Discussion :
Imperforate hymen is a rare congenital anomaly of the female genital tract with an estimated incidence of about 0.05-0.1%. 1 The anomaly is attributed to failure of the urogenital sinus endoderm to completely canalize, resulting in a hymen that completely obstructs the vaginal opening, and hence the genital outflow. 1,2 Imperforate hymen is often diagnosed in adolescent girls with primary amenorrhea, cyclic abdominal pain, urinary retention, and/or lower abdominal mass secondary to accumulation of menstrual blood. 1,2 Rarely, however, the diagnosis can be established in the neonatal period as the maternal, estrogen-induced, fetal genital tract secretions will accumulate in the obstructed vagina resulting in its distension “hydrocolpos”, with a bulging hymen. This in turn, may lead to serious consequences, as the distended vagina may cause pressure effect on the lower urinary tract with obstructive uropathy that may progress to renal failure. Hence, early detection and intervention is important to avoid such life-threatening renal failure. 1,3,4 The treatment of choice is based on cruciate incision or excision of the hymen. Hymen-preserving techniques can be offered for patients desiring virginity. Alternative treatments include a carbon dioxide laser or insertion of a Foley catheter. 1
Although rare, hydrocolpos secondary to imperforate hymen can develop in newborns. Healthcare providers should be aware of this pathology as an urgent surgical intervention may be necessary to avoid life-threatening conditions. References : | - Lee KH, Hong JS, Jung HJ, et al . Imperforate Hymen: A Comprehensive Systematic Review. J Clin Med. 2019; 8: 56.
- Egbe TO, Kobenge FM and Wankie EM. Virginity-Sparing Management of Hematocolpos with Imperforate Hymen: Case Report and Literature Review. SAGE Open Medical Case Reports. 2019; 7:1-7.
- Singh AP, Gupta AK, Pardeshi R, et al. Hydrocolpos caused by imperforate hymen in a preterm newborn. Saudi journal of medicine & medical sciences. 2019; 7(2):124.
- Ramphul M, Perry L, Bhatia C. Neonatal imperforate hymen with hydrocolpos. BMJ Case Rep[Internet]. 2016[Citado 29 de Enero de 2018];2016:1-2.
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Last Shown : Aug 2025
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