Introduction: Imperforate hymen is a rare condition but it is the most frequent obstructive anomaly of the female lower genital tract. In most cases the diagnosis is missed in childhood and is made after puberty when the patient presents with haematocolpos and heamatometra. The patient presented with uncommon symptoms of urinary retention apart from delayed menarche and pain. Patient: Here we present a 14-year-old girl who presented with lower abdominal pain and acute urinary retention. Intervention: She was diagnosed clinically and by ultrasound as imperforate hymen with haematocolpus. She was treated by a virginity preserving hymenotomy. Conclusion: This case is presented to address clinicians the possibility of imperforate hymen as a differential diagnosis in acute urinary retention and the ultrasound diagnoses of imperforate hymen.

Objectives: Our aim was to study the prevalence of isthmocele in cases with previous cesarean section scar presented to El Shatby maternity university hospital and its association with gynecological complications. Material and Methods: After approval of the ethics committee of Alexandria faculty of medicine, a sample of 300 patients delivered by cesarean section since 6 months or more presented by one or more of the following symptoms: Abnormal uterine bleeding (AUB) dysmenorrhea, secondary infertility, and lower abdominal pain were selected from the gynecology clinic of El Shatby maternity university hospital. All patients were subjected to history taking, clinical, and gynecological examination. Post-menstrual 2D transvaginal ultrasonography was done. Where the niche or isthmocele was seen as triangular or dome- shaped echo-free space. Data were collected and entered to the computer using Statistical Package for the Social Science program for statistical analysis. Results: Niche was found in 44 cases. Most of them were symptomatic. Duration from the last (CS) was statistically significant. Symptoms were related to number of previous cesarean sections. Conclusion: The incidence of post-cesarean section niche in El Shatby Maternity hospital was 14.67%. Most common symptoms were AUB and dyspareunia.

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