What clinical studies report rates of vaginal laceration from consensual intercourse and their dates?

1. The big picture from recent meta-analyses: pooled CSI injury rates and context

Two recent systematic syntheses quantified anogenital injury (AGI) after consensual sex: a 2024 forensic meta-analysis reported that 31% of participants in the consensual intercourse groups had some form of anogenital injury when combining tears/lacerations, bruises, abrasions and erythema across studies (Crawford et al., Nov 2024) ^[1], and a 2023 eClinicalMedicine systematic review found AGI in 394 of 1,291 participants (31%) following consensual intercourse in the studies they pooled and concluded AGI was significantly more likely after assault but not absent after consensual sex ^{[2] [3]}.

2. Individual clinical and prospective studies: lower macroscopic rates with method differences

Prospective and clinic-based examinations that relied on macroscopic inspection without colposcopy often reported much lower CSI injury rates; for example, a routine cervical screening comparison group showed about 5.9% sustaining a visible genital injury after consensual sex in one study used in systematic reviews (reported in a 2011 comparative paper) ^{[4] [5]}, and McLean et al. (cited in reviews) found an approximate 11% injury prevalence when macroscopic methods were used ^[6].

3. Studies using enhanced detection (colposcopy, dye) report higher rates

Studies that used colposcopy and toluidine blue dye routinely reported substantially higher detection of microtrauma and lacerations after consensual intercourse — examples cited in reviews include studies with colposcopic detection showing genital injury prevalences as high as 50% or more in carefully examined samples ^{[7] [6]}, and a classic small study of 48 women examined within 48 hours found a 10% injury rate but noted injuries were associated with dry/painful intercourse ^[7].

4. Case series and emergency cohorts document severe lacerations from consensual intercourse (dates and examples)

Clinical case-series and emergency-department cohorts describe individual and series reports of vaginal lacerations after consensual intercourse, particularly in adolescents and certain high-risk presentations: a 2011 adolescent series described three patients with consensual intercourse preceding vaginal fornix lacerations (Frioux et al., 2011) ^{[8] [9]}, retrospective emergency-department analyses and community-based cohorts reported severe lacerations requiring repair and admission (studies summarized in a 2010–2011 body of work and community retrospective reports) ^{[10] [9] [11]}.

5. Why reported rates vary: definitions, cohorts, timing and detection

Variation across studies is explained by heterogeneity in injury definitions (some include redness/swelling, others count only tears/lacerations), recruitment (volunteer vs. emergency/forensic vs. routine screening), timing of exam (within 24–72 hours matters), and detection technique (colposcopy and dye increase sensitivity), factors explicitly noted in the pooled reviews and systematic analyses ^{[2] [3] [6]}.

6. What can be concluded with confidence and what remains uncertain

Confident conclusions from the available literature are: lacerations and other anogenital injuries can and do occur after consensual intercourse and have been documented in multiple clinical studies and case series ^{[8] [11] [10]}; pooled analyses find roughly 31% prevalence of any AGI in CSI groups when sensitive methods are applied ^{[1] [3]}; and macroscopic-only studies report much lower CSI injury rates (around 5–11% in some cohorts) demonstrating methodological dependence of reported rates ^{[6] [4]}. The reporting material does not allow a single, definitive percentage specifically for "vaginal lacerations only" across all populations and methods without re-extracting each primary study’s laceration-specific counts, so precise, universally applicable laceration rates by year and study cannot be stated from the provided sources alone ^{[1] [2]}.