Injuries and anatomical variations of the female genitalia

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BACKGROUND: Female genital injuries are often underreported or misinterpreted, particularly in cases of sexual violence. Until now, most research has focused on injuries caused by sexual intercourse, while injuries arising from everyday activities or anatomical variations have received less attention. This study aims to document genital injuries in healthy women, regardless of sexual assault, in order to contribute to an understanding of genital injury patterns and improve forensic interpretation. METHODS: A monocentric observational study was conducted including 100 healthy female volunteers (aged 20-70) who underwent a standardized external genital examination including photographic documentation. Data was analysed regarding the presence of injuries and anatomical variations, injury type, and affected anatomical structures. Injuries were categorized as erosions, lacerations, petechiae, and ecchymoses, excluding redness and swelling. RESULTS: Genital injuries were observed in 30% of the participants. Erosions and petechiae were the most common types of injuries, each accounting for 12% of all cases. In terms of the affected structures, the clitoris (32.4%) and the labia majora and minora (23.5% each) were most frequently affected. CONCLUSION: This study provides valuable insights into the prevalence, distribution, and characteristics of genital injuries occurring in everyday life. Exposed structures, such as the clitoris and labia, are more susceptible to external accidental trauma compared to anatomically protected areas like the vaginal introitus. By providing information on the frequency of genital injuries, this study contributes to the understanding of genital injury patterns and will help improve forensic assessment in the future, particularly in cases of sexual violence.

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