Imperforate Hymen Presenting as Acute Urinary Retention in an Adolescent Girl: a Case Report

Abstract

An imperforate hymen is a congenital condition in which a solid membrane obstructs the vaginal introitus, separating it from the proximal uterovaginal tract. We report the case of a 12-year-old girl who presented with a five-month history of cyclical lower abdominal pain, a two-week history of progressively worsening difficulty with micturition, and complete urinary retention for two days before presentation. She had no prior history of vaginal bleeding and no family history of similar illness. Physical examination revealed a firm, well-defined, centrally located pelvic mass that was mildly tender and non-pulsatile, as well as a distended bluish membrane at the introitus. Abdominopelvic ultrasonography and an intravenous urogram were performed. Based on the clinical and radiological findings, a diagnosis of imperforate hymen complicated by haematocolpos, haematometra, acute urinary retention, and bilateral obstructive uropathy was made. The patient underwent hymenotomy using an X-shaped incision, with good postoperative recovery. She remained asymptomatic during six months of follow-up.