Hymen Sparing Surgery for Imperforate Hymen: Case Reports and Review of Literature

Imperforate hymen and its complications: report of two cases and review of literature

“…8 The function of the hymen is not clear but is thought to include innate immunity as it provides a physical barrier to infections during the prepubertal period when the vaginal immunity is not fully developed. 4 Imperforate hymen is rarely associated with other female genital tract malformations 2,3 although some authors 9,10 have emphasized the need to rule out associated Mullerian malformations. If the hymen is imperforate, mucus and blood from endometrial sloughing accumulate in the vagina which can present during three main stages in life.…”

“…In new-born and childhood period this may occur due to maternal estrogenic stimulation that leads to uterovaginal secretions filling up the blind vagina and presenting with hydrocolpos. 2,4,7 However, more commonly adolescent girls present after menarche when menstrual blood trapped in the vagina behind the imperforate hymen which is known as hematocolpos creating a bluish bulge at the introitus. With cyclic menstruation, the vaginal canal becomes greatly distended, and the cervix may begin to dilate and allow formation of a hematometra and hematosalpinx.…”

“…Amenorrhea, which may be primary due to accumulation of blood behind the imperforate hymen 3,4,7 or secondary which can occur following spontaneous closure of previously perforate hymen. The later mainly occurs in micro perforate or stenosed hymen following surgical or sexual trauma where initial light periods will be experienced but continuous stenosis leads to complete obstruction and amenorrhea.…”

“…1 Although the most common age of presentation is around puberty 2,3 diagnosis in utero [4][5][6] and during the new born period and childhood 4,7 are also reported. We report two cases of imperforated hymen with different symptoms of presentation.…”

Imperforate hymen

“…[1,2] The therapy is always represented by hymenectomy. [3] It has been reported that 2 distinct subpopulations of girls with IH exist on the basis of the age at diagnosis. [1] One group comprehends younger girls (< 3 years old) usually asymptomatic and diagnosed accidentally through physical examination alone.…”