicular hematoma had testicular atrophy in the following year. There was no mortality in the present series.

Conclusions: The EGOI at childhood ranges from minor derma-abrasion to complete tears of anorectum which requires colostomy. Onen’s GIS ensures better management.


Keywords


Child, Genital injury, Injury score, Trauma

Full Text:

PDF

References


Gabriel NM, Clayton M, Starling SP. Vaginal laceration as a result of blunt vehicular trauma. J Pediatr Adolesc Gynecol. 2009;22:166-8.

Hashis AA. Perineal trauma in children: a standardized management approach. Annal Pediatr Surg. 2011;7:55-60.

Onen A, Oztürk H, Yayla M, Basuguy E, Gedik S. Genital trauma in children: classification and management. Urology. 2005;65:986-90.

Sham M, Singh D, Wankhede U, Wadate A. Management of child victims of acute sexual assault: Surgical repair and beyond. J Indian Assoc Pediatr Surg. 2013;18:105-11.

Jones JG, Worthington T. Genital and anal injuries requiring surgical repair in females less than 21 years of age. J Pediatr Adolesc Gynecol. 2008;21:207-11.

American Association for the Surgery of Trauma, ‘‘Injury scoring scales,’’ Available at http://www.aast.org/Library/TraumaTools/InjuryScoringScales.aspx.

Boyd CR, Tolson MA, Copes WS. Evaluating trauma care: the TRISS method. Trauma score and the injury severity score. J Trauma. 1987;27:370-8.

The calculator, ‘‘Trauma injury severity score. Available at https://www.thecalculator.co/health/Trauma-Injury-Severity-Score-(TRISS)-Calculator-1022.html Accessed December 27, 2017.

Kadish HA, Schunk JE, Britton H. Pediatric male rectal and genital trauma: accidental and nonaccidental injuries. Pediatric Emerg Care. 1998;14:95-98.

Mohr AM, Pham AM, Lavery RF, Sifri Z, Bargman V, Livingston DH. Management of trauma to the male external genitalia: the usefulness of American Association for the Surgery of Trauma organ injury scales. J Urol. 2003;170:2311-5.

Merchant W, Gibbons D, Gonzales E. Trauma to the bladder neck, trigone and vagina in children. J Urol. 1984;131:747-50.

Levine JH, Longo WE, Pruitt C, Mazuski JE, Shapiro MJ, Durham RM. Management of selected rectal injuries by primary repair. Am J Surg. 1996;172:575-9.

Bakal U, Sarac M, Tartar T, Cigsar EB, Kazez A. Twenty years of experience with perineal injury in children. Eur J Trauma Emerg Surg. 2016;42:599-603.

Soyer T, Hançerlioğulları O, Çakmak M. Primary repair in complete testicular rupture: Case report. J Turk Assoc Pediatric Surg. 2008;22:138-41.

Leys CM, Gatti CM. The acute scrotum, In: Holcomb GW, Murphy JP (eds). Ashcraft’s Pediatric Surgery. Philadelphia: Saunders Elsevier;2010:687-91.

Herrera F, Coimbra R. Blunt pelvic trauma resulting in unilateral ruptured testicle: A case report and review of the literature. Internet J Urol. 2013;6:1-4

Pogorelic Z, Juric I, Biocic M, Furlan D, Budimir D, Todoric J et al. Management of testicular rupture after blunt trauma in children. Pediatr Surg Int. 2011;27:885-9.

Lopez HN, Focseneanu MA, Merritt DF. Genital Injuries Acute Evaluation And Management. Best Pract Res Clin Obstet Gynaecol. 2017 Sep 28.