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Updates in Surgery

, Volume 71, Issue 4, pp 735–740 | Cite as

Analysis of non-obstetric vaginal and vulvar trauma: risk factors for operative intervention

  • Sahil GambhirEmail author
  • Areg Grigorian
  • Sebastian Schubl
  • Cristobal Barrios
  • Nicole Bernal
  • Victor Joe
  • Viktor Gabriel
  • Jeffry Nahmias
Original Article
  • 23 Downloads

Abstract

Vaginal and vulvar trauma may occur accidentally or because of an act of violence. Due to its rarity, little is known about risk factors effecting need for operative intervention. We sought to perform a large descriptive analysis of adult non-obstetric vulvovaginal trauma (VVT) and elucidate risk factors for requiring operative intervention. A retrospective analysis of the National Trauma Data Bank was performed between 2007 and 2015. Patients ≥ 16 years old with vaginal or vulvar trauma were identified. Risk factors for surgical intervention were identified using a multivariable logistic regression analysis. From 2,040,235 female patients, 2445 (< 0.2%) were identified to have VVT with the majority being injury to the vagina (68.6%). In patients with injury to the vagina, age > 65 (OR = 0.41, CI 0.26–0.62, p < 0.001), Injury Severity Score > 25 (OR = 0.66, CI 0.50–0.86, p = 0.01) and victims of rape (OR = 0.39, 95% CI 0.26–0.57, p < 0.001) were less likely to require operative intervention. In patients with injury to the vulva, age > 65 (OR = 0.45, CI 0.21–0.94, p = 0.02), victims of rape (OR = 0.26, CI 0.08–0.87, p = 0.01) and gunshot violence (OR = 0.10, CI 0.02–0.59, p = 0.02) were less likely to require operative intervention, but those with a concomitant injury to the vagina were more likely to require operative intervention (OR = 2.56, CI 1.63–4.03, p < 0.001). Injuries to the vagina or vulva occur in < 0.2% of traumas. Interestingly, in both vulvar and vaginal trauma, older age, and involvement in rape were associated with lower risk for operative intervention. A combined injury to the vagina and vulva increases the need for operative intervention.

Keywords

Vaginal Vulvar Trauma Operative intervention 

Notes

Compliance with ethical standards

Conflict of interest

The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, informed consent is not required.

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Copyright information

© Italian Society of Surgery (SIC) 2019

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of California Irvine Medical CenterOrangeUSA

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