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Fulltext Coital injuries of the vagina

Subramaniam N, Yogaraj R

Med J Malaysia, 1986 Dec;41(4):343-6.
PMID: 3670158

This article is an analysis of seven patients who presented to the Gynaecology Unit, General Hospital, Ipoh, during the period 1984-1985 with vaginal injury sustained during normal coitus.
Four patients were between 22-34 years of age. The remaining three were in the 51-64 year group; all the three had undergone previous gynaecological surgery.
History of coitus as the precipitating cause was elicited in all our patients and having reached a diagnosis, subsequent management was fairly straightforward. Two patients presented with clinical features of haemorrhagic shock and required initial resuscitation with blood transfusion. Five patients required definitive surgical repair of the vaginal injuries, and in only two patients was conservative management possible. Both these patients were in the menopausal age group.
Study site: Hospital Ipoh, Perak, Malaysia

Matched MeSH terms: Vagina/injuries*
A cucumber in the abdomen penetrating through the vagina

Lee TT

Med J Malaya, 1970 Sep;25(1):53.
PMID: 4249497
Matched MeSH terms: Vagina/injuries*
Fulltext Coital injuries: a study of three cases

Narkunam R, Raman S, Kulenthran A, Sinnathuray TA

Med J Malaysia, 1984 Mar;39(1):78-81.
PMID: 6513845

This study reviews experiences in the management of three cases of lacerations of the vagina following coitus. A brief review of the recent literature is made. Although the extent of injuries can be very variable, the principles of management consist of prompt
resuscitation and arrest of haemorrhage, appropriate surgical repair under general anaesthesia, and systemic or local antibiotic therapy to combat infection. Avoidance of vigorous or abnormal coital practices, especially in single women, in the immediate postpartum period, and in postmenopausal women, can help to reduce the frequency and severity of such injuries.

Matched MeSH terms: Vagina/injuries*
Fulltext Coital injury requiring internal iliac artery ligation

Sivalingam N, Rajesvaran D

Singapore Med J, 1996 Oct;37(5):547-8.
PMID: 9046215

Profuse bleeding after voluntary sexual intercourse is an uncommon reason for admission to the gynaecological wards. Out of 12 such patients admitted to the Ipoh Hospital over a three-year period, one patient had life-threatening upper vaginal injury after coitus. Blood replacement and conventional suturing failed to arrest the bleeding. Bilateral internal iliac artery ligation promptly arrested further haemorrhage. Vigorous intercourse increases intra-abdominal pressure in women causing tensing of the cul-de-sac, decreasing the elasticity of the posterior fornix, resulting in vaginal laceration. Bilateral internal iliac artery ligation produces a 'pelvic compartment hypotension' converting a high arterial flow system to that of a low one resembling venous flow. The useful role of this procedure to contain pelvic haemorrhage is discussed.

Matched MeSH terms: Vagina/injuries*
Pelvic floor ultrasound findings in Ugandan women with obstetric fistula, unrepaired fourth degree obstetric tear, and pelvic organ prolapse

Krause HG, Wong V, Ng SK, Tan GI, Goh JTW

Aust N Z J Obstet Gynaecol, 2019 08;59(4):585-589.
PMID: 31146301 DOI: 10.1111/ajo.12990

BACKGROUND: While pelvic floor ultrasound is commonly utilised in high-resource locations, our understanding of pelvic floor characteristics in women suffering with obstetric fistula and unrepaired fourth degree obstetric tears in low-resource areas is limited.
AIMS: This study aimed to assess the pelvic floor ultrasound characteristics of Ugandan women suffering with obstetric fistula, unrepaired fourth degree obstetric tears and pelvic organ prolapse, and determine whether obstructed labour resulting in obstetric fistula causes more levator muscle defects compared to parous women without a history of obstructed labour.
MATERIALS AND METHODS: This was a prospective study in western Uganda assessing 82 women with obstetric fistula, unrepaired fourth degree obstetric tears and pelvic organ prolapse with a pelvic floor ultrasound scan.
RESULTS: Demographic characteristics were significantly different, with women suffering pelvic organ prolapse being older and more parous. Hiatal area on Valsalva was significantly smaller in the obstetric fistula group (mean 21.45 cm2 ) compared to non-obstetric fistula group (unrepaired fourth degree obstetric tears and pelvic organ prolapse; mean 30.44 cm2 ); a mean difference of 9.0 cm2 (95% CI: 5.4-12.6 cm2 , P

Matched MeSH terms: Vagina/injuries*
Delivery mode, levator avulsion and obstetric anal sphincter injury: A cross-sectional study 20 years after childbirth

Lin S, Atan IK, Dietz HP, Herbison P, Wilson PD

Aust N Z J Obstet Gynaecol, 2019 08;59(4):590-596.
PMID: 30793279 DOI: 10.1111/ajo.12948

BACKGROUND: Levator ani muscle (LAM) and anal sphincter injuries are common after vaginal birth and are associated with pelvic organ prolapse and anal incontinence.
AIMS: Our objective was to investigate long-term association between delivery mode, LAM avulsion and obstetric anal sphincter injuries (OASIS) in women at least 20 years after their first birth.
METHODS: All women recruited at 'index birth' of the Dunedin (New Zealand) arm of ProLong (PROlapse and incontinence LONG-term research) Study, were invited to have translabial and transperineal ultrasound assessment of LAM and anal sphincters. Post-processing analysis of imaging data was performed blinded against delivery data. Statistical analysis was performed using the χ2 test and results are expressed as odds ratios (OR).
RESULTS: Of the initial 1250 participants, 196 women returned for examination. Mean age was 50.8 years with a mean body mass index of 27.6 and median parity was three. They were seen on average 23 years after their first delivery. Four data sets were unavailable and one declined ultrasound assessment, leaving 191 for analysis. LAM avulsion was diagnosed in 29 (15.2%), and 24 women (12.6%) had significant anal sphincter defect. LAM avulsion was associated with forceps delivery (OR 2.45, 95% CI 1.04-5.80, P = 0.041). Forceps conveyed a greater risk of OASIS (21%) compared to a spontaneous vaginal delivery (11%) but did not reach statistical significance.
CONCLUSIONS: Forceps delivery is associated with long-term injurious effect on pelvic floor structures. Discussions of the long-term negative impact of pelvic floor structures and their functions are necessary to achieve an informed consent toward an operative vaginal delivery.

Matched MeSH terms: Vagina/injuries*