{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:13:38Z","timestamp":1792782818151,"version":"4.5.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Charit\u00e9 - Universit\u00e4tsmedizin Berlin","id":[{"id":"https:\/\/ror.org\/001w7jn25","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Legal Med"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Sexual assault may result in visible anogenital and extragenital injuries, but the absence of such findings remains a major challenge in forensic interpretation. This retrospective forensic outpatient study analyzed 306 adults examined after reported sexual assault at the Violence Protection Ambulatory of Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin between January 2016 and December 2023. Demographic, assault-related, and injury-related variables were extracted from finalized forensic examination reports. The primary aim was to assess the frequency of predefined anatomically or regionally corresponding visible injuries in relation to reported oral, vaginal, and anal sexual acts. Extragenital injuries were documented in 216\/306 cases (70.6%), whereas anogenital injuries were documented in 62\/306 cases (20.3%). Among 256 individuals reporting at least one oral, vaginal, or anal sexual act, predefined corresponding visible injuries were present in 72 cases (28.1%, 95% CI 23.0\u201333.9) and absent in 184 cases (71.9%). Corresponding anogenital injuries were uncommon after reported vaginal acts and were not significantly associated with reported vaginal acts or penile-vaginal penetration. Reported anal sexual violence and oral sexual violence were significantly associated with anal and facial injuries, respectively; however, corresponding injuries were still absent in most cases. In multivariable logistic regression, the number of reported sexual acts was the only variable independently associated with absence of corresponding visible injury. These findings demonstrate the limited sensitivity of visible injury documentation after reported sexual assault. The presence of a corresponding injury may support the assessment of consistency with the reported history, but the absence of visible injury must not be interpreted as excluding the reported assault.<\/jats:p>","DOI":"10.1007\/s00414-026-03941-8","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T01:53:53Z","timestamp":1785549233000},"page":"4265-4276","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Visible injury patterns in relation to reported sexual acts after sexual assault: a retrospective cohort study"],"prefix":"10.1007","volume":"140","author":[{"given":"Alice","family":"Buzzelli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7013-5896","authenticated-orcid":false,"given":"Julia","family":"Babigian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0082-327X","authenticated-orcid":false,"given":"Valentina","family":"Bugelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Oesterhelweg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8920-6771","authenticated-orcid":false,"given":"Alberto","family":"Amadasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"3941_CR1","unstructured":"European Institute for Gender Equality (2025) Gender Equality Index 2025: violence domain. https:\/\/eige.europa.eu\/gender-equality-index\/2025\/domain\/violence. Accessed 23 April 2026"},{"key":"3941_CR2","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1016\/j.jcfm.2006.08.008","volume":"14","author":"D Alempijevic","year":"2007","unstructured":"Alempijevic D, Savic S, Pavlekic S, Jecmenica D (2007) Severity of injuries among sexual assault victims. J Forensic Leg Med 14:266\u2013269. https:\/\/doi.org\/10.1016\/j.jcfm.2006.08.008","journal-title":"J Forensic Leg Med"},{"key":"3941_CR3","doi-asserted-by":"publisher","first-page":"2549","DOI":"10.1007\/s00414-025-03522-1","volume":"139","author":"D Kane","year":"2025","unstructured":"Kane D, Walshe J, Richardson D, Pucillo C, Ferguson W, Connor SO, Maher N, Flood K, Eogan M (2025) Genital and anal injury in women after sexual assault: prevalence rates and associated risk factors in 294 cases. Int J Legal Med 139:2549\u20132559. https:\/\/doi.org\/10.1007\/s00414-025-03522-1","journal-title":"Int J Legal Med"},{"key":"3941_CR4","doi-asserted-by":"publisher","first-page":"619","DOI":"10.23907\/2017.052","volume":"7","author":"SH Song","year":"2017","unstructured":"Song SH, Fernandes JR (2017) Comparison of injury patterns in consensual and nonconsensual sex: is it possible to determine if consent was given? Acad Forensic Pathol 7:619\u2013631. https:\/\/doi.org\/10.23907\/2017.052","journal-title":"Acad Forensic Pathol"},{"key":"3941_CR5","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.forsciint.2010.04.049","volume":"204","author":"I McLean","year":"2011","unstructured":"McLean I, Roberts SA, White C, Paul S (2011) Female genital injuries resulting from consensual and non-consensual vaginal intercourse. Forensic Sci Int 204:27\u201333. https:\/\/doi.org\/10.1016\/j.forsciint.2010.04.049","journal-title":"Forensic Sci Int"},{"key":"3941_CR6","doi-asserted-by":"publisher","first-page":"102392","DOI":"10.1016\/j.jflm.2022.102392","volume":"90","author":"H Buswell","year":"2022","unstructured":"Buswell H, Majeed-Ariss R, Rajai A, White C, Mills H (2022) Identifying the prevalence of genito-anal injuries amongst clients attending St Mary\u2019s Sexual Assault Referral Centre following an allegation of anal penetration. J Forensic Leg Med 90:102392. https:\/\/doi.org\/10.1016\/j.jflm.2022.102392","journal-title":"J Forensic Leg Med"},{"key":"3941_CR7","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1186\/s12905-022-01647-8","volume":"22","author":"O Brahim","year":"2022","unstructured":"Brahim O, Turki E, Chebbi E, Fersi O, Fatnassi R (2022) Sexual assault of women in the region of Kairouan, Tunisia: an 8-year retrospective study on epidemiological and medicolegal characteristics. BMC Womens Health 22:64. https:\/\/doi.org\/10.1186\/s12905-022-01647-8","journal-title":"BMC Womens Health"},{"key":"3941_CR8","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1111\/1471-0528.13093","volume":"122","author":"ML Larsen","year":"2015","unstructured":"Larsen ML, Hilden M, Lidegaard \u00d8 (2015) Sexual assault: a descriptive study of 2500 female victims over a 10-year period. BJOG 122:577\u2013584. https:\/\/doi.org\/10.1111\/1471-0528.13093","journal-title":"BJOG"},{"key":"3941_CR9","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1016\/s0196-0644(00)70054-0","volume":"35","author":"N Riggs","year":"2000","unstructured":"Riggs N, Houry D, Long G, Markovchick V, Feldhaus KM (2000) Analysis of 1,076 cases of sexual assault. Ann Emerg Med 35:358\u2013362. https:\/\/doi.org\/10.1016\/s0196-0644(00)70054-0","journal-title":"Ann Emerg Med"},{"key":"3941_CR10","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1007\/s00414-023-03134-7","volume":"138","author":"D Kane","year":"2024","unstructured":"Kane D, Eogan M (2024) Female perpetrated sexual assault: a review of attendances to the national sexual assault treatment units in the Republic of Ireland. Int J Legal Med 138:1157\u20131164. https:\/\/doi.org\/10.1007\/s00414-023-03134-7","journal-title":"Int J Legal Med"},{"key":"3941_CR11","doi-asserted-by":"publisher","first-page":"518","DOI":"10.55519\/JAMC-03-13049","volume":"36","author":"F Nadeem","year":"2024","unstructured":"Nadeem F, Wasif M, Ahmad I, Ali SA, Shazia S, Khan O (2024) Prevalence and pattern of injury in sexual assault cases presented at Khyber Medical College Peshawar. J Ayub Med Coll Abbottabad 36:518\u2013521. https:\/\/doi.org\/10.55519\/JAMC-03-13049","journal-title":"J Ayub Med Coll Abbottabad"},{"key":"3941_CR12","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1097\/PAF.0000000000000182","volume":"36","author":"AA Sharaf El-Din","year":"2015","unstructured":"Sharaf El-Din AA, Elkholy SM, Metwally ES, Farag HA (2015) Pattern of female sexual assault in Qalyubia Governorate, Egypt, during the period from 2009 to 2013: a retrospective study. Am J Forensic Med Pathol 36:276\u2013284. https:\/\/doi.org\/10.1097\/PAF.0000000000000182","journal-title":"Am J Forensic Med Pathol"},{"key":"3941_CR13","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.ejogrb.2021.09.020","volume":"266","author":"D Ricard-Gauthier","year":"2021","unstructured":"Ricard-Gauthier D, Abdulcadir J, Tony F, Yaron M (2021) Care of women and girls after sexual assault in Geneva: a descriptive study between 2005 and 2014. Eur J Obstet Gynecol Reprod Biol 266:77\u201382. https:\/\/doi.org\/10.1016\/j.ejogrb.2021.09.020","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"3941_CR14","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/S1028-4559(10)60035-6","volume":"49","author":"HL Hwa","year":"2010","unstructured":"Hwa HL, Chen SC, Wu MZ, Shun CT, Liu SK, Lee JC, Chen YC (2010) Analysis of cases of sexual assault presenting at a medical center in Taipei. Taiwan J Obstet Gynecol 49:165\u2013169. https:\/\/doi.org\/10.1016\/S1028-4559(10)60035-6","journal-title":"Taiwan J Obstet Gynecol"},{"key":"3941_CR15","doi-asserted-by":"publisher","first-page":"301","DOI":"10.3390\/ijerph21030301","volume":"21","author":"S Xodo","year":"2024","unstructured":"Xodo S, Tius V, Baccarini G, Driul L (2024) Female sexual violence: a 12-year experience at a single university hospital in North-East Italy. Int J Environ Res Public Health 21:301. https:\/\/doi.org\/10.3390\/ijerph21030301","journal-title":"Int J Environ Res Public Health"},{"key":"3941_CR16","doi-asserted-by":"publisher","first-page":"e0253980","DOI":"10.1371\/journal.pone.0253980","volume":"16","author":"A Blandino","year":"2021","unstructured":"Blandino A, Maggioni L, Chiaffarino F, Parazzini F, Capano D, Florio EM, Margherita M, Bertelle GM, Franceschetti L, Amadasi A, Vignali G, Ciprandi B, Crudele GDL, Merelli VG, Collini F, Muccino EA, Nicol\u00f2 P, Barbara G, Kustermann A, Cattaneo C, Gentilomo A (2021) Sexual assault and abuse committed against family members: an analysis of 1342 legal outcomes and their motivations. PLoS ONE 16:e0253980. https:\/\/doi.org\/10.1371\/journal.pone.0253980","journal-title":"PLoS ONE"},{"key":"3941_CR17","doi-asserted-by":"publisher","first-page":"112730","DOI":"10.1016\/j.forsciint.2025.112730","volume":"378","author":"J Babigian","year":"2026","unstructured":"Babigian J, Berti L, Oesterhelweg L, Amadasi A (2026) Petechiae in non-fatal strangulation: prevalence, predictors and time-dependent detectability in forensic assessment. Forensic Sci Int 378:112730. https:\/\/doi.org\/10.1016\/j.forsciint.2025.112730","journal-title":"Forensic Sci Int"}],"container-title":["International Journal of Legal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00414-026-03941-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00414-026-03941-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00414-026-03941-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T22:02:09Z","timestamp":1791842529000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00414-026-03941-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,1]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["3941"],"URL":"https:\/\/doi.org\/10.1007\/s00414-026-03941-8","relation":{},"ISSN":["0937-9827","1437-1596"],"issn-type":[{"value":"0937-9827","type":"print"},{"value":"1437-1596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,1]]},"assertion":[{"value":"21 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was conducted in accordance with the principles of the Declaration of Helsinki and relevant data protection requirements. The analysis was based on retrospective extraction of anonymized data from finalized routine forensic examination reports. No additional examination, intervention, or contact with the affected individuals was performed for the purpose of this study. The manuscript does not contain identifiable individual data or patient images. Due to the retrospective design, the anonymized nature of the dataset, and the use of routinely generated forensic documentation, individual informed consent for the present analysis was not obtained.","order":1,"name":"Ethics","label":"Ethical statement","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","label":"Competing interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Clinical trial number","group":{"name":"EthicsHeading","label":"Declarations"}}]}}