Gynaecological management of sexual assault victims

Abstract: Sexual assault is a crime which extremely violates victim’s integrity, often leading to strong psychological trauma. Appropriate management of sexual assault victims, both from the medical and the medico-legal side, requires cooperation of the physician examining the victim with law enforcement agencies. Proper collection and preservation of evidence is essential. Physicians should be equipped with a special kit for examination of sexual abuse victims, including a form with specific questions and a diagram for graphic illustration of the injuries. Both physical and gynaecological examination should be performed very gently. All the secured evidence and collected samples must be documented in detail. Lack of evidence of injuries on the victim’s body does not indicate that the events had not taken place as during numerous victims’ examinations no injuries are recorded. The likelihood of the victim being infected with sexually transmitted infections should be assessed and appropriate prevention should be applied. Depending on individual risk and preferences postcoital contraception is available. Finally, information about appropriate facilities, in which the victim will be able to receive psychological and legal assistance, should be given. Psychological care is essential as sexual abuse victims are at great risk of developing sexual dysfunctions and post-traumatic stress disorder. In some cases psychotherapy is required in order to restore sexual and psychological well-being.

Agnieszka Plachta, Joanna Kacperczyk-Bartnik, Agnieszka Dobrowolska-Redo, Pawel Bartnik, Ewa Romejko-Wolniewicz

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