The Forensic Nurse

While genital injury during a sexual assault is not all that common, there are some warning signs that you should look for. Injury may or not be immediately visible to the naked eye, or even with a woods lamp.

Symptoms of Genital Injuries in Females may include:

• pain in the abdomen

• pain inside or outside the vagina

• bleeding

• swelling

• redness and swelling within the vagina

• painful urination

• inability to urinate

• foul smelling discharge

• feeling faint

Signs of Genital Injuries in Females may include:

• cuts or tears anywhere in the genital region

• an object embedded in the vagina

• bite marks on the genitalia

• bruising of the vulva, the outside of the vagina

• bleeding under the skin of the vulva

• change in the shape of the vaginal lips, vulva, or other areas

• swelling

• redness and swelling within the vagina

• shock

Commonly referred to as a form of Post-Traumatic Stress Disorder or PTSD, Rape Trauma Syndrome is a mental health disorder that  can affect persons who have undergone a severely traumatic event such as rape, kidnapping, or domestic assault.

Some common symptoms of PTSD and Rape Trauma Syndrome are:  

• recurrent memories or flashbacks of the incident
• nightmares
• insomnia
• mood swings
• difficulty concentrating
• panic attacks
• emotional numbness
• depression
• anxiety

Persons who have been sexually assaulted have also been noted to have increased risk for developing other mental health problems. Over those who have not been victimized, rape victims are:

• three times more likely to have a major depressive episode
• four times more likely to have contemplated suicide
• thirteen times more likely to develop alcohol dependency problems
• twenty-six times more likely to develop drug abuse problems

According to the United States Code, there are two general classifications of sexual assault, sexual abuse and aggravated sexual abuse.

So what is the difference?

Sexual abuse is described as acts where an individual is forced to engage in sexual activity by use of threats or other fear tactics, or in instances where an individual may not be physically able to decline.

Aggrevated Sexual Abuse  is when an individual is forced to submit to sexual acts by use of physical force, threats of injury or death, kidnapping, or by substances that render a person unconscious or impared.

Some other terms that we may want to clarify at this point are:

Direct Visual Inspection
In this method, injuries are identified through simple observation by a health care professional during a standard gynecological or forensic examination. It was the primary method used in examining female victims after sexual assault from about 1970 to 1990.

Staining techniques
Several staining solutions have been used: Gentian violet, Lugol’s solution, toluidine blue and flurorscein. A health care professional applies a staining solution in and around the female genitals. The solution makes injured tissues stand out from uninjured, surrounding areas. For example, with Lugol’s, tears in the epithelium appear as unstained, lighter areas than surrounding, uninjured genital tissues; with toluidine blue, tears or injured genital tissues pick up the stain and appear darker than uninjured tissues.

Colposcope
A Colposcope is a device used  to illuminate and magnify the part of the body being inspected by a health care professional. In some models a green lens filters make scars or abnormal patterns of blood vessels stand out from normal genital tissue. Colposcopy enables examiners to detect microscopic injury, and it reduces the need for repeated examinations of rape victims. The colposcope can be attached to a 35mm, digital camera or video camera for documentation when evaluation by other medical experts is needed, or as evidence for prosecuting cases.

According to the National Crime Victimization Survey only 26% of those victims who where raped or victim of attempted rape where attacked by a person they did not know. That means that almost 3 out of 4 times the rapist / attempted rapist was either a friend, acquintance, date, family member, or other relative.

RAINN, or the Rape Abuse & Incest National Network is one of the most nationally recognized names when it comes to rape and sexual assualt . They are the nations largest anti-sexual assault organization.

They are currently championing the “rape can happen any time” 24/7 campaign to help educate the public about the crime of rape.

 “Rapists don’t take off nights and weekends. Neither can we.”

National Sexual Assault Hotline
Among its programs, RAINN created and operates the National Sexual Assault Hotline at 1.800.656.HOPE. This nationwide partnership of more than 1,100 local rape treatment hotlines provides victims of sexual assault with free, confidential services around the clock. The hotline helped 137,039 sexual assault victims in 2005 and has helped more than one million since it began in 1994.

Men Stopping Violence is a social change organization dedicated to ending men’s violence against women. Because a majority of violent crimes against women are commited by men, many people feel that violence prevention needs to start with men and educating males and females on how to deal with problems.

Contact Information for MSV

533 W. Howard Ave., Decatur, GA 30030
P: (404)270-9894 F: (404)270-9895
msv@menstoppingviolence.org