Coital trauma as seen at Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria
Keywords:Coital, Trauma, Morbidity, Mortality, Abakaliki
Background: Though pleasurable, coitus may result in morbidity and even mortality. One of such morbidities is coital trauma, a global occurrence that is grossly under reported. This study aimed to determine the causes and risk factors for coital trauma as well as its clinical presentation.
Methods: This was a 4 year retrospective study of patients that presented with coital injuries at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Data were obtained from patients’ clinical notes using a specially designed proforma. Statistical analysis was performed using Epi InfoTM 7.2.1.
Results: The majority of women that presented with coital trauma were adolescents (67.9%). Most of them were single (92.9%), nulliparous (89.3%) and had only primary education (57.1%). The commonest cause of coital trauma was rape (75%). The commonest risk factors were inadequate foreplay (57.1%) and coitarche (42.9%). Other risk factors were genital disproportion, pregnancy, puerperium and influence of drugs. The common clinical presentations were vaginal bruises (75%) and vaginal lacerations (64.3%) while the commonest site of injury was the hymen (42.9%) followed by the vulva (35.7%). Other less common sites of injury were the lower vagina and posterior fornix.
Conclusions: Coital trauma is relatively common and young girls are mainly affected. Rape is the major cause while inadequate foreplay and coitarche are the major predisposing factors.
Carol JL. Sexuality Now: Embracing Diversity. Belmont, CA: Wadsworth; 2010: 270-271.
Hembah-Hilekaan S, Pam I. Coitally Related Vaginal Injury in a woman in North Central Nigeria. Internet J Sexual Med. 2010;2(1).
Inuwa U, Bako B, Mairiga AG, Geidam AD. Coital trauma as seen at the University of Maiduguri Teaching Hospital, Maiduguri. BOMJ. 2013;10(1):25–9.
Komisaruk BR, Whipple B, Nasserzadeh S, Beyer-Flores C. The Orgasm Answer Guide. JHU Press; 2011: 108-9.
Tchounzou R, Chichom-Me fire A. Retrospective Analysis of Clinical features. Treatment and Outcome of Coital Injuries of the Female Genital Tract Consecutive to Consensual Sexual Intercourse in the Limbe Regional Hospital. J Sexual Med. 2015;3(4):256–60.
Omo-Aghoja LO, Ovbagbedia O, Feyi Waboso P, Okonofua FE. Coitally Related Traumatic Injury of the Female Genital tract in a Nigerian Urban setting: A 5-year review. Niger Postgrad Med J. 2009;16:59-63.
Fletcher H, Bambury I, Williams M. Post Coital posterior fornix perforation with peritonitis and haemoperitoneum. Int J Surg Case Rep. 2013;4(2):153–5.
Abdullahi HM, Yakasai IA. Coital laceration resulting in rectovaginal fistula: A case report. Int J Curr Microbiol App Sci. 2014;12(3):845-9.
Uzoigwe SA, Orazulike NC. Life threatening vaginal haemorrhage from coital laceration n a post-menopausal woman. Port Harcourt Medical Journal.2008;2(3):275-7.
Manohar R, Kavyashree G. Post coital vaginal tear- A rare life threatening emergency. J Evol Med Dental Sci. 2013;2(40):7673-39.
Jana N, Santra D, Das D, Das AK, Dasgupta S. Non Obstetric lower genital tract injuries in rural India. Int J Gynaecol Obstet. 2008;103:26-9.
Ezechi OC, Fasubaa OB, Dare FO. Vaginal Injury during Coitus at Ile Ife: A 16 year review. Nigeria J Med. 2009;9:16-8.
Amenu D. Rectovaginal fistula in a newly married woman. Gynecol Obstet (Sunnyvale). 2015;5(6):296.
Ijaiya MA, Mai AM, Aboyeji AP, Kumanda V, Abiodun MO, Raji HO. Rectovaginal fistula following Sexual intercourse; a case report. Ann Afr Med. 2009;8(1):59-60.
Abasiattai AM, Etuk SJ, Bassey EA, Asuquo EE. Vaginal injuries during coitus in Calabar: a 10 year review. Niger Postgrad Med J. 2005;12(2):140-4.
Jones ISC, O’connor A. Non obstetric vaginal trauma. Open J Obstet Gynaecol. 2013;3:21-3.
Alex E, Mtui E, Knapp G. Post coital posterior fornix perforation with vaginal evisceration. BMC women’s Health. 2014;14:141.