Query: imperforate hymen

title: Hydrometrocolpos in neonate with imperforate hymen: Diagnosis and treatment
abstract: Hydrometrocolpos is a rare condition. Hydrometrocolpos is a cystic dilatation of the uterovaginal with fluid accumulation due to a combination of stimulation of secretory glands of the reproductive tract and vaginal obstruction such as imperforate hymen, transverse vaginal septum or vaginal atresia.  In this paper, the researchers would report the rare case of hydrometrocolpos in the newborns with the imperforate hymen.  The researchers report a case a 24 year old primigravida at term was referred to the hospital with the suspected fetal congenital anomalies. It shows prenatal fetal ultrasonography with intra abdominal cystic mass. Then, a female neonate was delivered vaginally with a good Apgar score.  Physical examination of the neonate revealed a cystic mass intralabial caused by the bulging membrane in the vaginal introitus. Ultrasonography and magnetic resonance imaging postnatal further defined a cystic mass in the pelvic extending caudally into the vagina and mild left hydronephrosis which is the result of mass compression. Therefore, the diagnosis of hydrometrocolpos with the imperforate hymen was established.  The treatment by hymenotomy and marsupialization to the evacuated hydrometrocolpos was performed. The infants are recovered fully after the treatment and show postoperative ultrasonography resolution of hydrometrocolpos and hydronephrosis.

title: Huge abdominal mass with hematocolpometra due to imperforate hymen: an unusual clinical presentation
abstract: The imperforated hymen is one of the commonest genital tract malformations usually present with cyclic abdominal pain and an obstructive pelvic mass at post pubertal age. The unusual presentations are delayed menarche with obstructive symptoms rarely acute retention of urine, tenesmus, and constipation. We report an unusual case of 12 year old girl with a huge mass in the lower abdomen examination revealed imperforate hymen at early pubertal age. Further investigation of Magnetic Resonance Imaging (MRI) confirmed hematocolpometra. Then, she underwent simple hymenotomy and drainage of collected menstrual blood from the genital tract. She recovered well during the postoperative periods. We conformed normal menstrual flow at her first follow up. In conclusion, Imperforate hymen at peripubertal age with an unusual huge abdominopelvic mass concerns further imaging to assure the best outcome.

title: Late diagnosis of imperforate hymen with hematometrocolpos and bilateral hydronephrosis of a horseshoe kidney
abstract: Imperforate hymen is a fairly uncommon genital disorder where the hymen completely obstructs the vaginal opening. Several authors have ruled out its co occurrence with other congenital anomalies. In this report, we discuss the exceptional case of a late diagnosis of imperforate hymen associated with bilateral hydronephrosis of a horseshoe kidney in a 19 year old female patient. To our knowledge, an association of imperforate hymen and horseshoe kidney has never been reported.

title: Symptomatic Imperforate Hymen in Early Infancy: A Case Report
abstract: Imperforate hymen, though a congenital anomaly, usually presents late in puberty as lower abdominal pain, primary amenorrhea, and cyclical pain. Blood collects in vagina and uterus, proximal to imperforate hymen leading to their distention. Its presentation at infancy is a rare entity. We report such a rare case of symptomatic imperforate hymen in infancy, who presented with acute retention of urine, chills and rigor. Abdominal examination revealed an intra abdominal mass in the lower abdomen and pelvis with the absence of vaginal opening on perineal examination. Contrast enhanced computed tomography abdomen showed large abdominopelvic cystic lesion posterior to the urinary bladder and anterior to the rectum consistent with a highly distended vagina. She was managed by the incision of the imperforate hymen and drainage of the pus. A high index of suspicion is necessary whenever a female infant presents with abdomino pelvic mass with symptoms of fever or urinary retention.

title: Imperforate hymen: a rare cause of tenesmus
abstract: Imperforate hymen is an uncommon obstructive anomaly of the female reproductive tract for which early diagnosis is easy to miss. Untreated cases after menarche may cause cyclic lower abdominal pain and amenorrhea. Hymenotomy is considered proper management in order to avoid complications associated with late treatment. We report a case of an imperforate hymen in a 13 year old adolescent girl presenting with tenesmus and acute lower abdominal pain. The patient was treated with hymenotomy and postoperative period was uneventful. Tenesmus and lower abdominal pain resolved immediately after surgery and during follow up the girl reported normal menstrual cycles. According to our case, tenesmus may be an atypical clinical presentation of imperforate hymen. Therefore, imperforate hymen should not be eliminated from differential diagnosis when it comes to adolescent females with abdominal pelvic pain and gastrointestinal symptoms and gynecological examination should be performed.

title: Laparoendoscopic Single Site Surgery for Management of Tubo Ovarian Abscess After Hymenectomy for Imperforate Hymen
abstract: A tubo ovarian abscess is a potential late complication after hymenectomy for imperforate hymen, especially when complicated with hematosalpinx. Laparoendoscopic single site (LESS) surg.

title: Familial imperforate hymen in an adolescent girl: presenting as acute lower abdominal pains and distention a case report and review of literature
abstract: Imperforate hymen often is not diagnosed until an adolescent girl presents with complaints of primary amenorrhea and cyclical pelvic pains. We report the case of a 15 year old girl with a family history of imperforate hymen that presented with complaints of progressive lower abdominal pains and distention, and primary amenorrhea. A diagnosis of Imperforate hymen was made by history, findings at physical examination and trans abdominal ultrasonography. She subsequently had hymenotomy for hematocolpometra. Her postoperative recovery was normal and her menstruation became regular.

title: A case report of hydronephrosis caused by imperforate hymen in an infant
abstract: Hydronephrosis, mostly caused by ureteropelvic junction obstruction, rarely occurs in infants. However, imperforate hymen atresia in female infants may cause hydronephrosis, even though it is rare.  A 3 month old female infant was admitted to our hospital for frequent crying. There was no significant past medical history.  Following ultrasound imaging, the patient was diagnosed with hydronephrosis possibly caused by imperforate hymen.  The infant underwent hymenotomy with a cruciate incision to prevent future complications such as acute renal injury.  Hydronephrosis resolved after the operation. The outcome was very good, with no complications in the postoperative period.  Early ultrasound diagnosis plays a significant role in the management and treatment of infant patients. Ultrasound is the mandatory imaging technology for determining the cause of hydronephrosis.

title: Missed diagnosis of imperforate hymen later presenting with hypertension
abstract: An adolescent girl presented with hypertension and was found to have haematocolpos and imperforate hymen. She had a background of chronic abdominal pain and had sought medical attention multiple times prior, with the diagnosis being missed as pubertal evaluation and perineal examination had been neglected during those visits. Hypertension resolved following hymenectomy and drainage of haematocolpos with no long term sequelae.

title: Diagnosis and surgical treatment of bilateral ureteral calculi, hydronephrosis, pyometra, pyocolpos, vestibulovaginal stenosis, and imperforate hymen in a dog: A rare critical case report
abstract: Bilateral ureteral calculi, hydronephrosis, pyometra, pyocolpos, vestibulovaginal stenosis, and imperforate hymen in a dog are uncommon and can be difficult to diagnose. The aim of this article is to report diagnostic challenges and successful surgical treatment of this rare event and the long term outcomes.  A 5 year old, spayed (partial ovariohysterectomy) female dog was primarily diagnosed with bilateral hydronephrosis and ureter obstruction due to urolithiasis along with pyometra. The urolith was removed carefully by the right side ureterectomy, an appropriate ureteral stent was inserted from the bladder to the right kidney, and then, a vasectomy and hysterectomy were performed. The dog improved and was discharged. However, 50 days after surgery, pyocolpos due to imperforate hymen and vestibulovaginal stenosis were diagnosed and surgically corrected, and the ureteral stent was removed because the ureter had completely healed.  During the first admission, serum biochemistry results revealed the increased blood urea nitrogen (5.9 mg/dl) creatinine (116.2 mg/dl) amylase (1,345 U/l) and lipase (141 U/l) values. After surgical correction, all parameters returned to normal. However, 50 days after surgery, the C reactive protein concentration (143 mg/l) and white blood cell level increased (18.4 x 109/l) After a second surgical correction, the dog recovered fully within 10 days, and no postoperative complications were observed during the follow up of 6 months.  This report provides diagnostic assistance and surgical treatment options for a complex urogenital case. Careful examination during puberty is recommended to prevent the associated complications of this disorder.