Genital lesions after consensual sexual intercourse: They are frequent and they last for several days

Introduction: The significance of genital lesions in victims of rape is currently under debate in many countries. Legal experts are pointing at the lack of comprehensive knowledge of lesions sustained during consensual sexual intercourse as a key problem. The aim of this study was to provide insight into the duration of lesions, frequency of lesions seen with different investigative techniques and to identify pitfalls in the diagnosis of lesions.
Materials and Methods: 98 women were examined within 48 hours of consensual sexual intercourse using the naked eye, the colposcope and toluidine blue dye application. 50 of the women were re-examined after 3 or 4 days and again after 6 or 7 days, and Kaplan-Meier plots of the duration of lacerations were produced.
Results: Lacerations were the most frequent lesion seen with all three techniques, seen in 31%, 41% and 49% of participants, respectively. The median survival time for lacerations was 24 hours (n=19) seen with the naked eye, 40 hours seen with the colposcope (n=28) and 80 hours seen with toluidine blue dye (n=26). Several important pitfalls in the diagnosis of lesions using the three techniques were identified. We propose a model for the interpretation of lesions
Conclusions: Lesions are frequently seen after consensual sexual intercourse and they last for several days. Interpretation of genital lesions is not straightforward and care must be taken in both research and praxis to make the right conclusions.