Urogenital symptoms after sexual abuse vs irritant contact in premenarchal girls.

Objectives: Sexually abused (SA) girls report urogenital symptoms temporally related to inappropriate genital contact. Since girls also experience symptoms following genital irritant exposure and mostly all girls are exposed to genital irritants, we describe overall symptoms reported by girls that disclosed SA compared to those that did not and we compare how girls describe symptoms following a specific episode of contact SA vs a genital irritant exposure.

Design: Cross-sectional study. Parents/girls interviewed; medical records reviewed.

Participants: Five to 12-year-old premenarchal girls/parents.

Setting: An urban and a suburban pediatric practice; a regional treatment center for child abuse.

Outcome Measures: Prevalence of histories of urogenital symptoms in SA girls compared to girls attending well-child exams (controls); girls' description of urogenital symptoms following specific episodes of contact SA compared to specific episodes of genital irritant exposure.

Results: More parents/girls in SA group reported prior urogenital symptoms. Most SA girls said past symptoms were caused by inappropriate genital touching; most control girls could not identify causes for prior symptoms. Girls' responses following specific irritant exposures: 76% SA vs 24% control girls used negative terms to describe how it felt, 69% SA vs 6% control girls said it bothered her body and her feelings, and 33% SA vs 12% control girls described experiencing dysuria afterwards (all ps < 0.05).

Conclusions: Girls can relate urogenital symptoms to specific genital contacts; more SA girls reported unpleasant symptoms with an emotional component. A skilled medical history can help differentiate these conditions and diagnose sexual abuse with greater certainty.