- Risk factors: other forms of abuse, high stress environment, poor social/familial support, increased risk during adolescence
- Exam statements: always preface with "we are going to examine [insert age-appropriate genital description], this is okay because I am a doctor and your [caregiver] is here, otherwise no one else should look at or touch your private areas"
- Speculum: usually no need unless active vaginal bleeding
- Rectal exam: DRE usually not needed, endoscopic exam only if bleeding present, otherwise just examine externally
- Majority of post-abuse exams do not have any abnormal findings
- Diagnostic findings: evidence of ejaculation or pregnancy, SUI (syphilis, gonorrhea, HIV) not acquired perinatally/IV, new genital/anal injuries in absence of adequate accidental explanation, abnormally enlarged hymenal opening for age
References
- AUA Core Curriculum
- Baskin, Laurence S. Handbook of pediatric urology. Lippincott Williams & Wilkins, 2018.
- Schlomer, B. and M. Jacobs. "Pediatric Genitourinary Trauma." Campbell-Walsh Urology 12 (2020).