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Pediatric - Genital Injury

Genital injury

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Does this describe your child's symptoms?

Definition
  • Injuries to the female genital area (labia, vulva, vagina)
  • Injuries to the male genital area (scrotum or penis)

Types of Genital Injuries

  • Most are bruises (with swelling) or minor cuts that heal rapidly in 3 to 4 days.
  • Minor injuries can cause lots of bleeding here because of the rich blood supply.

Straddle Injuries

  • Definition: injury to the groin from falling on an object that is being straddled.
  • Examples are playground equipment, crossbars of a bicycle, fence, etc.
  • Females usually get a bruise or small cut of the labia majora or minora. The female urethra and hymen are usually spared because they are protected by the overlying labia.
  • In males, the urethra is more external and it can be compressed between the hard object and the bony pelvis.  The urethra can be bruised or torn.
  • The most reliable finding of a damaged urethra is a drop of blood at the opening of the urethra.  Other findings are bloody urine, difficulty starting the stream or painful urination.
When to Call Your Doctor

Call 911 Now (your child may need an ambulance) If
  • Major bleeding that can't be stopped
  • Fainted or too weak to stand
Call Your Doctor Now (night or day) If
  • You think your child has a serious injury
  • External bleeding won't stop after 10 minutes of direct pressure
  • Bleeding from inside the vagina
  • Vaginal injury with a penetrating object
  • Skin is split open or gaping and may need stitches
  • Zipper caught (stuck) on penis now
  • Swollen or painful scrotum
  • Painful urination or difficulty passing urine
  • Blood in urine
  • Severe pain
  • Age under 1 year old
  • Could have been caused by sexual abuse or assault
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen
Call Your Doctor During Weekday Office Hours If
  • No tetanus shot in over 5 years for DIRTY cuts (over 10 years for CLEAN cuts)
  • Genital pain or swelling persists over 7 days
  • You have other questions or concerns
Parent Care at Home If
  • Minor genital injury and you don't think your child needs to be seen
HOME CARE ADVICE FOR MINOR GENITAL INJURIES

  1. Bleeding:  
    • For any bleeding, apply direct pressure for 10 minutes with a sterile gauze.
    • Note: minor cuts in the genital area can cause much oozing of blood because of the rich blood supply.  
    • For the same reason, the area heals quickly (3 or 4 days).
  2. Cut or Scrape Treatment:
    • Wash the wound with soap and water for 5 minutes.
    • For any dirt, scrub gently with a wash cloth.
    • Apply an antibiotic ointment (OTC) 2 times per day.
  3. Local Cold:  For bruises or swelling, apply a cold wet washcloth to the area once for 20 minutes if tolerated. (Reason: reduce the bleeding and pain).
  4. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen as needed for pain relief.
  5. Expected Course: Cuts and other minor injuries in the genital area heal quickly in 3 or 4 days.
  6. Call Your Doctor If:
    • Pain becomes severe
    • Passing urine becomes difficult or painful
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 4/2/2009

Content Set: Pediatric HouseCalls Online

Copyright 1994-2009 Barton D. Schmitt, M.D.

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