Tag: Imperforate Hymen

Imperforate Hymen

Imperforate Hymen


INTRODUCTION OF IMPERFORATE HYMEN:

  • This condition is one of the most common types of blockages of the vagina.
  • An imperforate hymen is a condition in which the hymen covers the entire opening of the vagina, sealing it shut.
  • The condition is a congenital disorder, meaning that it’s something a girl is born with. 

SYMPTOMS OF IMPERFORATE HYMEN   :

  • Symptoms often appear when a girl reaches puberty, and may include abdominal pain and swelling that can last days.
  • Heamatocolpos : vagina fills with menstrual blood
  • Hematometria:uterus fills with (menstrual) blood
  • Physical symptoms generally occur because of a buildup of menstrual blood trapped in the vagina. That blood can also spill into the uterus and fallopian tubes.

Other symptoms of an imperforate hymen include:

  • Lack of a menstrual cycle despite having other signs of sexual maturity, such as developing breasts and pubic hair.
  • Abdominal or pelvic pain, often come and going each month.
  • Back pain.
  • Painful urination or no urination at all. This can occur when pooled blood presses against the urethra. The urethra is a tube that carries urine from the bladder to outside the body.
  • Bowel problems, such as constipation.
  • Cryptomenorrhea occurs due to Imperforate hymen
  • Some women may also have a painful abdominal mass.

TREATMENT OF IMPERFORATE HYMEN:

  • The standard treatment is to surgically cut away part of the hymen using a scalpel or laser. This procedure is called an hymenotomy.
  • Usually an X-shaped cut versus a small, pinpoint one is made in the hymen. 
  • This type of cut allows for proper drainage of backed-up menstrual blood and the subsequent relief of symptoms. 
  • Some doctors will stitch the ends of the incision to the vaginal wall to help prevent the hole from closing.
Exam Question
 
  • Cryptomenorrhea occurs due to Imperforate hymen
  • Acute pain in the lower abdomen & tense bulge in the region of hymen in 13 year old with absence of menarche suggests Imperforate hymen
  • Heamatocolpos is seen in Imperforate hymen
Don’t Forget to Solve all the previous Year Question asked on Imperforate Hymen

Imperforate Hymen

IMPERFORATE HYMEN

Q. 1

Cryptomenorrhea occurs due to :

 A

Imperforate hymen

 B

Asherman’s syndrome

 C

Mullerian agenesis

 D

All

Q. 1

Cryptomenorrhea occurs due to :

 A

Imperforate hymen

 B

Asherman’s syndrome

 C

Mullerian agenesis

 D

All

Ans. A

Explanation:

Imperforate hymen


Q. 2

A 13-year-old young girl presents in the casualty with acute pain in the lower abdomen. She has history of cyclical pain for last 6 months and she has not attained her menarche yet. On local genital examination, a tense bulge in the region of hymen was seen. The most probable diagnosis is:

 A

Rokitansky Kuster Hauser syndrome

 B

Testicular feminization syndrome

 C

Imperforate hymen

 D

Asherman’s syndrome

Q. 2

A 13-year-old young girl presents in the casualty with acute pain in the lower abdomen. She has history of cyclical pain for last 6 months and she has not attained her menarche yet. On local genital examination, a tense bulge in the region of hymen was seen. The most probable diagnosis is:

 A

Rokitansky Kuster Hauser syndrome

 B

Testicular feminization syndrome

 C

Imperforate hymen

 D

Asherman’s syndrome

Ans. C

Explanation:

Imperforate hymen occurs when the mesoderm of the primitive streak abnormally invades the urogenital portion of the cloacal membrane.
It often is not diagnosed until an adolescent presents with complaints of primary amenorrhea and cyclic pelvic pain.
It may present as back pain or difficulty with defecation or urination secondary to mass effect from vaginal distention.
Inspection of the vulva may reveal a purplish-red hymenal membrane bulging outward as a result of accumulation of blood above it (hematocolpos). Blood may fill the uterus (hematometra) and spill through the fallopian tubes into the peritoneal cavity.
 
Ref: Bauman D. (2013). Chapter 37. Pediatric & Adolescent Gynecology. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e.

Q. 3

Heamatocolpos is seen in:          

September 2005

 A

Septate uterus

 B

Bicornuate uterus

 C

Unicornuate uterus

 D

Imperforate hymen

Q. 3

Heamatocolpos is seen in:          

September 2005

 A

Septate uterus

 B

Bicornuate uterus

 C

Unicornuate uterus

 D

Imperforate hymen

Ans. D

Explanation:

Ans. D: Imperforate Hymen

Hematocolpos is a medical condition in which the vagina fills with menstrual blood.

It is often caused by the combination of menstruation with an imperforate hymen.

A related disorder is Hematometria, where the uterus fills with (menstrual) blood. This can be caused by a congenital stenosis of the cervix, or by a complication of a surgical treatment,



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