Using Colposcopy in the Rape Exam: Health Care, Forensic, and Criminal Justice Issues

• NCJ Number: 209583
• Journal: Journal of Forensic Nursing Volume: 1 Issue: 1 Dated: Spring 2005 Pages: 19,28,34
• Author(s): Marilyn Sawyer Sommers; Bonnie S. Fisher; Heather M. Karjane
• Date Published: 2005
• Length: 8 pages
• Grant Number(s): R01NR05352
• Sponsoring Agency: National Institute for Nursing Research
• Publication Format: Article
• Publication Type: Literature Review
• Language: English
• Country: United States of America

Annotation

This article analyzes the role of colposcopy in the forensic rape examination of adolescent and adult women.

Abstract

Colposcopy is a procedure that produces a magnified visual inspection of the internal and external genitalia in the context of a standard gynecological exam. It facilitates the identification of microscopic injuries, bruising, tears, abrasions, and lacerations that may occur during rape. This article first reviews the history of the role of colposcopy in rape exams. The most cited works are two studies by Slaughter et al. published in 1992 and 1997. The 1992 study was the first to report the regular use of colposcopy for rape examinations in adult women. It found that 87 percent of rape victims had identifiable injury revealed through colposcopy. The 1997 study reported on colposcopic findings following rape in 311 women and children and compared them to 75 controls. They found positive anogenital findings in 68 percent (213 of 311) of rape victims using colposcopy compared to a rate of 11 percent in controls who had consensual sex (n=75). The article also discusses the location of genital injury following rape. Using colposcopy, several investigators have identified the posterior fourchette as the most common genital location for injury in women due to rape. This is a band of tissue that connects the two labia minora. The article notes, however, that an absence of rigorous studies with large sample sizes limits knowledge about injuries following rape compared to injuries that result from consensual sexual intercourse. This article also discusses the influence of a rape victim's injury in determining whether or not the victim decides to report the rape to the police; the use of colposcopic findings in the criminal justice processing of rape cases, including the admissibility and role of expert testimony in court; and the role of the sexual assault nurse examiner. 2 tables and 23 references