Considerations

Injury to the genitals can be very painful. It may cause a lot of bleeding. Such injury can affect the reproductive organs and the bladder and urethra.

Damage may be temporary or permanent.

Causes

Genital injury in young girls may be caused by placing items into the vagina. Young girls (usually less than 4 years of age) may do this during normal exploration of the body. Objects used may include toilet tissue, crayons, beads, pins, or buttons.

It is important to rule out sexual abuse, rape, and assault. The health care provider should ask the girl how the object was placed there.

In young boys, common causes of genital injury include:

• Having the toilet seat fall down onto the area
• Getting the area caught in a pant zipper
• Straddle injury - falling and landing with the legs on each side of a bar, such as a monkey bar or middle of a bicycle

Symptoms

• Abdominal pain
• Bleeding
• Bruising
• Affected area has changed in shape
• Faintness
• Object embedded in a body opening
• Groin pain or genital pain (can be extreme)
• Swelling
• Urine drainage
• Vomiting
• A wound
• Urination, painful or inability to urinate
• Foul-smelling vaginal discharge

First Aid

Keep the person calm. Be sensitive to privacy. Cover the injured area while giving first aid.

Control bleeding by using direct pressure. Place a clean cloth or sterile dressing on any open wounds. If the vagina is bleeding severely, put sterile gauze or clean cloths on the area, unless a foreign body is suspected.

Apply cold compresses to help reduce swelling.

If the testicles have been injured, support them with a sling made from towels. Place them on like a diaper.

If there is an object stuck in a body opening or wound, leave it alone and seek medical attention. Taking it out may cause further damage.

DO NOT

Do not try to remove an object by yourself. Seek medical help immediately.

Never volunteer your thoughts on how you think the injury happened. If you think the injury was the result of assault or abuse, do NOT let the person change clothes or take a bath or shower. See immediate medical help.

When to Contact a Medical Professional

A straddle injury is damage to the testicle or urinary tract. Immediately get medical help if there is:

• A lot of swelling or bruising
• Blood in the urine

Call seek immediate medical help if there is a genital injury and:

• Pain, bleeding, swelling
• A concern about sexual abuse
• Problems urinating
• Blood in the urine

Prevention

Teach safety to young children and create a safe environment for them. Also, keep small objects out of the reach of toddlers.

Alternative Names

Scrotal trauma; Straddle injury; Toilet seat injury

References

Gerber GS, Brendler CB. Evaluation of the urologic patient: History, physical examination, and the urinalysis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 3.

Updated: 4/16/2012

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.