Hematometrocolpos Secondary to Imperforate Hymen Presenting with Urinary Retention in an Adolescent Girl

Case Report

Austin J Clin Case Rep. 2015;2(1): 1063.

Hematometrocolpos Secondary to Imperforate Hymen Presenting with Urinary Retention in an Adolescent Girl

Govani DR1, Campbell A2, Cho C3 and Patel RV4*

1Medical Student, University of Birmingham Medical School, UK

2Department of Ped Surgery, Leeds General Infirmary, UK

3Department of Obst & Gynec, Chesterfield Royal Hospital, UK

4Department of Ped Surgery, Saurashtra University, India

*Corresponding author: Patel RV, the Department of Surgery, Postgraduate Institute of Child Health and Research and K T Children Government Hospital, Saurashtra University, Rajkot 360001 Gujarat India

Received: July 05, 2014; Accepted: January 16, 2015; Published: January 21, 2015


Acute urinary retention is uncommon in females in general and children in particular. We report a 14-year-old adolescent girl presenting with acute urinary retention due to hematocolpometra secondary to imperforate hymen on a background of chronic constipation. This complicated the delay in diagnosis as there is reluctance of the adolescent girls to allow easy inspection of their external genitalia. Primary amenorrhea in association with cyclical lower abdominal pain and palpable central abdominal lump after relief of the urinary retention and constipation by an enema resulted in ultrasound scan examination which confirmed the diagnosis and perineal examination showed imperforate hymen as the cause. She underwent cruciate interdigiting hymenoplasty uneventfully with excellent cosmetic functional and anatomic results.


The imperforate hymen is a rare gynecologic abnormality that can be easily missed on initial presentation if a detailed history and perineal examination has not been performed. We wish to report an unusual case of acute urinary retention in a 14-year-old girl with background of chronic constipation and had yet not started menstruating with brief review of literature.

Case Report

A 14-year-old girl with a background history of chronic constipation and ongoing periodic abdominal pain of 9months duration was referred to us with urinary retention of 12 hours duration and acute constipation of 5 days. She was otherwise healthy without any prior medical or surgical history.

She was a febrile and hemodynamic ally stable with pulse 84 per minute, temperature 37 C and her blood pressure was 128/76 mm Hg. Prior to referral, an option of urinary catheter and a phosphate enema was given. It was thought that urinary retention was secondary to constipation and an enema was given.

She responded to it and opened bowels with a very hard stool and once that type 1 Bristol chart stool was passed, she was able to empty her bladder spontaneously without the need for any catherization.

Her periodic lower abdominal pain got aggravated. She had not started menarche and her mother had her menarche at 14 years of age. However, on arrival, she still had palpable lower abdominal central suprapubic non-tender mass arising from pelvis. Perineal examination showed imperforate flat hymen (Figure 1A). Rectal examination showed empty rectum with a soft non-tender mass in the distended vagina.

Citation: Govani DR, Campbell A, Cho C and Patel RV. Hematometrocolpos Secondary to Imperforate Hymen Presenting with Urinary Retention in an Adolescent Girl. Austin J Clin Case Rep. 2015;2(1): 1063. ISSN : 2381-912X