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Hematocolpos due to imperforate hymen: a case report and literature systematic review

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Abstract

Introduction and hypothesis

Hematocolpos is a rare condition, where menstrual blood fills the vagina, instead of being expelled, due to a series of uterovaginal pathologies, the most frequent of which is the imperforate hymen. To date, few cases of hematocolpos have been reported in the literature.

Methods

We report a case of hematometrocolpos due to imperforate hymen initially misdiagnosed as constipation and subsequently as ovarian mass; moreover, the present study undertakes a systematic review of studies on hematometrocolpos due to imperforate hymen to synthesize available knowledge on epidemiology, diagnosis, and management about this rare condition.

Results

A total of 35 studies, describing 61 patients, were identified. The presence of hematocolpos should be suspected in premenarchal patients complaining of low abdominal pain, abdominal swelling, and urinary retention. Genital examination disclosing a tender, pale hymen and ultrasound represent a useful tool for diagnosis. The goal of the management is to timely perform hymenotomy to drain the hematocolpos, followed by hymenectomy to prevent recurrence. Follow-up is needed to diagnose possible recurrences.

Conclusions

In the case of an adolescent girl complaining of genital pain associated with primary amenorrhea, hematocolpos due to imperforate hymen should be suspected.

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Data availability

The datasets generated and analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Authors

Contributions

G. Marino: project development, data collection, data analysis, manuscript writing/revision

N. Alfieri: project development, data collection, data analysis, manuscript writing/revision

I. Vaglio Tessitore: project development, data collection, data analysis, manuscript writing/revision

M. Barba: project development, data collection, data analysis, manuscript writing/revision

S. Manodoro: project development, data collection, data analysis, manuscript writing/revision

M. Frigerio: project development, data collection, data analysis, manuscript writing/revision

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Correspondence to Matteo Frigerio.

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Marino, G., Alfieri, N., Tessitore, I.V. et al. Hematocolpos due to imperforate hymen: a case report and literature systematic review. Int Urogynecol J 34, 357–369 (2023). https://doi.org/10.1007/s00192-022-05270-x

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