Management of the Male Rape Victim

Inform the police (with patient's consent).

Obtain written informed consent for examination.

Obtain and record the history in the patient's own words. A tape recorder may be helpful. Obtain answers to other specific questions (if they have not already been answered). Record the general appearance and demeanor of the victim, and note whether clothing is torn or stained.

Collect and label relevant evidence, and protect the chain of evidence.

Scrape under the fingernails, and also take trimmings from them.

Comb pubic hair, and look for loose hairs from the assailant.

Cut off a few pubic hairs and save them.

Collect any other loose hairs or dried blood.

Examine the perineum and other suspect areas with a Wood light (prostatic secretions are flourescent even when dry).

Examine a saline wet mount of rectal secretions for spermatozoa; record their number and motility.

Prepare four dried slides of rectal contents (wash the rectum with saline if it is dry), and fix them with ether-alcohol.

Collect rectal aspirate or washings into a screw-topped specimen tube for acid phosphatase determination (a positive reaction indicates the presence of prostatic fluid ejaculate).

Place a cotton swab of rectal contents into a specimen tube (for typing of the blood group antigen in semen).

Obtain material from the rectum for culture for gonococci.

Obtain urine for urinalysis (look for hematuria indicating genitourinary trauma).

Photograph all external lesions, but only with the patient's written consent.

If oral penetration has occurred, [appropriate] steps should be repeated with specimens from those sites.

Perform a physical examination; thoroughly examine the patient for signs of trauma, discharge, or bleeding; record the results of the examination; and photograph all lesions (this only with the patient's written consent).

Perform a pelvic examination; look carefully for signs of trauma to the external genitalia. Examine the mouth and rectum for injuries. Proctoscopy may be advisable where penetration has occurred and if foreign objects were used, since peritoneal perforation may occur from rectal trauma.

If indicated, using a warm, water-moistened anoscope, carefully examine the anus and rectal terminus for lacerations.

Obtain blood for blood chemistry studies (if indicated), a serologic test for syphilis, blood typing (to compare the alleged assailant's type with that of the victim), and pregnancy testing. [Sic!]