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Sexual Assault Examination

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Book cover Clinical Forensic Medicine

Abstract

Sexual assaults create significant health and legislative problems for every society. All health professionals who have the potential to encounter victims of sexual assaults should have some understanding of the acute and chronic health problems that may ensue from an assault. However, the primary clinical forensic assessment of complainants and suspects of sexual assault should only be conducted by doctors and nurses who have acquired specialist knowledge, skills, and attitudes during theoretical and practical training.

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References

  1. Bays, J., Chadwick, D. Medical diagnosis of the sexually abused child. Child Abuse Negl. 17:91–110, 1993.

    Article  PubMed  CAS  Google Scholar 

  2. Heger, A., Emans, S. J., Muram, D., eds. Evaluation of the Sexually Abused Child. Oxford University Press, New York, NY, 2000.

    Google Scholar 

  3. Royal College of Physicians. Physical Signs of Sexual Abuse in Children. RCP, London, UK, 1997.

    Google Scholar 

  4. General Medical Council. Intimate Examinations. GMC, London, UK, 1996.

    Google Scholar 

  5. Hicks, D. J. Rape: Sexual assault. Am. J. Obstet. Gynecol. 137:931–935, 1980.

    PubMed  CAS  Google Scholar 

  6. Evrard, J. R., Gold, G. M. Epidemiology and management of sexual assault victims. Obstet. Gynecol. 53:381–387, 1979.

    PubMed  CAS  Google Scholar 

  7. Keating, S. M., Allard, J. E. What’s in a name? Medical samples and scientific evidence in sexual assaults. Med. Sci. Law. 34:187–201, 1994.

    PubMed  CAS  Google Scholar 

  8. Keating, S. M. The laboratory’s approach to sexual assault cases. Part 1: sources of information and acts of intercourse. J. Forensic. Sci. Soc. 28:35–47, 1988.

    PubMed  CAS  Google Scholar 

  9. Clark, M. D. B. Metropolitan Police Laboratory Examination Kit for Sexual Offences. Police Surg. 15:447–452, 1979.

    Google Scholar 

  10. Ranson, D. The forensic medical examination. In: Forensic Medicine and the Law. Melbourne University Press, Victoria, Australia, pp. 119–127, 1996.

    Google Scholar 

  11. Kafarowski, E., Lyon, A. M., Sloan, M. M. The retention and transfer of spermatozoa in clothing by machine washing. Can. Soc. Forensic Sci. J. 29:7–11, 1996.

    Google Scholar 

  12. Benecke, M. DNA typing in forensic medicine and in criminal investigations: a current survey. Naturwissenschaften. 84:181–188, 1997.

    Article  PubMed  CAS  Google Scholar 

  13. Mannucci, A., Sullivan, K. M., Ivanov, P. L., Gill, P. Forensic application of a rapid and quantitative DNA sex test by amplification of the X-Y homologous gene amelogenin. Int. J. Leg. Med. 106:190–193, 1994.

    Article  CAS  Google Scholar 

  14. Foreman, L. A., Evett, I. W. Statistical analyses to support forensic interpretation for a new ten-locus STR profiling system. Int. J. Leg. Med. 114:147–155, 2001.

    Article  CAS  Google Scholar 

  15. Gill, P. Role of short tandem repeat DNA in forensic casework in the UK—past, present and future perspectives. Biotechniques. 32:366–372, 2002.

    PubMed  CAS  Google Scholar 

  16. Werrett, D. J. The national database. Forensic Sci. Int. 88:33–42, 1997.

    Article  Google Scholar 

  17. Hoyle, R. The FBI’s national database. Biotechnology. 16:987, 1998.

    Article  CAS  Google Scholar 

  18. Gill, P., Sparkes, B., Fereday, L., Werrett, D. J. Report of the European Network of Forensic Science Institutes (ENFSI): formulation and testing of principles to evaluate STR multiplexes. Forensic Sci. Int. 108:1–29.

    Google Scholar 

  19. Bar, W., Brinkman, B., Budowle, B., et al. DNA recommendations. Further report of the DNA Commission of the ISFH regarding the use of short tandem repeat systems. International Society for Forensic Haemogenetics. Int. J. Leg. Med. 110:175–176, 1997.

    Article  CAS  Google Scholar 

  20. Olaisen, B., Bar, W., Brinkmann, B., et al. DNA recommendations of the International Society for Forensic Genetics. Vox-Sang. 74:61–63, 1998.

    Article  PubMed  CAS  Google Scholar 

  21. Leriche, A., et al. Final report of the Interpol Working Party on DNA profiling. Proceedings from the 2nd Eurpoean Symposium on Human Idenitification. Promege Corporation, 48–54, 1998.

    Google Scholar 

  22. The Forensic Science Service. Low copy number DNA profiling. Available at Website: (http://128.1.18.1/html/corpcomm/hotnews/low.copy.htm).

  23. Monckton, D. G., Jeffreys, A. J. DNA profiling. Curr. Opin. Biotechnol. 4:660–664, 1993.

    Article  PubMed  CAS  Google Scholar 

  24. Rutty, G. An investigation into the transference and survivability of human DNA following simulated manual strangulation with consideration of the problem of third party contamination. Int. J. Leg. Med. 116:170–173, 2001.

    Article  Google Scholar 

  25. Sweet, D. J. Human bite marks—examination, recovery and analysis. In: Bowers, C. M. and Bell, G. L., eds., Manual of Forensic Odontology. American Society of Forensic Odontology, Colorado Springs, CO, 1995.

    Google Scholar 

  26. Clift, A., Lamont, C. M. Saliva in forensic odontology. J. Forensic Sci. Soc. 14:241–245, 1974.

    PubMed  CAS  Google Scholar 

  27. Bowers, C. M., Bell, G. L., eds. Manual of Forensic Odontology. American Society of Forensic Odontology, Colorado Springs, CO, 1995.

    Google Scholar 

  28. Sweet, D., Lorente, M., Lorente, J. A., Valenzuela, A., Villanueva, E. An improved method to recover saliva from human skin: the double swab technique. J. Forensic Sci. Soc. 42: 320–322, 1997.

    CAS  Google Scholar 

  29. Girardin, B. W., Faugno, D. K., Seneski, P. C., Slaughter, L., Whelan, M. Care of the sexually assaulted patient. In: Color Atlas of Sexual Assault.Mosby, St. Louis, MO, 1997, p. 96.

    Google Scholar 

  30. Lynnerup, N., Hjalgrim, H. Routine use of ultraviolet light in medicolegal examinations to evaluate stains and skin trauma. Med. Sci. Law. 35:165–168, 1995.

    PubMed  CAS  Google Scholar 

  31. Santucci, K., Nelson, D., Kemedy, K., McQuillen, K., Duffy, S., Linakis, J. Wood’s lamp utility in the identification of semen. Pediatrics. 104:1342–1344, 1999.

    Article  PubMed  CAS  Google Scholar 

  32. Jones, D. N. The task of the Forensic Science Laboratory in the investigation of sexual offences. J. Forensic Sci. Soc. 3:88–93, 1963.

    Google Scholar 

  33. Stoilovic, M. Detection of semen and blood stains using Polilight® as a light source. Forensic Sci. Int. 51:289–296, 1991.

    Article  PubMed  CAS  Google Scholar 

  34. Marshall, S., Bennett, A., Fravel, H. Locating semen on live skin using visible fluorescence. Paper presented at the Sixth International Conference in Clinical Forensic Medicine of the World Police Medical Officers, March 17–22, Sydney, Australia, 2002.

    Google Scholar 

  35. Nelson, D. G., Santucci, K. A. An alternative light source to detect semen. Acad. Emerg. Med. 9:1045–1048, 2002.

    Article  PubMed  Google Scholar 

  36. Sweet, D., Lorente, J. A., Valenzuela A., Lorente, M., Villanueva, E. PCR-based DNA typing of saliva stains recovered from human skin. J. Forensic Sci. Soc. 42:447–451, 1997.

    CAS  Google Scholar 

  37. Cartwright, P. S. Reported sexual assault in Nashville-Davidson County, Tennessee, 1980–1982. Am. J. Obstet. Gynecol. 154:1064–1068, 1986.

    PubMed  CAS  Google Scholar 

  38. Everett, R. B., Jimerson, G. K. The rape victim: a review of 117 consecutive cases. Obstet. Gynecol. 50:88–90, 1977.

    PubMed  CAS  Google Scholar 

  39. Soules, M. R., Stewart, S. K., Brown, K. M., Pollard, A. A. The spectrum of alleged rape. J. Reprod. Med. 20:33–39, 1978.

    PubMed  CAS  Google Scholar 

  40. Kerr, E., Cottee, C., Chowdhury, R., Jawad, R., Welch, J. The Haven: a pilot referral centre in London for cases of serious sexual assault. Br. J. Obstet. Gynaecol. 110:267–271, 2003.

    Google Scholar 

  41. Riggs, N., Houry, D., Long, G., Markovchick, V., Feldhaus, K. Analysis of 1,076 cases of sexual assault. Ann. Emerg. Med. 35:358–362, 2000.

    Article  PubMed  CAS  Google Scholar 

  42. Vale, G. L., Noguchi, T. T. Anatomical distribution of human bite marks in a series of 67 cases. J. Forensic Sci. Soc. 28:61–69, 1983.

    CAS  Google Scholar 

  43. Wright, R., West, D. J. Rape—a comparison of group offences and lone assaults. Med. Sci. Law. 21:25–30, 1981.

    PubMed  CAS  Google Scholar 

  44. Muller, C., Vogt, S., Goerke, R., Kordan, A., Weinmann, W. Identification of selected psychopharmaceuticals and their metabolites in hair by LC/ESI-CID/MS and LC/MS/MS. Forensic Sci. Int. 113:415–421, 2000.

    Article  PubMed  CAS  Google Scholar 

  45. Kintz, P., Cirimele, V., Jamey, C., Ludes, B. Testing for GHB in hair by GC/MS/MS after single exposure. Application to document sexual assault. J. Forensic Sci. 48:195–199, 2003.

    PubMed  CAS  Google Scholar 

  46. Negrusz, A., Moore, C. M., Hinkel, K. B., et al. Deposition of 7-aminoflunitrazepam and flunitrazepam in hair after a single dose of Rohypnol®. J. Forensic Sci. 46:1–9, 2001.

    Google Scholar 

  47. Guterman, L. Nailing the drug rapists. New Scientist. 160:4, 1998.

    Google Scholar 

  48. Wicks, J. Managing Director Tricho-Tec Ltd. Paper presented at the Association of Police Surgeons Autumn Symposium, Northamtpon, UK, November 2001.

    Google Scholar 

  49. Ledray, L. (1993) Evidence collection: an update. J. Sexual Abuse. 2:113–115.

    Article  Google Scholar 

  50. Young, W., Bracken, A. C., Goddard, M. A. A., Matheson, S. The New Hampshire sexual assault medical examination protocol project committee sexual assault: review of a national model protocol for forensic and medical evaluation. Obstet Gynecol. 80:878–883, 1992.

    PubMed  CAS  Google Scholar 

  51. Salter, M. T., Cooke, R. The significance of transfer of fibres to head hair, their persistence and retrieval. Forensic Sci. Int. 1981:211–221, 1996.

    Article  Google Scholar 

  52. Exline, D. L., Smith, F. P., Drexler, S. G. Frequency of pubic hair transfer during sexual intercourse. J. Forensic Sci. 43:505–508, 1998.

    PubMed  CAS  Google Scholar 

  53. Mann, M. J. Hair transfers in sexual assault: a six-year case study. J. Forensic Sci. Soc. 35:951–955, 1990.

    CAS  Google Scholar 

  54. Stone, I. C. Hair and its probative value as evidence. Texas Bar J. 45:275–279, 1982.

    Google Scholar 

  55. Riis, R. Sexual assault combing evidence. Presented at the NWAFS Meeting, Jackson Hole, WY, 1990.

    Google Scholar 

  56. Higuchi, R., Von Beroldingen, C. H., Sensabaugh, G. F., Erlich, H. A. DNA typing from single hairs. Nature. 332:543–546, 1988.

    Article  PubMed  CAS  Google Scholar 

  57. Prahlow, J. A., Lantz, P. E., Cox-Jones, K., Rao, P.N., Pettenati, M. J. Gender identification of human hair using fluoresence in situ hybridisation. J. Forensic Sci. 41:1035–1037, 1996.

    PubMed  CAS  Google Scholar 

  58. Cirimele, V., Kinttz, P., Staub, C., Mangin, P. Testing of human hair of flunitrazepam and 7-amino-flunitrazepam by GC/MS-NCY. Forensic Sci. Int. 84:189–200, 1997.

    Article  PubMed  CAS  Google Scholar 

  59. Ropero-Miller, J. D., Goldberger, B. A., Cone, E. J., Joseph, R. E. The deposition of cocaine and opiate analytes in hair and fingernails of humans following cocaine and codeine administration. J. Anal. Toxicol. 24:496–508, 2000.

    PubMed  CAS  Google Scholar 

  60. Tsatsakis, A. M., Psillakis, T., Paritsis, N. Phenytoin concentration in head hair sections: a method to evaluate the history of drug use. J. Clin. Psychopharmacol. 20:560–573, 2000.

    Article  PubMed  CAS  Google Scholar 

  61. Enos, W. F., Beyer, J. C. The importance of examining skin and hair for semen in sexual assault cases. J. Forensic Sci. Soc. 26:605–607, 1981.

    CAS  Google Scholar 

  62. Thomas, F., Baert, H. A new means of identification of the human being: the longitudinal striation of the nails. Med Sci Law. 5, 39–40, 1965.

    PubMed  CAS  Google Scholar 

  63. Lederer, T., Betz, P. Seidi, S. DNA analysis of fingernail debris using different multiplex systems: a case report. Int J Legal Med. 114, 263–266, 2001.

    Article  PubMed  CAS  Google Scholar 

  64. Evans, B. A., Bond, R. A., Macrae, K. D. Sexual behaviour in women attending a genitourinary medicine clinic. Genitourin Med. 64:43–48, 1988.

    PubMed  CAS  Google Scholar 

  65. Keating, S. M., Higgs, D. F. Oral sex—further information from sexual assault cases. J Forensic Sci Soc. 32:327–331, 1992.

    PubMed  CAS  Google Scholar 

  66. Bradham, G. B. The establishment of a treatment center for victims of rape. JSC Med Assoc. June, 283–286, 1981.

    Google Scholar 

  67. Sexual Offences Act. Website: (http://www.publications.parliament.uk), Home Office, London, UK, 2003.

  68. Lind, W., Carlson, D. Recovery of semen from chewing gum in an oral sexual assault. J Forensic Identification. 45, 280–282, 1995.

    Google Scholar 

  69. Hampton, H. L. Care of the woman who has been raped. N. Engl. J. Med. 332:234–237, 1995.

    Article  PubMed  CAS  Google Scholar 

  70. Willott, G. M., Crosse, M. A. The detection of spermatozoa in the mouth. J. Forensic Sci Soc. 26:125–128, 1986.

    PubMed  CAS  Google Scholar 

  71. Allard, J. E. The collection of data from findings in cases of sexual assault and the significance of spermatozoa on vaginal, anal and oral swabs. Sci. Justice. 37:99–108, 1997.

    PubMed  CAS  Google Scholar 

  72. Enos, W. F., Beyer, J. C. Spermatozoa in the anal canal and rectum and in the oral cavity of female rape victims. J. Forensic Sci. Soc. 23:231–233, 1978.

    CAS  Google Scholar 

  73. Schlesinger, S. L., Borbotsina, J., O’Neill, L. Petechial hemorrhages of the soft palate secondary to fellatio. Oral Surg. 40:376–378, 1975.

    Article  PubMed  CAS  Google Scholar 

  74. Giansanti, J. S., Cramer, J. R., Weathers, D. R. Palatal erythema, another etiologic factor. Oral Surg. 40:379–381, 1975.

    Article  PubMed  CAS  Google Scholar 

  75. Damm, D. D., White, D. K., Brinker, C. M. Variations of palatal erythema secondary to fellatio. Oral Surg. 52:417–421, 1981.

    Article  PubMed  CAS  Google Scholar 

  76. Girardin, B. W., Faugno, D. K., Seneski, P. C., Slaughter, L., Whelan, M. Findings in sexual asault and consensual intercourse. In: Color Atlas of Sexual Assault. Mosby, St. Louis, MO, 1997, p. 41.

    Google Scholar 

  77. Bellizzi, R., Krakow, A. M., Plack, W. Soft palate trauma associated with fellatio: case report. Mil. Med. 145:787–788, 1980.

    PubMed  CAS  Google Scholar 

  78. Girardin, B. W., Faugno, D. K., Seneski, P. C., Slaughter, L., Whelan, M. Findings in sexual asault and consensual intercourse. In: Color Atlas of Sexual Assault. Mosby, St. Louis, MO, 1997, p. 38.

    Google Scholar 

  79. Johnson, A. M., Wadsworth, J., Wellings, K., Field, J. Heterosexual practices. In: Sexual Attitudes and Lifestyles. Blackwell Scientific Publications, Oxford, UK, 1994, p. 160.

    Google Scholar 

  80. Bolling, D. R. Prevalence, goals and complications of heterosexual anal intercourse in a gynecologic population. J. Reprod. Med. 19:121–124, 1977.

    Google Scholar 

  81. Keating, S. M. Oral sex—a review of its prevalence and proof. J. Forensic Sci. Soc. 28:341–355, 1988.

    PubMed  CAS  Google Scholar 

  82. Keating, S. M., Higgs, D. F. The detection of amylase on swabs from sexual assault cases. J. Forensic Sci. Soc. 34:89–93, 1994.

    PubMed  CAS  Google Scholar 

  83. Skerlavy, M., Epstein, J. A., Sobrero, A. J. Cervical mucus amylase levels in normal menstrual cycles. Fertil. Steril. 19:726–730, 1968.

    Google Scholar 

  84. Banaschak, S., Moller, K., Pfeiffer, H. Potential DNA mixtures introduced through kissing. Int. J. Leg. Med. 111:284–285, 1998.

    Article  CAS  Google Scholar 

  85. Mader, C. L. Lingual frenulum ulcer resulting from orogenital sex. J. Am. Dent. Assoc. 103:888–890, 1981.

    PubMed  CAS  Google Scholar 

  86. Johnson, A. M., Wadsworth, J., Wellings, K., Field, J. Heterosexual practices. In: Sexual Attitudes and Lifestyles. Blackwell Scientific Publications, Oxford, UK, 1994.

    Google Scholar 

  87. Wellings, K., Nanchahai K., Macdowall, W., Sexual behaviour in Britan: early heterosexual experience. Lancet. 358:1843–1850, 2001.

    Article  PubMed  CAS  Google Scholar 

  88. Howitt, J., Rogers, D. J. Adult sexual offences and related matters. In: McLay, W. D. S., ed., Clinical Forensic Medicine. Greenwich Medical Media, Hong Kong, 1996, pp. 193–218.

    Google Scholar 

  89. Lines 1844 I.C. and K. 393.

    Google Scholar 

  90. Slaughter, L., Brown, C. R. V., Crowley, S., Peck, R. Patterns of genital injury in female sexual assault victims. Am. J. Obstet. Gynecol. 176:609–616, 1997.

    Article  PubMed  CAS  Google Scholar 

  91. Jenny, C., Kunhs, M. L., Fukiko, A. Presence of hymens in newborn female infants. Pediatrics. 80:399–400, 1987.

    PubMed  CAS  Google Scholar 

  92. Chadwick, D. L., Berkowitz, C. D., Kerns, D., McCann, J., Reinhart, M. A., Strickland, S. Color Atlas of Child Sexual Abuse. Year Book Medical Publishers, Chicago, IL, 1989.

    Google Scholar 

  93. Berenson, A., Chacko M. R., Wiemann, C. M., Mishaw, C. O., Friedrich, W. N., Grady, J. J. A case control study of anatomic changes resulting from sexual abuse. Am. J. Obstet. Gynecol. 182:820–834, 2000.

    Article  PubMed  CAS  Google Scholar 

  94. Berenson, A., Heger, A., Andrews, S. The appearance of the hymen in the newborn. Pediatrics. 87:458–465, 1991.

    PubMed  CAS  Google Scholar 

  95. Berenson, A. Appearance of the hymen in prepubertal girls. Pediatrics. 89:387–394, 1992.

    PubMed  CAS  Google Scholar 

  96. Emans, S. J., Woods, E., Allred, E., Grace, E. Hymenal findings in adolescent women, impact of tampon use and consensual sexual activity. Pediatrics. 125:153–160, 1994.

    Article  CAS  Google Scholar 

  97. Muram, D. Anatomic and physiological changes. In: Evaluation of the Sexually Abused Child. Oxford University Press, New York, NY, 1992, p. 72.

    Google Scholar 

  98. Emans, S. J. H., Goldstein, D. P. The physiology of puberty. In: Pediatric and Adolescent Gynecology, 3rd Ed., Little, Brown, Boston, MA, pp. 95–97, 1990.

    Google Scholar 

  99. Porkorny, S. F. Configuration of the prepubertal hymen. Am. J. Obstet. Gynecol. 157:950–956, 1987.

    Google Scholar 

  100. McCann, J., Wells, R., Simon, M., Voris, J. Genital findings in prepubertal girls selected for nonabuse: a descriptive study. Pediatrics. 86:428–439, 1990.

    PubMed  CAS  Google Scholar 

  101. Girardin, B. W., Faugno, D. K., Seneski, P. C., Slaughter, L., Whelan, M. Care of the sexually assaulted patient. In: Color Atlas of Sexual Assault. Mosby, St. Louis, MO, pp. 111–118, 1997.

    Google Scholar 

  102. Masters, W. H., Johnson, V. E. The vagina. In: The Human Sexual Response. Little Brown, Boston, MA, pp. 69–70, 1966.

    Google Scholar 

  103. Robinson, E. G. Management of the rape victim. Can. Med. Assoc. J. 115:520–523, 1976.

    PubMed  CAS  Google Scholar 

  104. Reade, D. J. Early scientific investigations of sexual assault. Police Surg. April:42–46, 1986.

    Google Scholar 

  105. Eungprabhanth, V. Finding of the spermatozoa in the vagina related to elapsed time of coitus. Z. Rechtamedizin. 74:301–304, 1974.

    Article  CAS  Google Scholar 

  106. Florence, A. Du sperme et des taches de sperme en medecine legale. Arch. d’Anthropol. Criminelle d’ Criminolo Psychol. Normale Pathol. 11:146–165, 1896.

    Google Scholar 

  107. Laurell, C. B. Electroimmunoassay. Scand. J. Clin. Lab. Invest. 29:21, 1972.

    CAS  Google Scholar 

  108. Collins, K. A., Rao, P. N., Hayworth, R., et al. Identification of sperm and non-sperm male cells in cervicovaginal smears using Fluoresecence In Situ Hybrid-isation—applications in alleged sexual assault cases. J. Forensic Sci. 39:1347–1355, 1994.

    PubMed  CAS  Google Scholar 

  109. Sibille, I., Duverneuil, C., Lorin de la Grandmaison, G., Y-STR DNA amplification as biological evidence in sexually assaulted female victims with no cytological detection of spermatozoa. Forensic Sci. Int. 125:212–216, 2002.

    Article  PubMed  CAS  Google Scholar 

  110. Rao, P. N., Collins, K. A., Geisinger, K. R., et al. Identification of male epithelial cells in routine post-coital cervicovaginal smears using Fluoresecence In Situ Hybridisation—application in sexual assault and molestation. Am. J. Clin. Path. 104:32–35, 1995.

    Google Scholar 

  111. Divall, G. B. Methods for the identification and menstrual blood. In: Lee, H.G. and Gaensslen, R.E., eds., Advances in Forensic Science, Biomedical Publications, Foster City, CA, pp. 1–14, 1985.

    Google Scholar 

  112. Allard, J. The facts of life. Contact-FSS Internal Publication. 25, 1996.

    Google Scholar 

  113. Davis, A., Wilson, E. The persistence of seminal constituents in the human vagina. Forensic Sci. 3:45–55, 1974.

    Article  Google Scholar 

  114. Graves, H. C. B., Sensabaugh, G. F., Blake, E. T. Postcoital detection of a male-specific semen protein: application to the investigation of rape. N. Engl. J. Med. 312:338–340, 1985.

    Article  PubMed  CAS  Google Scholar 

  115. Wilson, E. M. A comparison of the persistence of seminal constituents in the human vagina and cervix. Police Surg. 22:44–45, 1982.

    Google Scholar 

  116. Keating, S. M. The laboratory’s approach to sexual assault cases. Part 2. Demonstration of the possible offender. J. Forensic Sci. Soc. 28:99–110, 1988.

    PubMed  CAS  Google Scholar 

  117. Dziegelewski, M., Simich, J. P., Rittenhouse-Olson, K. Use of a Y chromosome probe as an aid in the forensic proof of sexual assault. J. Forensic Sci. 47:601–604, 2002.

    PubMed  Google Scholar 

  118. Gaensslen, R. E. Survival of spermatozoa in the vagina. In: Gaensslen, R. E., ed., Sourcebook in Forensic Serology, Immunology and Biochemistry. United States Government Printing Office, Washington, DC, pp. 144–152, 1983

    Google Scholar 

  119. Silverman, E. M., Silverman, A. G. Persistence of spermatozoa in the lower genital tracts of women. JAMA. 240:1875–1877, 1978.

    Article  PubMed  CAS  Google Scholar 

  120. Rupp, J. C. Sperm survival and prostatic acid phosphatase activity in victims of sexual assault. J. Forensic Sci. Soc. 14:177–183, 1969.

    CAS  Google Scholar 

  121. Paul, D. M. Examination of the living. In: Taylor’s Principles and Practice of Medical Jurisprudence, 13th Ed. Mant A. K., ed., Churchill Livingstone, Edinburgh, Scotland, pp. 64–105, 1984.

    Google Scholar 

  122. Allard, J. E. The collection of data from findings in cases of sexual assault and the significance of spermatozoa on vaginal, anal and oral swabs. Sci. Justice. 37:99–108, 1997.

    PubMed  CAS  Google Scholar 

  123. Slaughter, L., Brown, C. R. V. Colposcopy to establish physical findings in rape victims. Am. J. Obstet. Gynecol. 166:83–86, 1992.

    PubMed  CAS  Google Scholar 

  124. Cartwright, P. S., Moore, R. A., Anderson, J. R., Brown, D. H. Genital injury and implied consent to alleged rape. J. Reprod. Med. 31:1043–1044, 1986.

    PubMed  CAS  Google Scholar 

  125. Ramin, S. M., Satin, A. J., Stone, S. C., Wendel, G. D. Sexual assault in postmenopausal women. Obstet. Gynecol. 80:860–864, 1992.

    PubMed  CAS  Google Scholar 

  126. Norvell, M. K., Benrubi, G. I., Thompson, R. J. Investigations of microtrauma after sexual intercourse. J. Reprod. Med. 29:269–271, 1984.

    PubMed  CAS  Google Scholar 

  127. Fraser, I. S., Lahteenmaki, P., Elomaa, K., et al. Variations in vaginal epithelial surface appearance determined by colposcopic inspection in healthy sexually active women. Hum. Reprod. 14:1974–1978, 1999.

    Article  PubMed  CAS  Google Scholar 

  128. Lauber, A. A., Souma, M. L. Use of toluidine blue for documentation of traumatic intercourse. Obstet. Gynecol. 60:644–648, 1982.

    PubMed  CAS  Google Scholar 

  129. McCauley, J., Gorman, R. L., Guzinski, G. Toluidine blue in the detection of perineal lacerations in pediatric and adolescent sexual abuse victims. Pediatrics. 78:1039–1043, 1986.

    PubMed  CAS  Google Scholar 

  130. McCauley, J., Guzinski, G., Welch, R., Gorman, R., Osmers, F. Toluidine blue in the corroboration of rape in adult victim. Am. J. Emerg. Med. 5:105–108, 1987.

    Article  PubMed  CAS  Google Scholar 

  131. Wilson, K. F. G. Lower genital tract trauma. Aust. N. Z. J. Obstet. Gynaecol. 6:291–293, 1966.

    PubMed  CAS  Google Scholar 

  132. Adams, J. A., Girardin, B., Faugno, D. Adolescent sexual assault: documentation of acute injuries using photo-colposcopy. J. Pediatric Adolesc. Gynecol. 14:175–180, 2001.

    Article  CAS  Google Scholar 

  133. Bowyer, L., Dalton, M. E. Female victims of rape and their genital injuries. Br. J. Obstet. Gynecol. 104:617–620, 1997.

    CAS  Google Scholar 

  134. Manser, T. Findings in medical examinations of victims and offenders in cases of serious sexual offences—a survey. Police Surg. 38:4–27, 1991.

    Google Scholar 

  135. Kellogg, N. D., Parra, J. M. Linea vestibularis: a previously undescribed normal genital structure in female neonates. Pediatrics. 87:926–929, 1991.

    PubMed  CAS  Google Scholar 

  136. De San Lazaro, C., Sivaramakrishnan, S. Summer sandal genital injury. J. Clin. Forensic Med. 5:32–33, 1998.

    Article  PubMed  Google Scholar 

  137. Dowd, M. D., Fitzmaurice, L., Knapp, J. F., Mooney, D. The interpretation of urogenital findings in children with straddle injuries. J. Pediatric Surg. 29:7–10, 1994.

    Article  CAS  Google Scholar 

  138. Ferrell, J. Sexual assault: clinical issues, Foley catheter balloon technique for visualizing the hymen in female adolescent sexual abuse victims. J. Emerg. Nurs. 21:585–586, 1995.

    Article  PubMed  CAS  Google Scholar 

  139. Muram, D. Child sexual abuse: relationship between sexual acts and genital findings. Child Abuse Negl. 13:211–216, 1989.

    Article  PubMed  CAS  Google Scholar 

  140. McCann, J., Voris, J., Simon, M. Genital injuries resulting from sexual abuse: a longitudinal study. Pediatrics. 89:307–317, 1993.

    Google Scholar 

  141. Berkowitz, C., Evik, S., Logan, M. A simulated ‘acquired’ imperforate hymen following the genital trauma of sexual abuse. Clin. Pediatr. 26:307–309, 1993.

    Google Scholar 

  142. Goodyear-Smith, F. A., Laidlaw, T. M. What is an “intact hymen”? A critique of the literature. Med. Sci. Law. 38:289–301, 1998.

    PubMed  CAS  Google Scholar 

  143. Teixera, W. Hymenal colposcopic examination in sexual offences. Am. J. Forensic Med. Pathol. 3:201–214, 1981.

    Google Scholar 

  144. Underhill, R., Dewhurst, J. The doctor cannot always tell: medical examination of the ‘intact’ hymen. Lancet. 1:375–376, 1978.

    Article  PubMed  CAS  Google Scholar 

  145. Wilson, F., Swartz, D. P. Coital injuries of the vagina. Obstet Gynecol. 39:182–184, 1972.

    PubMed  CAS  Google Scholar 

  146. Fish, S. A. Vaginal injury due to coitus. Am. J. Obstet. Gynecol. 72:544–548, 1956.

    PubMed  CAS  Google Scholar 

  147. Metsala, P., Nieminen, U. Traumatic lesions of the vagina. Acta Obstet. Gynecol. Scand. 47:483–488, 1968.

    Article  Google Scholar 

  148. Gray, M. J., Norton, P., Treadwell, K. Tampon-induced injuries. Obstet. Gynecol. 58:667–668, 1981.

    PubMed  CAS  Google Scholar 

  149. Hakanson, E. Y. Trauma to the female genitalia. Lancet. 86:286–291, 1966.

    Google Scholar 

  150. Burgess, A. W., Holmstrom, L. L. The rape victim in the emergency ward. Am. J. Nurs. 73:1741–1745, 1973.

    Google Scholar 

  151. Slaughter, L., Brown, C. R. V. Cervical findings in rape victims. Am. J. Obstet. Gynecol. 164:528–529, 1991.

    PubMed  CAS  Google Scholar 

  152. Fraser, I. S., Lahteenmaki, P., Elomaa, K., et al. Variations in vaginal epithelial surface appearance determined by colposcopic inspection in healthy, sexually active women. Hum. Reprod. 14:1974–1978, 1999.

    Article  PubMed  CAS  Google Scholar 

  153. Masters, W. H., Johnson, V. E. The penis. In: The Human Sexual Response. Little Brown, Boston, MA, pp. 171–203, 1966.

    Google Scholar 

  154. Muram, D. Anatomy. In: Hegar, A. and Emans, S. J., eds., Evaluation of the Sexually Abused Child. Oxford University Press, New York, NY, p. 73, 1992.

    Google Scholar 

  155. Girardin, B. W., Faugno, D. K., Seneski, P. C., Slaughter, L., Whelan, M. Anatomy and the human sexual response. In: Color Atlas of Sexual Asault. Mosby, St. Louis, MO, p. 11, 1997.

    Google Scholar 

  156. Stephen, J. C., Collins, K. A., Pettenati, M. J., Fitts, M. Isolation and identification of female DNA on post-coital penile swabs. Am. J. Forensic Med. Pathol. 21:97–100, 2000.

    Article  Google Scholar 

  157. Farah, R., Cerny, J. C. Penis tourniquet syndrome and penile amputation. Urology. 11:310–311, 1973.

    Article  Google Scholar 

  158. Garty, B. Z., Mimouni, M., Varsano, I. Penile tourniquet sydrome. Cutis. 31:431–432, 1983.

    PubMed  CAS  Google Scholar 

  159. Kerry, R. L., Chapman, D. D. Strangulation of appendages by hair and thread. Pediatric Surg. 8:23–27, 1973.

    Article  CAS  Google Scholar 

  160. Wheatley, J. K. Genital injury during intercourse. Med. Aspects Hum. Sex. 17:24A–24J, 1983.

    Google Scholar 

  161. Ball, T. P., Pickett, J. D. Traumatic lymphangitis of penis. Urology. IV:594–597, 1975.

    Article  Google Scholar 

  162. Davies, D. M., Mitchell, I. Fracture of the penis. Br. J. Urol. 50:426, 1978.

    PubMed  CAS  Google Scholar 

  163. Pryor, J. P., Hill, J. T., Packham, D. A., Yates-Bell, A. J. Penile injuries with particular reference to injury to the erectile tissue. Br. J. Urol. 53:42–46, 1981.

    PubMed  CAS  Google Scholar 

  164. Paul, D. M. The medical examination of the live rape victim and the accused. Leg. Med. Ann. 139-153, 1977.

    Google Scholar 

  165. Wells, D. L. Genital trauma amongst young boys. J. Clin. Forensic Med. 3:129–132, 1996.

    Article  PubMed  CAS  Google Scholar 

  166. Hobbs, C. J., Wynne. J. M. Physical signs of child abuse. W. B. Saunders, Philadelphia, PA, 1996.

    Google Scholar 

  167. Johnson, A. M., Wadsworth, J., Wellings, K., Field, J. Heterosexual practices. In: Sexual Attitudes and Lifestyles. Blackwell Scientific Publications, Oxford, UK, p. 163, 1994.

    Google Scholar 

  168. Johnson, A. M., Wadsworth, J., Wellings, K., Field, J. Sexual diversity and homosexual behaviour. In: Sexual Attitudes and Lifestyles. Blackwell Scientific Publications, Oxford, UK, pp. 183–223, 1994.

    Google Scholar 

  169. Bang, L. Rape victims—assaults, injuries and treatment at a medical rape trauma service at Oslo Emergency Hospital. Scand. J. Primary Health Care. 11:15–20, 1993.

    CAS  Google Scholar 

  170. Hillman, R. J., O’Mara, N., Taylor-Robinson, D., Williams Harris, J. R. Medical and social aspects of sexual assault of males: a survey of 100 victims. Br. J. Gen. Pract. 40:502–504, 1990.

    PubMed  CAS  Google Scholar 

  171. Hillman, R., O’Mara, N., Tomlinson, D., William Harris, J. R. Adult male victims of sexual assault: an underdiagnosed condition. Int. J. STD AIDS. 2:22–24, 1991.

    PubMed  CAS  Google Scholar 

  172. Temkin, J. Rape and the Legal Process. Sweet & Maxwell, London, UK, 1987.

    Google Scholar 

  173. Royal College of Physicians. Glossary of terms. In: Physical Signs of Sexual Abuse in Children. RCP, London, UK, pp. 67–68, 1997.

    Google Scholar 

  174. Girardin, B. W., Faugno, D. K., Seneski, P. C., Slaughter, L., Whelan, M. Anatomy and the human sexual response. In: Color Atlas of Sexual Assault. Mosby, St. Louis, MO, pp. 14–16, 1997.

    Google Scholar 

  175. Fenger, C. Anal canal. In: Sternberg, S. S., ed., Histology for Pathologists, 2nd Ed., Lippincott-Raven, Philadelphia, PA, pp. 551–571, 1997.

    Google Scholar 

  176. Nivatovongs, S., Stern, H. S., Fryd, D. S. The length of the anal canal. Dis. Colon Rectum. 24:600–611, 1981.

    Article  Google Scholar 

  177. Goligher, J. Surgical anatomy and physiology of the anus, rectum and colon. In: Surgery of the Anus, Rectum and Colon, 5th Ed. Baillière Tindall, London, UK, p. 15, 1984.

    Google Scholar 

  178. Parks, A. G., Porter, N. H., Melzak, J. Experimental study of the reflex mechanism controlling the muscles of the pelvic floor. Dis. Colon Rectum. 5:401–414, 1962.

    Article  Google Scholar 

  179. Davies, A. Discussion of spermatozoa in the anal canal and rectum and in the oral cavity of female rape victims. J. Forensic Sci. Soc. 24:541–542, 1979.

    CAS  Google Scholar 

  180. Green, R. J., Sayce, M. D. Problems associated with the typing of semen on anal swabs. J. Forensic Sci. Soc. 25:55–56, 1985.

    PubMed  CAS  Google Scholar 

  181. Willott, G. M., Allard, J. E. Spermatozoa—their persistence after sexual intercourse. Forensic Sci. Int. 19:135–154, 1982.

    Article  PubMed  CAS  Google Scholar 

  182. Bush, R. A., Owen, W. F. Trauma and other noninfectious problems in homosexual men. Med. Clin. North Am. 70:549–566, 1986.

    PubMed  Google Scholar 

  183. Goligher, J. Anal fissure. In: Surgery of the Anus, Rectum and Colon, 5th ed. Baillière Tindall, London, UK, p. 150, 1984.

    Google Scholar 

  184. Keighley, M. R. B., Williams, N. S. Fissure in ano. In: Surgery of the Anus, Rectum and Colon. Saunders, Philadelphia, PA, pp. 364–386, 1993.

    Google Scholar 

  185. Girardin, B. W., Faugno, D. K., Seneski, P. C., Slaughter, L., Whelan, M. Findings in sexual assault and consensual intercourse. In: Color Atlas of Sexual Assault. Mosby, St. Louis, MO, p. 50, 1997.

    Google Scholar 

  186. Girardin, B. W., Faugno, D. K., Seneski, P. C., Slaughter, L., Whelan, M. Glossary. In: Color Atlas of Sexual Assault. Mosby, St. Louis, MO, p. 192, 1997.

    Google Scholar 

  187. Crass, R. A., Tranbaugh, R. F., Kudsk, K. A., Trunkey, D. D. Colorectal foreign bodies and perforation. Am. J. Surg. 142:85–88, 1981.

    Article  PubMed  CAS  Google Scholar 

  188. Barone, J. E., Yee, J., Nealon, T. F. Management of foreign bodies and trauma of the rectum. Surg. Gynecol. Obstet. 56:453–457, 1983.

    Google Scholar 

  189. Rakotomalala, L., de Parades, V., Parisot, C., Atienza, P. Ruptures multiples du sphincter interne après viol anal: une cause peu connue d’incontinence anale. Gastroenterol. Clin. Biol. 20:1142–1143, 1996.

    PubMed  CAS  Google Scholar 

  190. Chun, A. B., Rose, S., Mitrani, C., Silvestre, A. J., Wald, A. Anal sphincter structure and function in homosexual males engaging in anoreceptive intercourse. Am. J. Gastroenterol. 92:465–468, 1997.

    PubMed  CAS  Google Scholar 

  191. Miles, A. J. G., Allen-Mersh, T. G., Wastell, C. Effect of anoreceptive intercourse on anorectal function. J. R. Soc. Med. 86:144–147, 1993.

    PubMed  CAS  Google Scholar 

  192. Blackledge, R.D., Condom trace evidence: a new factor in sexual assault investigations. FBI Law Enforcement Bull, May 12–16, 1996.

    Google Scholar 

  193. Greaves, C. Safe sex? Is it so safe? Contact-FSS Internal Publication. 25:20–21, 1998.

    Google Scholar 

  194. McCrane W.C., Delly J.G. (1973) The Particles Atlas. 3:600, 702, 1973.

    Google Scholar 

  195. Blackledge, R. D., Vincenti, M. Identification of polydimethylsiloxane lubricant traces from latex condoms in cases of sexual assault. J. Forensic Sci. Soc. 34:245–256, 1994.

    Article  PubMed  CAS  Google Scholar 

  196. Jansen, K. Date rape drugs. Bull. Int. Assoc. Forensic Toxicol. 28:18–20, 1998.

    Google Scholar 

  197. Ferner, R. E. Ethanol. In: Forensic Pharmacology. Oxford University Press, Oxford, UK, pp. 122–124, 1996.

    Google Scholar 

  198. Kubba, A., Wilkinson, C. Recommendations for Clinical Practice: Emergency Contraception. FFP & RHC RCOG, London, UK, 1998.

    Google Scholar 

  199. Jenny, C., Hooton, T. M., Bowers, A., et al. Sexually transmitted diseases in victims of rape. N. Engl. J. Med. 322:713–716, 1990.

    Article  PubMed  CAS  Google Scholar 

  200. Estreich, S., Forster, G. E., Robinson, A. Sexually transmitted diseases in rape victims. Genitourin Med. 66:433–438, 1990.

    PubMed  CAS  Google Scholar 

  201. Robinson, A. J., Watkeys, J. E. M., and Ridgeway, G. L. Sexually transmitted organisms in sexually abused children. Arch. Dis. Child. 79:356–358, 1998.

    PubMed  CAS  Google Scholar 

  202. British Association for Sexual Health and HIV. National guidelines on the management of adult victims if sexual assault. Available at Website: (http://www.mssvd.org). Accessed on November 3, 2002.

  203. Ross, J. D. C., Scott, G. R., Busuttil, A. Rape and sexually transmitted diseases: patterns of referral and incidence in a department of genitourinary medicine. J. R. Soc. Med. 84:657–659, 1991.

    PubMed  CAS  Google Scholar 

  204. Lacey, H. B. Rape, the law and medical practitioners. Br. J. Sex. Med. Winter:89–92, 1991.

    Google Scholar 

  205. Hammerschlag, M. R. Sexually transmitted diseases in sexually abused children: medical and legal implications. Sex. Transm. Inf. 74:167–174, 1998.

    Article  CAS  Google Scholar 

  206. Thomas, A., Forster, G., Robinson, A. Rogstad K. National guidelines on the management of suspected sexually transmitted infections in children and young people. Available at Website: (http://www.mssvd.org). Accessed 2003.

  207. Girardin, B. W., Faugno, D. K., Seneski, P. C., Slaughter, L., Whelan, M. Care of the sexually assaulted patient. In: Color Atlas of Sexual Assault. Mosby, St. Louis, MO, p. 123, 1997.

    Google Scholar 

  208. Hochbaum, S. R. The evaluation and treatment of the sexually assaulted patient. Emerg. Med. Clin North Am. 5:601–622, 1987.

    PubMed  CAS  Google Scholar 

  209. Gibb, A. M., McManus, T., Forster, G. E. Should we offer antibiotic prophylaxis post sexual assault? Int. J. STD AIDS. 14:99–102, 2003.

    Article  PubMed  CAS  Google Scholar 

  210. Crowe, C., Forster, G. E., Dinsmore, W. W., Maw, R. D. A case of acute hepatitis B occurring four months after multiple rape. Int. J. STD AIDS. 7:133–134, 1996.

    Article  PubMed  CAS  Google Scholar 

  211. Limb, S., Kawsar, M., and Forster, G. E. HIV post-exposure prophylaxis after sexual assault: the experience of a sexual assault service in London. 13:602–605, 2002.

    CAS  Google Scholar 

  212. Weinberg, G. A. Post-exposure prophylaxis against human immunodeficiency virus infection after sexual assault. Pediatr. Infect. Dis. 21:957–960, 2002.

    Article  Google Scholar 

  213. National HIV Prevention Information Service. Post-exposure prophylaxis (PEP) against HIV infection following sexual and injection drug use exposure. Edward King of NAM Publications, London, UK, 1998.

    Google Scholar 

  214. Burgess, A. W., Holmstrom, L. L. Rape trauma syndrome. Am. J. Psychiatry. 131:981–986.

    Google Scholar 

  215. Duddle, M. Emotional sequelae of sexual assault. J. R. Soc. Med. 84:26–28, 1991.

    PubMed  CAS  Google Scholar 

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Rogers, D., Newton, M. (2005). Sexual Assault Examination. In: Stark, M.M. (eds) Clinical Forensic Medicine. Forensic Science and Medicine. Humana Press. https://doi.org/10.1385/1-59259-913-3:061

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