1 Medical evaluations are commonly requested in children who are suspected victims of sexual abuse. The evaluation of children with anogenital symptoms and signs should include a consideration of alternative conditions and causes not directly related to sexual abuse.ĬHILD SEXUAL abuse is a common pediatric problem affecting approximately 12% of girls younger than 14 years. Children with anogenital symptoms but without a disclosure or suspicion of sexual abuse are unlikely to have examination findings suggestive of abuse. Common examination findings included anogenital erythema, enhanced vascularity of the hymen or vestibule in prepubertal girls, labial adhesions, and culture-negative vaginitis.Ĭonclusions Few children are referred for sexual abuse evaluations based on physical signs or symptoms alone. Only patients with the presenting symptom of lesions had an increased likelihood of a sexual abuse diagnosis. Seventy-two patients had normal examination findings. Although 85 patients had examination findings that corroborated the presenting symptom(s), 70 had nonspecific examination findings or a diagnosis other than sexual abuse. We used a standardized classification system and determined that 25 patients (15%) had examination findings in the sexual abuse clinic that were suggestive of or probable or definitive for sexual abuse. Of 184 complaints, the most common presenting symptom or sign was anogenital bleeding or bruising (29.3%), followed by irritation or redness (21.7%), abnormal anogenital anatomy (20.7%), vaginal discharge (18.4%), lesions (6.5%), and "other" symptoms or signs (3.3%). Most (75%) referrals were from medical clinics. Results A medical records review of 3660 cases was done 157 cases were identified for study. Setting Child and adolescent ambulatory care sexual abuse clinic. Objective To determine whether children referred to a sexual abuse clinic because of anogenital symptoms or signs have examination findings that are suggestive of or probable or definitive for sexual abuse. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.This will also help prevent the spread of other sexually transmitted diseases. You can help protect yourself, however, by using a latex or plastic condom. It's difficult to protect yourself by just asking if they have warts. Your partner may not know they have this virus or may have tiny warts that are difficult to see or feel. Freezing, laser surgery, drug, or chemical treatments are used. The virus that causes these warts, humanpapilloma virus (HPV), is passed during sex, and is considered a risk-factor for a cancer. If you think you have been exposed to warts, let your health care provider know. Sometimes warts may be discovered during a pelvic exam. There is no pain with these, though some women notice mild itching. Warts may be harder to feel inside the vagina. Sometimes they can be noticed at the opening of the vagina. They are small, pebbly growths that can be felt with a finger. Warts in the vagina are similar to the warts on our hands, but are caused by different viruses. Treatment is not needed unless they become painful or bleed. Polyps are small skin tags found in the vagina that usually are not noticed. These may need treatment with medicine, laser, or other surgical procedures. Rarely, painful cysts, from a disease called endometriosis, can form. They do not need any treatment unless they get larger. Most of these are Gartner's cysts that formed when women were babies. Many are found along the sides of the vagina, but they rarely get larger than a dime. Inside the vagina, they are usually painless, round lumps that can get to be the size of a plum before you notice them. CystsĬysts are made when a gland or duct is clogged and liquid collects in a sac. Although these occur often, they are not harmful.
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