Abstract :
The clinical presentation of imperforate hymen varies significantly from patient to patient
depending on the age at diagnosis, but in most cases, the diagnosis is missed in early childhood and
therefore, the diagnosis is made after puberty when the patient presents with hematocolpos,
hematometra or both. When this happens, the patient may present with unlikely symptoms like
urinary retention or bowel obstruction or both. Rarely, a neglected case can even present with
multiple complications like acute urinary retention and large protruding introital mass with multiple
ulcerations, as happened in our case. Here we discuss case of a 15 years old girl with imperforate
hymen and presented with history of lower abdominal pain and distension associated with acute
urinary retention. She was treated by hymenectomy and improved dramatically and was discharged
on the 6
th day post operatively. This case report is presented to address the clinicians regarding the
possibility of imperforate hymen with hematocolpos as a differential diagnosis in adolescent girls,
particularly those who have not started having their menses in their teens and present with acute
urinary retention, so that their external genitalia are carefully examined to exclude the possibility of
imperforate hymen as a cause of acute urinary retention due to the hematocolpos.
Keyword :
Hematocolpos, Imperforated hymen, Acute urinary retention.