Vaginal foreign bodies and child sexual abuse.

OBJECTIVE

To determine whether vaginal foreign bodies (VFBs) in prepubertal girls are associated with sexual abuse and whether evidence exists in earlier reports for such an association.

DESIGN

Retrospective case review.

SETTING

General pediatric clinic at Duke University Medical Center, Durham, NC.

PARTICIPANTS

All 12 girls 10 years of age and under who, between 1985 and 1988, were seen in the general clinic and subsequently found to have VFBs.

INTERVENTIONS

None.

MEASUREMENTS AND RESULTS

Clinic protocol required referral of all children with vaginal bleeding, unusual discharge, or VFBs to the Child Protection Team at the medical center, which also served as a pediatric gynecology consultation service. Records for the 12 girls, whose mean age was 6.3 years, showed 19 visits for single, multiple, or recurrent VFBs. Two girls had concurrent sexually transmitted diseases. Eight met diagnostic criteria for confirmed sexual abuse; three, for suspected abuse; and in one, abuse status was unknown.

CONCLUSIONS

Vaginal foreign bodies in young girls may be a previously unrecognized indicator of sexual abuse. Girls with VFBs should be evaluated for possible sexual abuse. Prospective studies on the suggested association between VFBs and sexual abuse need to be conducted.