Late diagnosis of imperforate hymen with hematometrocolpos and bilateral hydronephrosis of a horseshoe kidney

Abstract

Imperforate hymen is a fairly uncommon genital disorder where the hymen completely obstructs the vaginal opening. Several authors have ruled out its co-occurrence with other congenital anomalies. In this report, we discuss the exceptional case of a late diagnosis of imperforate hymen associated with bilateral hydronephrosis of a horseshoe kidney in a 19-year-old female patient. To our knowledge, an association of imperforate hymen and horseshoe kidney has never been reported.

Peritoneal Rupture of Hematocolpos in Distal Vaginal Atresia

“…In advanced stages, the latter can progress to kidney failure. 13,14 This patient presented to us with severe hydroureteronephrosis. There was a transient elevation in her serum creatinine levels due to severe dehydration, which gradually improved after surgery.…”

Ultrasonographic examination and resolution of a pronounced hematocolpometra linked to an imperforate hymen: A detailed case study

“…Diagnosing a hematocolpometra caused by an imperforate hymen is not difficult; it can be done simply by physical examination with an inspection and an ultrasound without needing other advanced methods such as magnetic resonance imaging. Despite this, cases of delayed diagnosis of this pathology are still being reported [9] . Insufficient examination of the newborn and insufficient consultation with a gynecologist when symptoms occur in early adolescence are the main factors contributing to this delay.…”

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.…”