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Signs of sexual trauma in children4/15/2024 ![]() ![]() ![]() showed that in a group of 161 abused girls, 59.6% reported urogenital symptoms. The authors showed that 62,9% of children had physical symptoms, 2.8% had abnormal genital findings, 2.5% had urinary tract infections and 1.9% contractd sexually transmitted infections. in a large report from New Zealand reviewed 2310 cases. showed that in a group of 428 sexually abused children, 20% of the victims complained of one or more genitourinary symptoms. Additionally, rates of daytime incontinence, nocturnal enuresis, diurnal incontinence, urgency, and continence maneuvers were 25.7%, 17.1%, 22.9%, 42.9%, and 20%, respectively, in the sexual touch group, while they were found to be 5.9%, 0%, 0%, 17.6%, and 5.9%, respectively, in the sexual penetration group. ![]() However, the difference was not statistically significant. Another study conducted by Yildirim et al., presented an incontinence rate of 30.76% and 23.3% in the sexually abused group and in the control group, respectively. Another study has shown that young rape victims were 2.7 times more likely to have pelvic floor dysfunction, including lower urinary tract disorders, than non-victimized controls. One recent study, conducted on 1280 children, has shown that prevalence of enuresis was increased in children with allegations of sexual abuse when compared to the general pediatric population and concerned 13% of 5–9 year olds, 14.7% of 10–16 year olds and 18.2% of 17–18 year olds. They include daytime incontinence in 2.1–3.1% of children, urgency in 1.3–4.7% and nighttime incontinence in 1.5–8.9%. In the pediatric population which has not been exposed to sexual abuse, urinary symptoms are reported in about 2–9% of children. Yet, urinary symptoms are often present in children exposed to sexual violence. However, only a few papers were published about children and some have failed to demonstrate a statistically significant association ( Table 1). A similar observation concerns people with urinary symptoms and posttraumatic stress disorder. Studies concerning urinary symptoms in sexually abused adults confirm an association between the occurrence of sexual exploitation and urological symptoms. In a study examining 551 cases of CSA reported in the U.S., only 8 cases (1.5%) were deemed false accusations of sexual abuse. ![]() Any suggestion given by a child should raise the level of concern that sexual abuse has occurred, because children very infrequently feign stories of sexual abuse. It is necessary to maintain a high level of vigilance because physical findings may not be easily detectable. Pediatricians and urologists who routinely see patients with voiding problems are in an exceptional position to identify children who have been victimized. More frequently children are referred to a urologist because of urogenital system complaints, such as recurrent infections, hematuria, dysuria, chronic pain in the lower abdomen, urinary retention, daytime and nighttime incontinence or LUTS symptoms like, nocturia, urinary frequency, painful voiding or urgency. Ĭonfirmation of possible CSA is rarely a direct reason for a child to visit an urologist. The majority of victims describe a single type of sexual activity, but over 20% have experienced multiple types of forced sexual acts. Most children, that is 75% to 85%, are abused by a male perpetrator known to the child. Boys also experience more severe forms of CSA. Girls are abused more often when compared to boys, however, the abuse towards boys is more often associated with physical violence. In Poland, 14.4% of girls and 3.9% of boys experienced sexual exploitation. According to data from European countries, sexual abuse of children affects 10-40% of girls and 5–20% of boys. ![]()
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