Case report: Hematometra and urinary retention secondary to imperforated hymen

Abstract

Background: imperforation of the hymen is the most frequent congenital and obstructive anomaly of the female genital tract, a consequence of a structural disorder of the Müllerian ducts, with an incidence of 0.1%. lt is generally diagnosed at puberty with non-specific symptoms. Objective: to emphasize the gynecological exploration and development in adolescents, to avoid associated complications such as obstruction of the menstrual flow outlet.

Case Description: 12 year-old female, with no pathological and surgical history. S he denied onset of menarche and sexual activity. With a history of urinary retention of 3 weeks of evolution, anuria of 48 hours and intense pelvic pain. On physical examination, a suprapubic, soft, smooth, non­ fluctuating mass, painful on deep palpation accompanied by a bladder balloon, on gynecological examination with an imperforate hymen; Abdominal ultrasound reportad: 847 ce hematocolpos and 1O mm thick endometrium suggestive of hematometra. Hymenectomy was performed, obtaining 900 mi of blood content, with satisfactory evolution after surgery.

Conclusion: Urinary retention associated with primary amenorrhea in an adolescent forces us to think of a genital obstructive phenomenon, so continuous physical examination is essential for the diagnosis and definition of management of many gynecological diseases in adolescence.