Repair 

Trauma to the external genitalia. Types of injuries of the male genital organs Mechanical damage to the labia in women

Due to a bruise of the perineum, severe damage to the genital organs can occur, and not only the external ones. In gynecology, such violations are more common - you can get bruised genitals and perineum not only during household or surgical procedures, during childbirth, in an accident. Soft tissue ruptures are extremely painful and require a long recovery, however, in some cases, injuries of the genital organs are not accompanied by severe complications.

ICD 10 injury code

According to the international classification of diseases (ICD 10), bruises of the external genital organs are coded S30.2.

Causes


A woman can get bruised labia during rough intercourse. Unfortunately, the number of rapes, including domestic rapes, is not decreasing. This leads to the appearance of various injuries - damage to the tissues of the perineum, hematomas, bruises. Non-traditional sex and sexual perversions, sex toys and intimate objects for role-playing games also cause bruises in girls and men.

It is possible to injure the external genitalia by negligence - a direct blow to the genitals when falling can cause. In this case, injuries to the pubic bone may occur, for example, the bruised area swells and hurts. Men are often injured during a fight or sports training: sparring, cycling, horseback riding, etc.

Women get the most serious bruises during atypical labor activity. It is impossible for foreign bodies to get into the birth canal. That is why it is important that during labor there is a qualified obstetrician-gynecologist who will control delivery. But even the help of doctors does not guarantee a favorable outcome if there are pathologies. When the pregnancy is unfavorable, doctors choose the tactics of saving the child and preserving, if possible, the integrity of the female genital organs: the cervix and ovaries.

In childhood, bruises of the perineum with the involvement of the genital organs are more common. They may be the result of negligence during training on shells. In children, hematomas often form in the groin, which is associated with rupture of the walls of blood vessels. These lesions are usually harmless and do not require specific treatment.

Symptoms

If the perineum is damaged, then the symptoms develop quickly. Bruises are painful, an extensive bruise spreads in the inguinal region, a tumor appears. Other symptoms of a stroke include:

  • the appearance of clearly localized cones;
  • open wounds and bleeding;
  • loss of sensation in the affected area;
  • hyperemia and fever;
  • acute inflammatory reactions.

Severe perineal hematomas, soft tissue ruptures, and vulvar bruises occur during delivery. During this period, the woman does not feel anything but severe pain caused by the movement of the fetus. It is possible to determine bruises of the vagina and cervix after the period of childbirth. Inspection is carried out only externally. Since the cause of the injury in this situation is clear, further diagnosis is not required.

Perineal wounds resulting from a bruise require more careful study. It is necessary to exclude damage to the rectum and bone structures. In such cases, profuse bleeding, unbearable pain are characteristic.

First aid

Treatment is possible only in a trauma center. Bruises in a girl may seem harmless, but the consequences of an injury are fraught with gynecological disorders. Help with household trauma will provide cold to the site of injury and peace. Cold is not used for more than 2 hours, leaving ice for 15-20 minutes. When blood appears, the wound is treated with a non-alcoholic antiseptic - chlorhexidine, Miramistin.

The difficulty in conducting treatment at home lies in the localization of damage. If there is an open wound, but there is a high probability of infection during bowel movements or urination.

Diagnosis and treatment

Patients with perineal injuries are not frequent hospital guests, but genital bruises do occur and require increased attention. Treatment depends on the specific injury. For the most part, in women, damage occurs due to rudeness during intercourse and during labor. In the first case, it is enough to get a consultation with a gynecologist, in the second - to undergo appropriate treatment: stitching the gap, anti-inflammatory and anti-edematous therapy, antiseptic treatment of the vulva and perineum.

Against hematomas on the first day I also use cold, they give vitamins K and P, calcium chloride. Torn tissues are sewn up, antibiotics are prescribed. If a foreign body is found, it is removed surgically. Recovery after a rupture and damage to the cervix will be lengthy. Assign "sexual" rest, which may last up to several months.

Bruises in children require increased attention. As soon as the main symptoms disappear, a control diagnosis is carried out. It is recommended to do an abdominal ultrasound to rule out hidden damage. In children who were observed after an injury by a doctor, complications occur extremely rarely. Light injuries remain undetected by the child. In this case, they take expectant tactics and do not carry out specific therapy.

Complications and consequences

If the hematoma does not go away, then anemia develops. This is one of the frequent complications of trauma, since the perineum and genitals are not very convenient for treatment. In the case of acute anemia, the hematoma is opened, blood clots are removed, and the wound is drained. The cavity is sewn up tightly, and in case of infection, a drainage tube is left for the subsequent administration of the drug and removal of pus.

Problems arise when a belated visit to the doctor. Immediately after the bruise, the victims prefer to sit out, but it is during this period that medical assistance should be provided. If there is a rupture of soft tissues with damage to blood vessels and an extensive hematoma, then you should not hesitate to visit the hospital. If the labia majora is incised, it needs to be sewn up, otherwise the tightening will be uneven, scars and scars will remain. This is what happens if you don't see a doctor on time.

The risk of infection also remains high. The victim may be offered a course of antibiotic therapy and anti-tetanus treatment if the injury was received during surgical procedures or pathological delivery. Observation of women giving birth is longer. It is important to preserve the functions of the genital organs and prevent complications that can lead to problems with conceiving and bearing a child in the future.

Dear readers of the 1MedHelp website, if you have any questions on this topic, we will be happy to answer them. Leave your feedback, comments, share stories of how you survived a similar trauma and successfully coped with the consequences! Your life experience may be useful to other readers.

To serious enough, requiring the help of a doctor.

What is considered trauma?

Of course, “battle wounds” from sex include scratches, bruises from a passionate kiss or hitting your head on the headboard. But still, it is customary to call injuries violations of the integrity of the skin or mucous membranes in the genital area.

In large cities, several women a month turn to doctors with injuries after intimacy. These are far from women of easy virtue, but the most ordinary wives or girlfriends, who did not take into account their own anatomical features and their relationship with the size of their partner.

A trifle, but unpleasant

The most harmless, but no less unpleasant, are various kinds of chafing. They occur with very long and frequent sexual intercourse and a lack of lubrication. As a result of friction of the skin against dry mucous membranes, there is swelling of the tissues of the labia minora and the entrance to the vagina, microscopic tears and pain during washing or sex. These injuries are not dangerous, but unpleasant - for a few days they will cool ardent lovers.

During the healing of these wounds, it is worth refraining from sexual intercourse and using antiseptic solutions (Epigen or Miramistin). This will prevent infection of microtrauma. If the soreness does not go away in 3-5 days, you should consult a doctor. Sometimes sexually transmitted infections give similar symptoms.

Minor injuries

Minor injuries can be caused by piercings in intimate places (in the area of ​​the clitoris, labia), growing hair in intimate places or stubble on the face (in the case of oral sex). Using sophisticated postures, you can get dislocations and sprains.

In the heat of passion, bites, bruises on the neck, scratched shoulders and back can appear.

Bites in intimate places are painful and do not heal well on the nipples, labia. On the clitoris, with a bite, a very painful hematoma can even form. Wounds after bites in the intimate area often become infected and bleed, so they require a doctor's consultation if the pain does not go away after a couple of days.

One of the typical traumatic injuries during sex on carpets are burns of the back and lower back, usually in women. They occur due to intense friction on the pile of the carpet by the skin. After some time, redness with severe burning develops on the skin, the integrity of the skin is damaged or forms a blister, as with a burn.

More serious injuries

With very hard sex, injuries to the genital organs are possible, provoking pain in the groin, urination disorders and pain during it. In addition, with a large size of the partner's penis, a woman may develop internal injuries - ruptures of the anterior wall of the vagina or the vaginal fornix (the area of ​​​​transition to the cervix).

With a sharp and deep introduction of the penis into the vagina, sharp pain and bleeding can occur, especially if the angle of insertion is not parallel to the axis of the vagina. This can occur when changing positions and throwing the woman's legs back on the man's shoulders. Such injuries are acquired by women whose partners have impressive “dignity” sizes, as well as those who use sexual toys that are not physiologically large.

With deep penetration, injuries to the uterus and ligaments are possible - with a strong push by the penis, a woman may feel a sharp pain in the abdomen. As a result of stretching of the ligaments that hold the uterus, it can shift from its normal axis and threaten reproductive function in the future.

Consequences of unconventional sex

Injuries in non-traditional sex

Injuries during sex in women

The leader in injuries is anal sex, during intimate relationships, the rectal mucosa can be damaged, a tear of the rectal sphincter can occur with the resulting physiological problems.

During anal sex, cracks can form - they heal for a long time and painfully, can cause inflammation of the rectum (proctitis) and the formation of hemorrhoids. For diseases in the rectal area, anal sex is contraindicated.

If you really want to experiment, use special lubricants, listen very carefully to your feelings and avoid pain.

exotic injuries

Sometimes, in especially emotional and shy women, with sharp sounds or movements, a stress mechanism can work - a strong reflex spasm of the muscles of the vagina with pinching of the penis in it. This condition is called vaginismus, and it is only funny to those who have not been in such a situation.

In order to get out of the “death grip”, a woman needs to tighten the muscles in the press area, simulating going to the toilet “in a big way”. To save his “dignity”, a man needs to insert his index finger into the anus of his partner and pull it back strongly. If these manipulations do not help, call an ambulance, only doctors can relieve the spasm.

The duration of the lesson is 6 hours.

Purpose of the lesson: to acquaint students with traumatic injuries of the female genital organs, to teach methods of their diagnosis, emergency care and treatment.

The student must know: possible causes of traumatism of female genital organs, clinic, diagnostics, treatment and prevention of traumatism.

The student must be able to: diagnose traumatic injuries of the female genital organs, provide first aid, prescribe treatment.

Location of the lesson: study room, gynecological department, operating room.

Equipment: tables, slides, videos.

Lesson plan:

Organizational issues - 10 min.

Student survey - 35 min.

Work in the gynecological department - 105 min.

Continuation of the lesson in the training room - 100 min.

Final control of knowledge. Answers on questions. Homework - 20 min.

Trauma (Greek trauma - wound, damage) - a violation of the anatomical integrity of tissues or organs with a disorder in their function, due to the influence of various environmental factors (mechanical, thermal, chemical, radiation, etc.). Traumatism has always accompanied a person, being a consequence of his interaction with the environment. There is no single universal classification of injuries, but it is recommended to use the International Classification of Diseases, Injuries and Causes of Death IX revision. Nevertheless, in everyday practice, all injuries can be divided into industrial, domestic, street, sports, military, agricultural, intentional.

In obstetric and gynecological practice, damage to the female genital organs can be conditionally divided into several groups:

    Damage to the external genitalia, perineum and vagina.

    Damage to the cervix and body of the uterus.

    Genital (genitourinary and intestinal-genital) fistulas.

The conditionality of this classification is determined by the fact that the nature of the damage can be from superficial to deep, sometimes penetrating into the abdominal cavity, and at the same time be combined. It should be noted that the most severe traumatic injuries occur in girls.

Damage to the vulva and vagina

The most common causes of such injuries can be a bruise, a blow, a fall on a blunt or sharp object, burns, childbirth, rough sexual intercourse, especially while intoxicated, rape of minors, careless examination with the help of mirrors of elderly women. Stab, cut and gunshot wounds of the genitals of a woman are not common. Injuries during the first sexual intercourse are rare. They can be very diverse: from damage to the hymen and labia minora to injuries to the perineum, vagina, urethra, bladder, rectum and posterior vaginal fornix. They can be superficial and deep, penetrating into the abdominal cavity and retroperitoneal space. Extremely severe and multiple injuries (up to penetrating) are observed during the rape of minors.

The greatest danger is the injury of the clitoris and bulbusvestibulae, as it is accompanied by massive, sometimes even fatal bleeding. A fracture of the pelvic bones is often accompanied by damage (rupture) of the vagina, urethra, and bladder.

A bruise or blow with a blunt object leads to the formation of a hematoma of the vulva, perineum, and vagina. When falling on a sharp object or hit by the horns of an animal, damage can occur not only to the perineum and vagina (with perforation of the vagina), but also to the rectum and bladder.

The clinical picture of the above injuries consists of pain and bleeding. With an injury to the bladder, rectum, incontinence of urine, feces and gases, prolapse of the intestine may be noted. With belated diagnosis, infection of the wound, the development of sepsis and peritonitis are possible, in some cases, the formation of intestinal-vaginal and urogenital fistulas.

The hematoma of the vulva and vagina has the appearance of a rapidly growing bluish-red tumor-like formation, which can spread upwards - to the womb, backwards - to the perineum and anus, in depth - to the paravaginal tissue. Vaginal hematoma is most often located in its upper or middle third, and then spreads to the external genitalia. The patient notes a feeling of tension in the area of ​​injury, cramping pain, tenesmus, difficulty urinating, sometimes there are signs of anemia.

Diagnosis is based on the data of anamnesis, examination, vaginal and rectal examination, examination with the help of mirrors. If a penetrating injury to the abdominal cavity or bladder injury is suspected, laparoscopy, bladder catheterization, cystoscopy, radiography of the pelvic bones, and diagnostic laparotomy are indicated.

Therapy for trauma to the external genitalia and vagina depends on the nature of the damage itself. In mild cases, you can limit yourself to only treating the damaged area, in others - bed rest with some medical prescriptions, and in more complex cases - only operational assistance. Sometimes anti-shock measures are needed. In addition, care should be taken to pre-treat wounds according to generally accepted surgical principles and to prevent tetanus, since injury often occurs in conditions of possible infection. Stable (non-growing) hematomas are treated conservatively: rest, cold, pressure bandage, hemostatic drugs, analgesics, vitamins PP and C, physiotherapy, according to indications - antibacterial agents. A progressive or infected hematoma must be opened, followed by ligation of the bleeding vessel. With massive blood loss, first of all, it is necessary to ensure hemostasis, replenish blood loss, and then provide for further therapeutic measures.

With a combined injury with damage to neighboring organs, urgent laparotomy, revision of the pelvic organs and abdominal cavity, suturing the wound or resection, for example, of the intestine, are necessary.

Almost all genital injuries occur in men and include damage to the testicles, scrotum, and penis. Female genital mutilation (the removal of the clitoris, preserved in some cultures) is viewed by many as a trauma to the genitals and a form of child abuse.

Most testicular injuries result from blunt trauma; penetrating injuries are less common. Blunt trauma can cause a hematoma or, if severely injured, rupture of the testicle.

Injuries to the scrotum can be caused by infection, burns, or avulsion.

The mechanisms of damage to the penis are varied. Possibly the most common cause of damage is from pants zippers. Penile fractures (ruptures of the cavernous bodies) most often occur during intercourse, and may be accompanied by damage to the urethra. Other types of damage include amputations (inflicted by the patient himself, or when clothes get caught in production mechanisms) and strangulation (the most common cause is the use of rings to enhance erection). Penetrating injuries, including animal bites and gunshot wounds, are less common and usually associated with urethral injury.

These lesions may be complicated by the development of Fournier's gangrene (necrotizing fasciitis) caused by a mixed aerobic-anaerobic infection. Predisposing factors include alcohol abuse, diabetes mellitus, prolonged bed rest, immunodeficiency, and chronic bladder catheterization. Complications of genital injury include erectile dysfunction, infection, tissue loss, and urethral stricture.

Symptoms and diagnosis of genital injuries

Injuries to the testicles and scrotum may not manifest, or they may present with swelling and tenderness. Hematocele, painful on palpation, may develop when the albuginea is ruptured; with a rupture of the vaginal membrane, bruising is possible in the groin and perineum. Penile fractures present with severe swelling, hemorrhage, and sometimes visible and palpable deformity. Necrotizing infection of the scrotum initially presents with pain, swelling, and hyperthermia and progresses rapidly.

Diagnosis of external injuries of the scrotum and penis is based on clinical data. Testicular injury is diagnosed by ultrasound of the scrotum. Retrograde urethrography should be performed in all patients with genital trauma due to the high risk of associated urethral injury.

The clinical course of necrotizing gangrene of the scrotum is rapidly progressive, accompanied by skin necrosis and even septic shock. Diagnosis is based on physical examination findings. At the beginning of the disease, the scrotum is edematous, tense, with hemorrhages, then blisters, darkening and crepitus appear. In the early stages, patients have systemic manifestations of sepsis, the severity of which is disproportionate to the local manifestations of the disease.

The variety of injuries and damage to the male genital organs is amazing. Mainly:

  • breaks or tears of the frenulum;
  • cut, stab or biting wounds of the penis;
  • bruises;
  • subcutaneous rupture of the cavernous bodies;
  • dislocation of the penis;
  • infringement of the penis;
  • damage to the scrotum;
  • testicular torsion, etc.

Types of injury

  • The most common type of minor penile injury is skin pinching lightning lock. Despite the small surface of the wound, it causes very severe pain. In order not to open the wound when trying to open the lock, it is better to cut the zipper below the pinched skin so that the zipper opens itself.
  • One of the causes of damage to the penis is excessive friction. Such problems most often occur in passionate lovers and men who begin sexual activity. The former are characterized by relatively deep skin lesions that leave scars. The second is typical tears in the fold of the foreskin.
  • In men with congenital short frenulum, during intercourse, gap or frenulum tear penis, which is accompanied by pain and bleeding.
  • A very peculiar type of damage to the penis is its infringement, which is observed, for example, when pulling a member with a thread, wire or cord, when putting ring-shaped objects on it. In children, such injuries are the result of pranks, and in adults, the result of onanism, an attempt to maintain an erection or prevent urinary incontinence.
  • There are even several cases of serious injuries to the penis as a result of its introduction into the hose of a vacuum cleaner. However, the main problem was thrombosis of the vein of the penis.
  • In a particularly unfortunate situation, you can even get penile fracture when it does not enter the vagina during intercourse, but hits the woman's thigh or pelvic bone with force. In this case, a click is heard, and the penis becomes blue or black due to hemorrhage.
  • Dislocation of the penis can occur in the same situation as a fracture, due to rupture of the ligaments that fix the penis to the pelvic bones. At the same time, the cavernous bodies are displaced under the skin of the scrotum, perineum (the penis is palpated in the form of an empty bag). After the penis is repositioned, the torn ligaments are sutured.
  • In addition, due to trauma to the penis with a rupture of one of the cavernous bodies, cavernite- inflammation of the cavernous bodies of the penis.
  • If the penis is continuously in a state of erection for an abnormally long time (from several hours to several days), then this is already the result of a violation of blood circulation. In this case, the erection does not stop, and the person experiences severe pain. This is due to a rupture of an artery passing inside the penis - as a result, a large amount of blood flows out, and there is no outflow - this rather serious disease is called "priapism". By the way, men suffering from diabetes and sickle cell anemia are predisposed to priapism.
  • With infectious and inflammatory diseases of the urethra (urethra) or after ruptures of the arteries or spongy tissue of the penis, scars can form during the healing process, which not only lead to impaired blood flow, but also prevent the formation of a uniform tension of the entire penis. In the normal state, soft tissues expand in all directions, and in the presence of scar tissue in this area, tissue expansion does not occur. As a result, it develops Peyronie's disease, the result of which is the curvature of the penis during erection. When he is in a relaxed state, this curvature is hardly noticeable, however, with the onset of an erection due to pronounced mechanical disturbances, sexual intercourse is often impossible.

In children, against the background of sudden movements, jumps, falls, testicular torsion, arising from the underdevelopment of the ligament that fixes the testicle to the bottom of the scrotum, which is manifested by its excessive mobility.