Girls who have been abused sexually are more likely to be diagnosed with urinary and genital health problems, new data indicate.
The information may help physicians intervene early on with sexually abused girls to prevent problems or keep them from persisting or worsening into adulthood, say authors of a study published online December 19 in the Journal of Pediatrics.
Pascale Vézina-Gagnon, a PhD candidate from the Department of Psychology, Université de Montréal, Québec, Canada, and colleagues compared a group of 882 children who had been victims of sexual abuse with a group of 882 children from the general population.
They found that sexually abused girls (up to 12 years after the abuse) were 2.1 times as likely to be diagnosed with urinary problems and 1.4 times more likely to be diagnosed with genital health problems than girls in the general population.
The researchers did not find a significant link between boys who were sexually abused and genital or urinary health problems.
Vézina-Gagnon told Medscape Medical News that reasons for that may include that genitourinary problems may not be the best system to check in boys when looking for links between sexual abuse and physical problems. Checking their gastrointestinal health, for instance, may provide more information, she said.
Also, as the study covered only up to 12 years after the abuse, it may have missed any effect on the prostate that could take longer to develop. “Maybe it’s too early to see the difference,” she said.
The researchers also did not find a link between the number of sexually transmitted infections and sexual abuse in children, which was a surprise, Vézina-Gagnon said, noting that that association has been seen in previous studies of adults.
That could be a limitation of the databases, she said, as they included people only up to age 18 years, and many children may not be sexually active by then.
Asked whether, given these findings, urinary and genital health problems could be seen as a signal to further investigate the possibility of sexual abuse, Vézina-Gagnon said because those symptoms are fairly common among girls, that may be impractical and not supported by this study. But, she added, having conversations about sexual activity with all patients is important.
The most commonly reported urinary problems in the study population were urinary tract infections and bacterial infections in the kidneys. The most frequently reported genital problems were vaginitis; penile disorders; inflammation of the cervix, the uterus, the vagina and the vulva; and ovarian cysts and menstrual problems.
Previous studies on the link between sexual abuse and physical health have focused on adults and often asked them to self-report victimization and health issues in the past.
This study used three Canadian administrative databases to determine relevant diagnoses between January 1996 and March 2013. This study also included boys when most previous studies among adolescents focused only on girls.
The authors write that infections related to genitourinary health, such as sexually transmitted infections, urinary tract infections, and vaginitis, are particularly important to track during adolescence, when sexual activity often begins.
Adolescence is a critical period for preventing infections and disease before they become chronic, they note.
Vézina-Gagnon said the next step for her research is to see whether among sexually abused girls who have genitourinary problems there is a stronger association when they also have psychological problems.
“That could help explain why some girls who have been sexually abused have more genitourinary problems than others,” she said.
The study was funded by a grant from Québec’s Ministry of Justice and a scholarship from the Fonds de recherche du Québec–Santé. The authors have disclosed no relevant financial relationships.
J Pediatrics. Published online December 19, 2017. Full text
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