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The utility of anoscopy and colposcopy in the evaluation of male sexual assault victims.
Ann Emerg Med 2000; 36(5):432-7AE

Abstract

STUDY OBJECTIVE

We sought to compare the use of anoscopy and colposcopy in examinations of male sexual assault victims and to characterize the demographics of male sexual assault victims.

METHODS

This is a case series of 67 male sexual assault victims evaluated over an 8-year period by the Sexual Assault Forensic Examination team. The setting is a university-based emergency department serving as the primary site for examination of sexual assault victims by trained nurse practitioners and physician's assistants. Police and victims' advocates are available at the time of the examination. Anoscopy was done routinely over the entire study period in all patients with any anal penetration or involvement. Colposcopy use started in 1994 to magnify and take pictures. Patients were categorized into 2 groups. Group 1 consisted of subjects receiving only anoscopy, and group 2 consisted of subjects receiving initial colposcopy. Anoscopy in group 1 and colposcopy in group 2 were compared for positive results. A positive result was defined as an additional finding to those obtained by means of gross examination by using the test being evaluated (anoscopy versus colposcopy). Colposcopy and anoscopy were also compared among the subjects receiving both tests. Groups were compared by using a Pearson chi(2) test.

RESULTS

Sixty-seven male sexual assault victims were evaluated between 1991 and 1998. The average age was 26+/-8 years, and the distribution of races was 30% black, 62% white, and 8% Hispanic. Results of gross examination were positive in 42 (63%) subjects. Four patients did not receive either anoscopy or colposcopy. Of the remaining 63, 25 patients had anoscopy only (group 1), and 38 patients had initial colposcopy (group 2). There were no significant differences in age, race, or rate of positive gross examination results between groups. Findings in addition to those obtained by means of gross examination were revealed by means of anoscopy in 8 (32%) of 25 subjects in group 1 and colposcopy in 3 (8%) of 38 subjects in group 2 (P =.03, difference 24%, 95% confidence interval 4% to 44%). In the 36 subjects who had both examinations, the gross examination revealed at least one finding in 22 (61%). The combination of anoscopy and colposcopy yielded positive findings in 17 subjects, including 4 subjects who had no findings on gross examination (increasing the positive rate to 26/36 [72%]).

CONCLUSION

In male sexual assault victims with anal penetration, anoscopy is significantly better for gathering evidence than is colposcopy. The addition of colposcopy and anoscopy increased the rate of cases with positive findings from 61% to 72%. These 2 methods together may be a valuable adjunct in gathering evidence of damage.

Authors+Show Affiliations

University of California at Davis Medical Center, and Sexual Assault Forensic Examination team, University of California-Davis, Sacramento, CA 95817, USA. Aernst56@aol.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

11054195

Citation

Ernst, A A., et al. "The Utility of Anoscopy and Colposcopy in the Evaluation of Male Sexual Assault Victims." Annals of Emergency Medicine, vol. 36, no. 5, 2000, pp. 432-7.
Ernst AA, Green E, Ferguson MT, et al. The utility of anoscopy and colposcopy in the evaluation of male sexual assault victims. Ann Emerg Med. 2000;36(5):432-7.
Ernst, A. A., Green, E., Ferguson, M. T., Weiss, S. J., & Green, W. M. (2000). The utility of anoscopy and colposcopy in the evaluation of male sexual assault victims. Annals of Emergency Medicine, 36(5), pp. 432-7.
Ernst AA, et al. The Utility of Anoscopy and Colposcopy in the Evaluation of Male Sexual Assault Victims. Ann Emerg Med. 2000;36(5):432-7. PubMed PMID: 11054195.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The utility of anoscopy and colposcopy in the evaluation of male sexual assault victims. AU - Ernst,A A, AU - Green,E, AU - Ferguson,M T, AU - Weiss,S J, AU - Green,W M, PY - 2000/10/29/pubmed PY - 2001/2/28/medline PY - 2000/10/29/entrez SP - 432 EP - 7 JF - Annals of emergency medicine JO - Ann Emerg Med VL - 36 IS - 5 N2 - STUDY OBJECTIVE: We sought to compare the use of anoscopy and colposcopy in examinations of male sexual assault victims and to characterize the demographics of male sexual assault victims. METHODS: This is a case series of 67 male sexual assault victims evaluated over an 8-year period by the Sexual Assault Forensic Examination team. The setting is a university-based emergency department serving as the primary site for examination of sexual assault victims by trained nurse practitioners and physician's assistants. Police and victims' advocates are available at the time of the examination. Anoscopy was done routinely over the entire study period in all patients with any anal penetration or involvement. Colposcopy use started in 1994 to magnify and take pictures. Patients were categorized into 2 groups. Group 1 consisted of subjects receiving only anoscopy, and group 2 consisted of subjects receiving initial colposcopy. Anoscopy in group 1 and colposcopy in group 2 were compared for positive results. A positive result was defined as an additional finding to those obtained by means of gross examination by using the test being evaluated (anoscopy versus colposcopy). Colposcopy and anoscopy were also compared among the subjects receiving both tests. Groups were compared by using a Pearson chi(2) test. RESULTS: Sixty-seven male sexual assault victims were evaluated between 1991 and 1998. The average age was 26+/-8 years, and the distribution of races was 30% black, 62% white, and 8% Hispanic. Results of gross examination were positive in 42 (63%) subjects. Four patients did not receive either anoscopy or colposcopy. Of the remaining 63, 25 patients had anoscopy only (group 1), and 38 patients had initial colposcopy (group 2). There were no significant differences in age, race, or rate of positive gross examination results between groups. Findings in addition to those obtained by means of gross examination were revealed by means of anoscopy in 8 (32%) of 25 subjects in group 1 and colposcopy in 3 (8%) of 38 subjects in group 2 (P =.03, difference 24%, 95% confidence interval 4% to 44%). In the 36 subjects who had both examinations, the gross examination revealed at least one finding in 22 (61%). The combination of anoscopy and colposcopy yielded positive findings in 17 subjects, including 4 subjects who had no findings on gross examination (increasing the positive rate to 26/36 [72%]). CONCLUSION: In male sexual assault victims with anal penetration, anoscopy is significantly better for gathering evidence than is colposcopy. The addition of colposcopy and anoscopy increased the rate of cases with positive findings from 61% to 72%. These 2 methods together may be a valuable adjunct in gathering evidence of damage. SN - 0196-0644 UR - https://www.unboundmedicine.com/medline/citation/11054195/The_utility_of_anoscopy_and_colposcopy_in_the_evaluation_of_male_sexual_assault_victims_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-0644(00)25505-4 DB - PRIME DP - Unbound Medicine ER -