Appearance of the genitalia in non-abuse prepubertal girls

Abstract

Objective: To study genital appearance of prepubertal girls without history of sexual abuse.

Method: This study was a prospective cross-sectional study. The author evaluated prepubertal girls, aged 0-10 years, without history of sexual abuse. Caretakers and patients were interviewed for possible abuse and medical history, and each girl received a genital examination. Examination techniques included a supine labial separation approach, and a supine labial traction method.

Result: Forty prepubertal girls between the ages of 1 day and 10 years, mean age 5.2 years, were examined. Hymenal configurations included crescentic (72.5%), annular (27.5%), fimbriated (7.5%), and septate (2.5%). Nonspecific findings included peri-hymenal bands (25%), longitudinal intravaginal ridges (2.5%), hymenal tags (5%), hymenal bumps/mounds (12.5%), anterior hymenal cleft/notch (5%), midline sparing (2.5%), erythema (50%), and nonspecific vaginal discharge (22.5%). Perihymenal abrasion was found in one girl who had history of dysuria, and itching and scratching her genitalia.

Discusssion: Overall, most patients were found to have nonspecific findings of penetrating trauma (97.5%). The suspicious finding of penetrating trauma was found in one case (2.5%) which may cause by genitalia scratching.

Conclusion: Normal or nonspecific findings of penetrating trauma of genital examinations are mostly found in prepubertal girls without history of sexual abuse. It is possible that suspicious findings of penetrating trauma may be found in these girls. Correlation of abuse history is needed.

Key words: Appearance of genitalia, Prepubertal girl