Female genital injuries resulting from consensual and non-consensual vaginal intercourse

ObjectivesThe purpose of this study was to compare the incidence of genital injury following penile–vaginal penetration with and without consent.DesignThis study compared observations of genital injuries from two cohorts.SettingParticipants were drawn from St. Mary's Sexual Assault Referral Centre and a general practice surgery in Manchester, and a general practice surgery in Buckinghamshire.ParticipantsTwo cohorts were recruited: a retrospective cohort of 500 complainants referred to a specialist Sexual Assault Referral Centre (the Cases) and 68 women recruited at the time of their routine cervical smear test who had recently had sexual intercourse (the Comparison group).Main outcome measuresPresence of genital injuries.Results22.8% (n = 00, 95% CI 19.2–26.7) of adult complainants of penile–vaginal rape by a single assailant sustained an injury to the genitalia that was visible within 48 h of the incident. This was approximately three times more than the 5.9% (n = 68, 95% CI 1.6–14.4) of women who sustained a genital injury during consensual sex. This was a statistically significant difference (a < 0.05, p = 0.0007). Factors such as hormonal status, position during intercourse, criminal justice outcome, relationship to assailant, and the locations, sizes and types of injuries were also considered but the only factor associated with injury was the relationship with the complainant, with an increased risk of injury if the assailant was known to the complainant (p = 0.019).ConclusionsMost complainants of rape (n = 500, 77%, 95% CI 73–81%) will not sustain any genital injury, although women are three times more likely to sustain a genital injury from an assault than consensual intercourse.