Imperforate hymen: a rare case of secondary amenorrhoea

Spontaneous Reformation of Imperforate Hymen after Repeated Hymenectomy

BACKGROUND

Imperforate hymen prevents menstrual blood drainage, which causes cyclic lower abdominal pain and amenorrhea. Untreated patients might develop serious complications such as endometriosis and infertility. Hymenectomy represents the adequate treatment.

CASE

In a 16-year-old female virgin presented with recurrent lower abdominal pain, urine retention, and secondary amenorrhea after 3 hymenectomy surgeries. The examination revealed imperforate hymen. A fourth hymenectomy was performed with continuous locked sutures over all of the edges.

SUMMARY AND CONCLUSION

Recurrent imperforate hymen after hymenectomy should be suspected if symptoms recur. Diagnosis can be achieved through meticulous clinical examination and appropriate imaging techniques.

Unique Case of Imperforate Hymen

BACKGROUND

Imperforate hymen typically presents in adolescence with pain, hematocolpometra and primary amenorrhea. This case documents a previously unreported etiology for an atypical presentation with a history of recent menstruation.

CASE

A female adolescent presented with symptoms of urinary retention and leg pain. She reported a history of irregular, painful menses. Clinical examination revealed a pelvic mass and imperforate hymen. Sonography was consistent with hematocolpometra. Before a planned hymenectomy, the patient began to pass dark blood through a fistulous opening in her vulva. Hymenectomy resulted in complete resolution of the pain and hematocolpometra.

SUMMARY AND CONCLUSION

Identification of the fistulous tract explained the patient's history of menstrual bleeding despite an imperforate hymen. Spontaneous rupture of hematocolpometra through a fistulous tract to the vulva is a previously unreported atypical presentation of imperforate hymen in a "menstruating" adolescent with pain and a pelvic mass.

Acute Urine Retention Caused by Hematocolpos After Failed Hymenotomy in 23 Year Old Female

Mechanical obstruction by hematocolpos can result in acute urinary retention.¹ Imperforate hymen is a rare condition that presents mainly with primary amenorrhea, cyclic abdominal pain and rarely, urine retention in pubertal girls.² This is a 23-year old female who presented with acute urine retention. She had history of previous vaginal repair of imperforate hymen. On examination patient was found to have imperforate hymen. After fixing a catheter, an US scan showed hematocolpos that was confirmed CT. She was eventually underwent hymenectomy. We conclude that in peripubertal female with acute urinary retention, hematocolpos should be considered.

Imperforate Hymen - a rare cause of acute abdominal pain and tenesmus: case report and review of the literature

Imperforate hymen is a rare condition that presents with amenorrhea, cyclical abdominal pains and urine retention among pubertal girls. A 14 year old girl with imperforate hymen underwent hymenotomy for hematocolpometra, having presented with abdominal pains and tenesmus.