Pediatric Case ReportRecurrent Urinary Retention Due to Imperforate Hymen After Hymenotomy Failure: A Rare Case Report and Review of the Literature
Section snippets
Case
In September 2009, a 14-year-old girl was admitted to the pediatric emergency department with a 12-hour history of acute urinary retention, accompanied by dysuria and severe lower abdominal pain. There was no history of nausea, vomiting, altered bowel habits, or fever. She had not been taking any medications recently, including antihistamines and anticholinergic drugs. The patient had not yet started her menses.
On physical examination, her vital signs were normal. Secondary sexual
Comment
The hymen is a balance sheet of mesoderm that is perforated normally during the later stages of embryonic development.3 Imperforate hymen is usually an isolated anomaly, although associated malformations, especially those of the genitourinary tract, have been reported. Most cases reported in the literature are sporadic; however, some familial cases have been described as presumptive of probable genetic predisposition.3
During the neonatal period, imperforate hymen may present with fetal ascites
Conclusion
Although hematocolpos associated with imperforate hymen and urinary retention is uncommon, it should be included in the differential diagnosis in adolescent females with acute abdominal pain and urinary retention. Inspection of the external genitalia, along with catheterization and detailed history-taking, with emphasis on menstruation, can aid in preventing misdiagnosis and commencing with additional radiological diagnostic examinations and appropriate surgical treatment. Moreover,
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