Comparison of Examination Methods Used in the Evaluation of Prepubertal and Pubertal Female Genitalia: A Descriptive Study

• NCJ Number: 222328
• Journal: Child Abuse & Neglect Volume: 32 Issue: 2 Dated: February 2008 Pages: 229-243
• Author(s): Cathy Boyle; John McCann; Sheridan Miyamoto; Kristen Rogers
• Date Published: February 2008
• Length: 15 pages
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

The purpose of this study was to compare the effectiveness of three different examination methods in their ability to help an examiner detect both acute and non-acute genital injuries in prepubertal and pubertal girls suspected of having been sexually abused.

Abstract

Results indicate that each of these three examination methods have an inherent value. The supine labial separation method provides the examiner with an excellent view of the labia, the posterior fourchette, and the perineum, but it may not afford a good view of the vestibule, surface of the hymen, and the fossa navicularis as does the supine labial traction technique. Neither the supine labial separation method nor the supine labial traction was as successful as the prone knee-chest position in smoothing out the hymen and allowing the examiner to view the interior of the vaginal canal. The study findings show that the results of a medical examination will vary by the method employed. While no single method detected all the injuries, the use of the multimethod examination approach did prove to be a valuable addition in the evaluation of both the prepubertal and the pubertal girl’s genitalia, particularly in the identification of a hymenal laceration. The medical evaluation of sexually abused children and adolescents has undergone many changes since the problem first came to the attention of the medical community. In response to this need, the medical community has been pursuing a variety of examination methods in order to provide a technique(s) that would provide the examiner with the greatest amount of information while being the least intrusive. This study was undertaken to compare the results of three examination methods: supine labial separation approach, supine labial traction technique, and prone-knee chest position. It also sought to determine if a combined approach, using the three methods, would be sufficiently advantageous for routine use in the evaluation of both the prepubertal and the pubertal adolescent girl suspected of having been sexually abused. Figures, tables, and references