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The prevalence of genital injuries in post-pubertal females presenting for forensic examination after reported sexual violence: a systematic review

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Abstract

Background

Sexual violence is a prevalent issue in contemporary society requiring a robust forensic healthcare response. It is critically important that forensic examiners put clinical examination findings into an appropriate evidence-based context. The presence of genital injuries has been shown to increase the likelihood of successful criminal prosecution and report the crime. However, the reported rates of genital injury vary widely in published studies.

Aims and objectives

We aim to critically evaluate and synthesize existing literature on the prevalence of genital injuries in post-pubertal females, examined following sexual violence, with a view to describing the prevalence and characteristics of genital injuries as well as the range of forensic practices employed.

Methods

Three online databases (PubMed, Embase, and Scopus) were systematically searched with key terms.

Results

Of the 1224 studies screened, 141 full-text publications met the inclusion criteria. Reported injury prevalence rates varied widely. Details pertaining to forensic examinations included in each study, such as grade of the examiner, type of examination, location of examination, and time interval from assault to examination also varied widely. Injury prevalence was highest in studies where enhanced visualization techniques were utilized.

Conclusions

This systematic review demonstrates that there is no universally agreed standard for documenting genital injuries in cases of sexual violence and highlights the need for standardized approaches and guidelines for assessing, documenting, and reporting these injuries. The review provides robust evidence to support a call for establishing consistent context, terminology, classification systems, and data collection methods to improve the comparability and reliability of future research findings.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request

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Authors and Affiliations

  1. Department of Obstetrics & Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, 1, Dublin, Ireland

    D Kane & M Eogan

  2. Sexual Assault Treatment Unit (SATU), Rotunda Hospital, Parnell Square, Dublin, 1, Dublin, Ireland

    D Kane & M Eogan

  3. School of Medicine, University of Galway, Galway, Ireland

    KM Kennedy

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Kane, D., Kennedy, K. & Eogan, M. The prevalence of genital injuries in post-pubertal females presenting for forensic examination after reported sexual violence: a systematic review. Int J Legal Med 138, 997–1010 (2024). https://doi.org/10.1007/s00414-023-03117-8

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