Congenital anomalies causing hemato/hydrocolpos: imaging findings, treatments, and outcomes

Abstract

Hemato/hydrocolpos due to congenital urogenital anomalies are rare conditions discovered in neonatal, infant, and adolescent girls. Diagnosis is often missed or delayed owing to its rare incidence and nonspecific symptoms. If early correct diagnosis and treatment cannot be performed, late complications such as tubal adhesion, pelvic endometriosis, and infertility may develop. Congenital urogenital anomalies causing hemato/hydrocolpos are mainly of four types: imperforate hymen, distal vaginal agenesis, transverse vaginal septum, and obstructed hemivagina and ipsilateral renal anomaly, and clinicians should have adequate knowledge about these anomalies. This article aimed to review the diagnosis and treatment of these urogenital anomalies by describing embryology, clinical presentation, imaging findings, surgical management, and postoperative outcomes.

Challenges in prenatal diagnosis of foetal anorectal malformation and hydrocolpos – Case report

“…There is no data on fetal presentation of hydrometrocolpos due to the rarity of the disease and the difficulty in prenatal diagnosis. The prevalence of congenital dilatation of the uterus and vagina causing hydrometrocolpos is less than 1 per 30,000 births with the first report published in 1856 [ 5 , 6 ].…”

Hydrometrocolpos in Infants: Etiologies and Clinical Presentations

“…The mass may also cause compression effects, such as hydroureteronephrosis, urinary retention, and constipation [3].…”

“…The reported incidence of hydrometrocolpos is around 0.006% [ 1 ]. Hemato/hydrometrocolpos is caused by congenital urogenital anomalies or acquired etiologies such as infection, trauma, or sexual abuse [ 2 , 3 , 4 , 5 ]. The most common congenital cause is imperforate hymen [ 1 ], and the other associated structural anomalies include transverse vaginal septum, distal vaginal agenesis, persistent urogenital sinus, and cloacal malformation [ 6 , 7 ].…”

“…Vaginal retention of menstrual blood at puberty, which is hematometrocolpos, results in painful primary amenorrhea and pelvic mass [ 8 ]. The mass may also cause compression effects, such as hydroureteronephrosis, urinary retention, and constipation [ 3 ].…”

Distal vaginal atresia: a report of a rare type found a late-term fetus and its histological comparison with the normal pelvis

“…Vaginal atresia is often associated with a duplicated uterus and unilateral renal agenesis. This condition was termed Herlyn-Werner-Wunderlich syndrome [1][2][3][4][5], but subsequent researchers considered this term to be a synonym of obstructed hemivagina and ipsilateral renal anomaly syndrome [6][7][8]. A duplicated vagina and a bicornuate uterus are the typical morphologies in these patients.…”