Usefulness of colposcopy in assessment of rape victims - Tips from Other Journals

Date: May, 1992

Establishing physical findings in rape victims, which depends on gross visualization of trauma, is important for patient management and documenting evidence. However, the yield from these examinations is often low. Two studies have demonstrated that toluidine blue, a nuclear stain commonly used in gynecologic practice to detect vulvar cancer, can enhance the visualization of genital trauma. Positive findings were reported in about half of the women in the studies. Slaughter and Brown hypothesized that colposcopy might also enhance visualization of genital trauma. To evaluate the usefulness of colposcopy in the assessment of rape victims, they conducted a study of women who reported being sexually assaulted.

The study included 131 women. Genital examinations using the colposcope were performed within 48 hours of the reported assault. Positive findings were found in 114 women (87 percent). Injuries included lacerations, abrasions, ecchymosis and swelling. Injuries were typically seen on the'posterior fourchette, the anatomic site of attachment to the perineal body and the point of greatest stress when forceful stretching is applied. Sixtyfour patients returned for follow-up examination after an average of 25 days. The acute trauma had resolved in 60 of these patients.

This study demonstrated that colposcopy may be the best examination method yet reported for demonstrating genital findings associated with rape. A followup examination showing resolution of the genital trauma may help link the traumatic event to the injuries observed. (American Journal of Obstetrics and Gynecology, January 1992, vol. 166, p. 83. )

COPYRIGHT 1992 American Academy of Family PhysiciansCOPYRIGHT 2004 Gale Group

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