Hymenal transections in children found by photocolposcopy in suspected sexual abuse cases is associated with a history of bleeding

•80 girls who underwent an investigation with photocolposcopy for abuse showed 21% transections and 6% fresh lacerations or other fresh lesion.•Transections were more frequent in pubertal girls, in multiple episodes, in sexually active, if reported bleeding, if more than a year since abuse.•There was no association with reported pain.•Most of the statistically significant associations disappeared after a binary logistic regression analysis, except for reported bleeding.•Bleeding after a sexual assault could indicate more severe lesions, which might explain why such cases do not heal completely.