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Hymen imperforé: diagnostic négligé à la naissance, urgence chirurgicale a l'adolescence
... Hymenal imperforation is a relatively rare but the most common congenital malformation of the female genital tract (1). It is often isolated but sometimes associated with malformations of the urogenital tract (2). ...
Background: Although imperforate hymen occurs in approximately 0.1[P] of female newborns, familial occurrence of imperforate hymen has been reported only once. Cases: We report two families in which imperforate hymen was diagnosed in three siblings of each family. One family is described in detail; the patients were two postmenarchal young women and one premenarchal girl. Conclusion: Imperforate hymen usually occurs sporadically but can be familial. We advise screening all female newborns and children for vaginal patency, especially family members of an affected child. Identification of other families with a similar problem might point to a specific mode of inheritance. (Obstet Gynecol 1993;82:655-6) (C) 1993 The American College of Obstetricians and Gynecologists
Persistent low back pain in children demands thorough investigation. An unusual cause of such discomfort is hematocolpos secondary to imperforate hymen in premenarchal girls. Experience with four patients whose initial primary symptom was low back pain has been documented. All had large pelvic masses with greater than 400 ml of old blood being drained at hymenotomy in all patients. Irritation of the sacral plexus or nerve roots is postulated as a mechanism for the referred back pain. Hematocolpos should be included in the differential diagnosis of prepubertal girls who have low back pain.
A method for the management of imperforate hymen using carbon dioxide laser is described. In four patients presenting with imperforate hymen, the hymen was excised by CO2 laser under local anesthesia. No bleeding or wound infection occurred, and healing was prompt and satisfactory. Two out of four patients became sexually active and experienced no introital dyspareunia. We conclude that the CO2 laser may be an alternative method of treatment for this rare congenital abnormality.
Presented are two cases of imperforate hymen with hematocolpos seen in a pediatric emergency department (ED) during a seven-month period. The first case presented with abdominal pain, urinary obstruction, and constipation on initial visit. The diagnosis was not made on the initial presentation. The patient was seen a second time, and final diagnosis was not made until a third visit to the pediatric outpatient clinic. The second case presented with syncope and bilateral lower abdominal pain. Ultrasound and subsequent surgery confirmed the physical findings in the ED of imperforate hymen and hematocolpos. Both patients underwent hymenectomy, and they have experienced no further symptoms.
Imperforate hymen is a rare diagnosis to make in the emergency department and important to treat immediately. Hydronephrosis is a known but rare complication of an imperforate hymen. We present the case of a premenstrual adolescent with an undiagnosed imperforate hymen complaining of increasing abdominal pain. The article discusses the history, physical examination, evaluation, differential diagnosis, ultrasound findings, complications, and prompt surgical treatment necessary.
Acute urinary retention in two adolescent girls with hematometrocolpos caused by imperforate hymen are reported. The accumulation of the menstrual blood in the vagina and uterus may form a mechanical effect on the urethra and bladder and lead to the obstructive urinary symptoms. Hymenotomy created individually by CO2 laser and cruciate incision was performed. The two patients were discharged on the same day after operation and made an uneventful recovery.
Acute urinary retention is a symptom that often accompanies hematocolpometra. The imperforate hymen is a rare gynecologic abnormality that can be easily diagnosed on initial presentation. We report on a 14-year-old white girl with hematocolpometra and imperforate hymen. The symptoms, operative findings and postoperative involution of internal genitalia are described.
Imperforate hymen is a rare occurrence in younger women resulting in hydrocolpos and hydrometrocolpos. Though imperforate hymen may be diagnosed in infancy, females ages 9-15 years most often present with the problem. Imperforate hymen usually is a congenital anomaly, but has been reported as a result of sexual abuse. This case report reviews the presentation and treatment of a 13-year-old female with imperforate hymen.
Imperforate hymen is an uncommon anomaly of the reproductive tract, occurring in approximately 0.1% of newborn females. The familial occurrence of imperforate hymen in a child, her mother, and her mother's monozygotic twin is reported.
Case report.
Academic medical center.
Three affected family members.
Karyotype and pedigree analysis.
The proband, presenting with peritonitis, was evaluated at age 12 for imperforate hymen because this condition was diagnosed in her mother at age 14. At age 14, the mother's monozygotic twin was asymptomatic except for primary amenorrhea and was also demonstrated to have imperforate hymen. No other reproductive system abnormalities were known to be present in the remaining family members. Chromosomal structural analysis confirmed that the mother of the proband had no chromosomal abnormalities.
The occurrence of imperforate hymen in two consecutive generations of a family is consistent with a dominant mode of transmission, either sex-linked or autosomal. Previously reported examples of siblings with imperforate hymen suggested a recessive mode of inheritance. Taken together, these cases suggest that imperforate hymen can be caused by mutations in several genes. This case highlights the importance of evaluating all family members of affected patients. Familial examples of other developmental anomalies of the female reproductive tract also suggest a multifactorial genetic etiology.
Santé de la reproduction
- F Piamale
Piamale F. Santé de la reproduction,
In: Enquête à indicateurs multiples
-MICS 2000. Rapport final du
bureau central de recensement.
Bangui 2001:161-84.
Paramètres sexuels chez les femmes Centrafricaines en milieu urbain
- A Sepou
- M C Yanza
- Z Domande-Modanga
- E Nguembi
Sepou A, Yanza MC, Domande-Modanga Z, Nguembi E. Paramètres sexuels chez les femmes
Centrafricaines en milieu urbain.
Med Afr Noire 2002;49:87-91.