A case series of imperforate hymen

A case series of imperforate hymen DOI: https://doi.org/10.18203/2320-1770.ijrcog20252749Keywords: Imperforate hymen, Amenorrhea, Congenital uterine anomaly, Cyclical abdominal painAbstract Imperforate hymen is an uncommon congenital anomaly of the female genital tract, which is caused by the persistence of the hymenal membrane to perforate during embryogenesis. Although it is benign, delayed diagnosis can cause marked morbidity and it typically occurs in adolescents with primary amenorrhea, cyclic abdominal pain, urinary retention, or pelvic mass. Their early recognition is essential to prevent patients from developing sequelae such as endometriosis, infection, infertility, or urinary tract injury. We report a series of three adolescent girls with imperforate hymen who presented with abdominal pain, urinary retention and primary amenorrhea. Diagnosis was based on physical examination, including ultrasonography and all patients were managed with hymenotomy or hymenectomy with good response and return of normal menstruation. This case series emphasizes the need for a high index of suspicion of imperforate hymen in adolescent girls with lower abdominal pain or delayed menarche and that timely diagnosis, correction, and surgical management are crucial to prevent long-term complications. Metrics References Berenson A, Heger A, Andrews S. Appearance of the hymen in newborns. Pediatrics. 1991;87(4):458-65. DOI: https://doi.org/10.1542/peds.87.4.458 Berenson AB. Appearance of the hymen at birth and one year of age: a longitudinal study. Pediatrics. 1993;91(4):820-5. DOI: https://doi.org/10.1542/peds.91.4.820 Lee KH, Hong JS, Jung HJ, Jeong HK, Moon SJ, Park WH, et al. Imperforate Hymen: A Comprehensive Systematic Review. J Clin Med. 2019;8(1). DOI: https://doi.org/10.3390/jcm8010056 Ben Hamouda H, Ghanmi S, Soua H, Sfar MT. Spontaneous rupture of the imperforate hymen in two newborns. Arch Pediatr. 2016;23(3):275-8. DOI: https://doi.org/10.1016/j.arcped.2015.11.022 Glavan N, Haller H, Brnčić-Fischer A, Glavan-Gačanin L, Miletić D, Jonjić N. Imperforate hymen presenting as vaginal cyst in a 16-month-old child - considerations for an early diagnosis. Scott Med J. 2016;61(1):48-50. DOI: https://doi.org/10.1177/0036933015615263 Marino G, Alfieri N, Tessitore IV, Barba M, Manodoro S, Frigerio M. Hematocolpos due to imperforate hymen: a case report and literature systematic review. Int Urogynecol J. 2023;34(2):357-69. DOI: https://doi.org/10.1007/s00192-022-05270-x Tanitame K, Tanitame N, Urayama S, Ohtsu K. Congenital anomalies causing hemato/hydrocolpos: imaging findings, treatments, and outcomes. Jpn J Radiol. 2021;39(8):733-40. DOI: https://doi.org/10.1007/s11604-021-01115-7 Segal TR, Fried WB, Krim EY, Parikh D, Rosenfeld DL. Treatment of microperforate hymen with serial dilation: a novel approach. J Pediatr Adolesc Gynecol. 2015;28(2):21-2. DOI: https://doi.org/10.1016/j.jpag.2014.06.001 Ossman AME, El-Masry YI, El-Namoury MM, Sarsik SM. Spontaneous Reformation of Imperforate Hymen after Repeated Hymenectomy. J Pediatr Adolesc Gynecol. 2016;29(5):63-5. DOI: https://doi.org/10.1016/j.jpag.2016.02.001 Grimstad F, Strickland J, Dowlut-McElroy T. Management and Prevention of Postoperative Complications in a Neonate with a Symptomatic Imperforate Hymen. J Pediatr Adolesc Gynecol. 2019;32(4):429-31. DOI: https://doi.org/10.1016/j.jpag.2019.04.003