Failure in the formation of a hymeneal orifice is a rare congenital malformation. There are many cases of imperforated hymen with hematocolpos in literature. However this condition associated with obstructive uropathy such as acute urinary retention is rare. We experienced a case of imperforated hymen with hematocolpos which caused acute urinary retention in a 16-year-old girl. Herein we report this case with brief review of literature.
Adolescent ; Female ; Hematocolpos ; Humans ; Hymen* ; Urinary Retention*

Hematocolpos is a congenital abnormality resulting from vaginal obstruction. This is relatively not rare condition but is rarely associated with obstructive uropathy such as acute urinary retention and hydronephrosis. We encountered a rare case of hematocolpos, secondary to imperforate hymen, which caused hydronephrosis and urinary retention.
Congenital Abnormalities ; Female ; Hematocolpos* ; Hydronephrosis ; Hymen* ; Urinary Retention*

A 24 year-old patient, single, with cervical agenesis and imperforate hymen is presented. She underwent hymenectomy for hematosalpinx and right oophorectomy for endometriosis, before finally undergoing hysterectomy. Cervical agenesis is a rare anatomic developmental abnormality and proposed guidelines in managing similar conditions are reviewed in this report. The management of choice will defend on the condition of the patient and the availability of resources. The patient underwent multiple surgeries in the past. However, despite all efforts to address her medical condition, due to the complications, the small chance of getting pregnant, and the absence of an experienced surgeon capable of performing a reconstructive procedure, she was eventually convinced to undergo hysterectomy. With cervical agenesis, the patient is faced with psychological difficulties that should be addressed. One can only hope that the future will hold a more optimistic outlook for young girls with this rare congenital abnormality.
Human ; Female ; Young Adult ; ABNORMALITIES ; HEMATOMETRA ; HEMATOCOLPOS ; HYSTERECTOMY

A not so benign disease of imperforate hymen in a 20 year old who presented with acute hypogastric pain will be discussed. The diagnosis of an imperforate hymen should be made during routine neonatal pediatric examination. However, it is not unusual to see a teenage girl present with typical findings of cyclic adominal pain, urinary retention, constipation and a bulging introital mass with hematocolpos and hematometra on ultrasounds examination. Additional findings may include hematosalpinges and formation of endometrial cysts with severe pelvic adgesions. Conservative management generally includes hymenectomy with drainage of the blood and antibiotic therapy. Patients are generally discharged after 24 hours or the procedure is done as an outpatient basis with oral pain medications given. However in our case, the dilemma in terms of management of conservative versus aggressive surgery was encountered. Our patient was only 20 years old presenting with primary amenorrhea and cyclic dysmenorrhea for 7 years with the possibility of a pelvic "clean up" and the problems of premature menopause and infertility were at the back of our minds. A greater awareness of this complication should prompt clinicians to consider this entity when dealing with cases such as this one.
Human ; Female ; Young Adult ; HEMATOCOLPOS ; HEMATOMETRA ; VAGINA ; HYMEN

We present a case of complete vaginal stenosis in a woman diagnosed with Sheehan’s syndrome. The patient delivered at full-term 5 months prior, and experienced massive postpartum bleeding at that time. During evaluation of persistent amenorrhea, we found that her vaginal orifice was completely adhesive and obstructed. Prior to corrective surgery, we managed the patient with an oral contraceptive to induce uterine bleeding into the vaginal outflow tract. After three cycles of an oral contraceptive, we could confirm that there was no stenotic lesion in the vaginal cavity as a hematocolpos was created. Adhesiolysis with scar revision for the vaginal stenosis was successfully performed; it was found that the lesion was limited to only the distal part of the vaginal outlet. Complete vaginal stenosis in reproductive age women with hypopituitarism has not been reported. The artificial induction of hematometrocolpos before surgery was useful in determining the extent of the stenotic lesion, and assured safety.
Adhesives ; Amenorrhea ; Cicatrix ; Constriction, Pathologic* ; Female ; Hematocolpos ; Hemorrhage ; Humans ; Hypopituitarism ; Postpartum Period ; Uterine Hemorrhage

Uterus didelphys with unilateral obstructed hemivagina is indeed a very rare congenital anomaly. Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis usually presents after menarche with progressive abdominal pain during menses secondary to hematocolpos. The method of choice for diagnosis is magnetic resonance imaging (MRI). MRI can do much for the early diagnosis and the prevention against further complications of this condition because it can demonstrate the mullerian duct anomaly complicated with obstructed hemivagina in detail and even ipsilateral renal agenesis. A greater awareness of the syndrome of uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis should lead to its prompt diagnosis, allowing for early and appropriate surgical intervention as well as decreased long-term morbidity. Early accurate diagnosis after menarche followed by excision and marsupialization of the blind hemivagina offers complete relief of symptoms and preserves reproductive potential. We report a case of uterine didelphys with obstructed hemivagina and ipsilateral renal agensis with a brief review of the literature.
Abdominal Pain ; Diagnosis ; Early Diagnosis ; Female ; Hematocolpos ; Magnetic Resonance Imaging* ; Menarche ; Uterus*

The unique clinical syndrome of the uterus didelphys, a unilateral partially or completely obstructed vagina, and ipsilateral renal agenesis is quite rare, and observed on the right side in greater frequency than on the left. The case of fifteen year old girl with uterus didelphys, unilateral partially obstructed vagina and acute renal failure associated with ureteral stone in unilateral kidney is described. Extracorporealshock wave lithotripsy (ESWL) and evacuation of the hematocolpos and excision of the vaginal septum were done. Aware of this relatively rare condition is mainstay of prompt diagnosis which will prevent permanent renal failure and unnecessary and destructive surgery.
Acute Kidney Injury ; Congenital Abnormalities ; Female ; Hematocolpos ; Kidney ; Kidney Diseases ; Lithotripsy ; Renal Insufficiency ; Ureter ; Uterus ; Vagina

PURPOSE: To assess the role of MRI in the diagnosis of uterine anomaly. MATERIAL AND METHODS: MRI(n:15), hysterosalpingography(n:7) and ultrasonography(n:7) were performed in 15 patients with suspected MullerJan duct anomaly. Nine cases were proved by operation and six cases were diagnoed with imaging and clinical findings. According to Buttram and Gibbons modified classification, the anomalies were 4 cases of class I, 2 cases of class III, one case of class IV, and 8 cases of class V. RESULTS: MRI enabled accurate diagnoses of anomalies in all cases, but HSG and USG showed wrong diagnoses in 3 of 7 cases and in 1 of 7 cases. CONCLUSION: MRI, especially T2-weighted images parallel to long axis of uterine corpus, was very useful in diagnosis of the Mullerian duct anomaly, because it could depict exactly the external fundal contour, intercornual distance, septum, transverse vaginal septum, and associated abnormalities such as hematocolpos and hematometra.
Axis, Cervical Vertebra ; Classification ; Diagnosis ; Female ; Hematocolpos ; Hematometra ; Humans ; Hylobates ; Magnetic Resonance Imaging*

The incidence of all transverse vaginal septum is 1:2,100 - 1:72,000. The transverse vaginal septum is a developmental defect of vagina which may be fused incompletely between the Mullerian duct component and the urogenital sinus component of vagina. Serious complications may be hematocolpos, hematometra and hematosalpinx. Simple surgical excision or simple incision have been developed to treat congenital transverse vaginal septa, but also caused common complications such as secondary tissue contracture. Garcia technique using eight vaginal mucosa flaps was developed to avoid common complication of secondary vaginal stenosis. Here, we present a case of contracted transverse vaginal septum who has been performed a simple incision 13 years ago, successfully performed the modified Garcia technique without serious postoperative complication.
Constriction, Pathologic ; Contracture ; Female ; Hematocolpos ; Hematometra ; Incidence ; Mucous Membrane ; Postoperative Complications ; Vagina

Three-dimensional ultrsonography has been applied to diagnose mullerian anomalies. However, in Korea, no such case has been reported in literatures. An adolescent female was evaluated for dysmenorrhea, and a hematocolpos was found at private clinic. We performed three-dimensional ultrsonography and found uterus didelphys by confirming seperated uterine fundi and cervices. Abscence of right kidney was also found by ultrsonography. The diagnosis of Herlyn-Werner-Wunderlich syndrome was made and marsupialization of the right hemivagina was performed, with relief of symptoms.
Adolescent ; Dysmenorrhea ; Female ; Hematocolpos ; Humans ; Imaging, Three-Dimensional ; Kidney ; Korea ; Uterus