Acute urinary retention in a female adolescent

Abstract

Introduction: Acute urinary retention requires timely evaluation and management in order to prevent damage to the kidneys and urinary tract. Case Report: An 11yearold female child came to the emergency department complaining of abdominal pain for three days and oliguria with dysuria for the last 24 hours. Physical examination showed a palpable mass in lower abdomen up to umbilical level and a bulging mass in the introitus. A Foley catheter was inserted, draining 500 mL of urine with relief of the abdominal pain. After emptying the bladder, a residual mass was palpated. Renal ultrasound showed no abnormalities and pelvic ultrasound demonstrated a large homogeneous echogenic mass in the lower uterine region, diagnosed as hematocolpos. Further surgical hymenectomy resolved patient's symptoms. Conclusion: Acute urinary retention is relatively infrequent in children. Hematocolpos is a rare gynaecological abnormality that results from imperforate hymen. Retained blood in the vagina can cause compression of the urethra and consequent urinary retention. Hematometrocolpos is another rare cause of acute urinary retention. In the evaluation of a premenarchal adolescent

Unusual case of acute urinary retention in a young female

“…In a young female, obstructive causes include pelvic masses, faecal impaction, pregnancy, imperforate hymen or urogenital abnormalities resulting in the formation of hydrocolpos,4 all of which our patient did not have. Functional causes of AUR include inflammatory, pharmacological, infectious or neurological (eg, transverse myelitis, cauda equina) aetiologies.…”

Obstructive Uropathy as a Complication of Hematometrocolpos in an Adolescent Female: A Case Report

“…Given the mass effect and resultant hydronephrosis secondary to blood accumulation in the vagina and/or uterus which stretch, compress, and obstruct the urethra, urinary tract infections may commonly occur as a complication with an incidence rate of 20-48%. 1,8,9 Symptoms that were difficult to relate to imperforated hymens, like back pain, constipation, respiratory distress, nausea, and vomiting, were also reported. 4 Suspected hematometrocolpos can be diagnosed by careful perineal examination and inspecting a bulged hymen at the vaginal introitus; thus, careful gynecological examination in any adolescent female presenting with abdominal pain or obstructive uropathy with primary amenorrhea is highly recommended.…”