In this section
History should include:
General assessment of the child looking for evidence of other injuries.
Examination should be performed only ONCE therefore, consider early involvement of a senior clinician. If suspicious of non-accidental injury contact the Victoria Forensic Paediatric Medical Service (VFPMS) on 1300 66 11 42 for advice prior to performing your examination.
Examination is usually performed in the supine frog-legged position. Explanation and gentle handling of the child is important. Consider analgesia +/- procedural sedation.
Document a detailed description of the injury. A clockface can often be used to describe the location of the injury (see diagram below).
Features to consider on examination:
General principles of care
If suspicious of non-accidental injury contact the Victoria Forensic Paediatric Medical Service (VFPMS) on 1300 66 11 42 for advice/assessment.
Severity of Injury
Follow up / Consultation
(bleeding is minor or has stopped and the child can void spontaneously)
Salt water baths for comfort
Topical anaesthetic cream or barrier cream to reduce local pain on micturation
Reduction in strenuous activity for 24 hours to prevent re-injury
(Ongoing bleeding, laceration borders not visualised, labia minora tear, unable to void, clinician concern)
Management as above
Consider urethral catheter if unable to void e.g. in the presence of a large vulval hematoma
Local paediatric team
Local Gynaecology service
Parent information sheet: link to handout