In the absence of a Gynae, I had to attend this case. A female of 27 yrs in her honeymoon visited due to profuse vaginal bleeding after having normal coitus. P/S examination reveals a laceration of about 0.75 cms in Post Fornices. There were no tear or scratches on Introitus. No sign of any Hymen rupture were noted. She denied any use of DILDO/Vibrator etc. What can be the reason of laceration too deep ? I sent blood sample to rule out STI.
Is not uncommon to find lacerations in the posterior fornix. First of all endopelvic fascia support un post fornix is weaker than on anterior fornix, becoming a weaker wall. On a second note, during coitus lower third of the vaginal wall contracts while the upper part expands and lenghtens, rising the uterus ventrally. That leaves the post posterior fornix exposed to injury.
You are confused with Hymenal rupture. It is not a continuous membrane. Sexual intercourse can be performed without any apparent tear in it. Trauma to posterior fornix is common. It is due to direct injury during intercourse. Sometimes gut may come through the tear. In that case, it is known as vaginal evisceration. During forceful intercourse specially in some particular position, there is increase pressure within vagina, and penis will act as piston on a syringe causing more pressure on posterior fornix.
John R Newcombe Equine Fertility Clinic, Brownhills UK
Para-cervical rupture of the vaginal fornix also occurs in horses (mares) usually when there is a mis-match in size (stallion a lot bigger) or in particularly 'well-hung' stallions. Since mares do not conceive to this mating, it appears that the whole ejaculate (50 to 300 ml) is ejaculated into the peritoneal cavity including considerable elements of penile debris and both penile and vulvo-vaginal flora. Yet clincal evidence of peritonitis has not been reported !