- Imperforate Hymen: A Comprehensive Systematic Review. [Journal Article]
- JCJ Clin Med 2019 Jan 07; 8(1)
- Imperforate hymen (IH) is an uncommon congenital anomaly of the female genital tract, with the hymen completely obstructing the vaginal opening. Despite the simple diagnosis and treatment of IH, miss…
Imperforate hymen (IH) is an uncommon congenital anomaly of the female genital tract, with the hymen completely obstructing the vaginal opening. Despite the simple diagnosis and treatment of IH, missed or delayed diagnosis is often a clinical problem owing to its low incidence, nonspecific symptoms, or insufficient physical examination. The aim of this study is to identify the characteristics, clinical presentations, treatment modalities, and outcomes of imperforate hymen patients. In this study, a literature search of PubMed, Scopus and Medline databases was performed for sources published up to 3 July 2018 for English-language studies with the term "imperforate hymen". The literature review identified 251 citations and 155 articles (143 case reports, 12 case series) containing 253 patients who were finally included (two papers were not written in English). Among 236 postnatal patients, the mean age of the patients was 10.7 ± 4.7 years. Abdominal pain (54.2%), urinary retention (20.3%), abnormal menstruation (14.0%), dysuria (9.7%), increased urinary frequency (5.1%), severe presentation of renal failure (n = 5, 2.1%), and urinary tract infection (n = 1, 0.4%) were presented. Most patients diagnosed with the condition underwent surgical treatment (83.5%), most of whom were treated via a hymenotomy (35.2%) and hymenectomy (36.4%), and the use of prophylactic antibiotics were only used in 7 patients. There were no differences in outcomes between two surgical methods. In addition, 141 (59.7%) patients showed improvement and 5 deceased patients were not related to IH or the operation itself; Complications, such as vaginal adhesion, were only noted in 6.6% of patients. In addition, among 17 cases of newborns with a diagnosis of IH before birth, hymenectomy (n = 5, 29.4%) and hymenotomy (n = 9, 52.9%) were the main treatment modalities and showed improved prognosis in 52.9% of newborns. Because IH diagnosis is easy and postsurgical prognosis is good, clinicians should carefully examine every female patient at birth. IH should be considered regarding adolescent girls with abdominal pain, lower back pain, or urinary retention, and perform appropriate physical examinations of the genital introitus. In addition, accurate diagnosis as IH, not misdiagnosing as vaginal septum or agenesis, is important to prevent severe complications such as stricture and ascending infection.
- Pelvic pain in young girls: not only dysmenorrhoea! [Journal Article]
- BCBMJ Case Rep 2018 Nov 08; 2018
- Imperforate hymen is the most frequent cause of haematocolpos, although it is a rare malformation (1:2000). We present two cases of young girls with cyclic abdominal pain and urinary symptoms. At gyn…
Imperforate hymen is the most frequent cause of haematocolpos, although it is a rare malformation (1:2000). We present two cases of young girls with cyclic abdominal pain and urinary symptoms. At gynaecological examination, they all presented imperforate hymen and ultrasound revealed significant vaginal distension. X-shaped hymenectomy was performed in all patients. The later the diagnosis of imperforate hymen, the higher the risk of complications like haematometra, haematosalpinx, haemoperitoneum and infections such as tubo-ovarian abscesses, peritonitis and endometriosis (retrograde menstruation theory).
- The impact of hymenectomy on future gynecological and obstetrical outcomes. [Journal Article]
- JMJ Matern Fetal Neonatal Med 2018 Sep 25; :1-5
- CONCLUSIONS: Hymenectomy is associated with significant long-term obstetrical and gynecological complications. Informing medical teams of these risks might promote early detection and minimize associated complications such as laceration-associated blood loss and preterm delivery.
- Vaginal Rejuvenation: A Review of Female Genital Cosmetic Surgery. [Review]
- OGObstet Gynecol Surv 2018; 73(5):287-292
- CONCLUSIONS: Cosmetic gynecology surgery has become more popular in recent years, with few studies assessing the long-term benefits and harms of these treatments. Gynecologists should be aware of the lack of evidence supporting the effectiveness of FGCS in light of the growing marketing efforts and patient demand for these procedures.
- Hematometrocolpos Disguised as Abdominal Pain. [Case Reports]
- JEJ Emerg Med 2017; 53(5):e97-e99
- Hematometrocolpos caused by an imperforate hymen is a common form of vaginal outflow obstruction. This is a rare pediatric anomaly that can present with atypical or vague symptomatology, such as abdo…
Hematometrocolpos caused by an imperforate hymen is a common form of vaginal outflow obstruction. This is a rare pediatric anomaly that can present with atypical or vague symptomatology, such as abdominal pain or constipation or urinary retention in the setting of amenorrhea. It is essential to obtain a gynecologic history and inquire about menstrual cycles to properly evaluate a young female with such a common complaint as abdominal pain. Failure to perform a gynecologic examination in the emergency department setting may delay diagnosis and appropriate care for this rare condition, which can lead to serious complications.
- Imperforate Hymen: Varied Presentation, New Associations, and Management. [Journal Article]
- JIJ Indian Assoc Pediatr Surg 2017 Oct-Dec; 22(4):207-210
- CONCLUSIONS: Hymen development origin is variable and complex. Imperforate hymen is rarely a part of systemic/genetic anomaly. Genital examination at birth or during puberty is mandatory which often guides the timing of hymenectomy and prevents the sequelae of imperforate hymen. Hymenectomy is ideal during puberty and resolves all genitourinary obstructions.
- Microperforate hymen presenting with incomplete abortion: A case report. [Case Reports]
- JOJ Obstet Gynaecol Res 2017; 43(8):1353-1355
- A 20-year-old patient with 3 months of amenorrhea presented in the labor room with bleeding per vaginum and having experienced lower abdominal pain for 2 h. She had a history of difficult intercourse…
A 20-year-old patient with 3 months of amenorrhea presented in the labor room with bleeding per vaginum and having experienced lower abdominal pain for 2 h. She had a history of difficult intercourse and prolonged menstrual flow. Inspection revealed a bleeding point over an obstructing membrane at the level of the vaginal introitus. Subsequent vaginal examination confirmed the diagnosis of microperforate hymen. Her urine pregnancy test was positive and an ultrasound examination revealed the presence of retained products of conception in the endometrial cavity. Hymenectomy was carried out to evacuate the retained products of conception and the margins of the hymen were sutured to prevent restenosis. The outcome was uneventful. This case study suggests that even though subocclusive hymenal anomalies, such as microperforate hymen, can interfere with normal vaginal intercourse, it does not lead to infertility and can permit pregnancy. Hence, awareness about this rare entity may lead to early detection and improvement in the patient's quality of life.
- Spontaneous Reformation of Imperforate Hymen after Repeated Hymenectomy. [Case Reports]
- JPJ Pediatr Adolesc Gynecol 2016; 29(5):e63-e65
- CONCLUSIONS: Recurrent imperforate hymen after hymenectomy should be suspected if symptoms recur. Diagnosis can be achieved through meticulous clinical examination and appropriate imaging techniques.
- Vaginismus in Iran: A Single Center Report of 7 Years Experience. [Journal Article]
- NMNephrourol Mon 2015; 7(6):e30077
- CONCLUSIONS: As vaginismus can affect the stability of marriage, it is necessary to assess sexual dysfunction from all directions, including demographic characteristics and variables that affect the incidence of vaginismus. Therefore, based on the data obtained, we can diagnose and properly treat sexual dysfunction, in time, and teach couples how to deal with it.
New Search Next
- Acute Urine Retention Caused by Hematocolpos After Failed Hymenotomy in 23 Year Old Female. [Journal Article]
- UCUrol Case Rep 2015; 3(2):50-1
- 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, …
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.