Ouch! Straddle Injuries: Diagnosis and Care

Warm weather means more time at the playground, family bike rides, and trips to the pool. These activities are super fun but accidents can happen, and falls might result in injuries to the genitals.

What Is a Straddle Injury?

Straddle injuries occur when a child falls on an object—such as playground equipment, bicycle crossbars, pool ladders—and strikes the genitalia, causing an injury. Most straddle injuries involve only the external genitalia (vulva). The injury might be a bruise, hematoma (collection of blood under the skin with swelling) or laceration (cut).

How Is a Straddle Injury Diagnosed?

Patients who have a straddle injury experience pain and sometimes bleeding from the laceration. It is important to get the injury evaluated and treated promptly. Most patients are evaluated in the emergency department with an exam of the genitals to determine the extent of the injury. If the injury is more severe, or the full extent of the injury is unclear, or the child is too uncomfortable, your healthcare team may recommend an exam under anesthesia.

How Is a Straddle Injury Treated?

Treatment varies depending upon the extent of the injury. Small lacerations might not need stitches; however, larger, or deeper cuts might need stitches. Often the repair can be done in an emergency department, in a healthcare office, or (rarely) in the operating room. If the laceration is small and at the surface your healthcare provider might recommend using estrogen cream on the injury to help with healing. Bruises or hematomas typically do not need a surgical repair; they will heal on their own with time. If a hematoma is increasing in size rapidly or a child is unable to urinate surgery might be necessary.

How Do We Care for a Straddle Injury at Home?

It is important to keep the injured area clean. Have your child soak in a tub of warm water for 10 minutes per day, then gently pat the vulva dry. You can also rinse the vulva with warm water using a squirt bottle or hand-held shower head if you don’t have a bathtub at home.

If the injury is painful, cool compresses (ice pack wrapped in a towel) applied to the vulva are helpful for pain and swelling. You can also use pain relievers as needed (follow the bottle dosing instructions).

Sometimes children with a genital injury find it difficult or painful to urinate. You can help by having them urinate in a bathtub of warm water, or by pouring warm water over the vulva as they urinate. If they cannot urinate at all, contact your healthcare provider.

It’s important to follow up with your healthcare provide to make sure the injury is healing well. If you notice ongoing bleeding, increasing bleeding, a hematoma that is getting larger in size, worsening pain, or increased redness of the skin around the injury, contact your healthcare provider.

What Can I Do to Prevent Straddle Injuries?

We want children to be active outside, but it’s important to always have appropriate supervision and take care when doing activities that might increase the risk of a straddle injury. Have a fun and safe summer!

The Department of Pediatric and Adolescent Gynecology provides comprehensive patient care focused on the diagnosis, medical and surgical management of female reproductive health. To request an appointment, call (614) 722-2250 or visit our page.