Management of hematometrocolpos due to dysfunctional uterine bleeding following progestin use: a case report

Abstract

Hematometrocolpos is accumulation of blood in the vagina and uterine cavity due to intra-uterine hemorrhage. A 20-year-old female presented to our clinic with massive menorrhagia at menarche after progestin usage. Hematometrocolpos was detected by transabdominal ultrasonography. She was pale because of heavy bleeding for 5 days and hemoglobin level was measured as 5.1 g/dl. Initial treatment was blood transfusion and medical drug therapy. After resolution of the hematometrocolpos was shown by transabdominal ultrasound 2 days later, the patient, who was stable, was discharged without complication. Obstruction of the female genital outflow tract is rarely seen. Hematocolpos has been reported in elderly women following vaginal occlusion due to radiotherapy, vaginal fibroma and labial synechiae causing infection or inflammatory conditions. The case is presented here because of the successful management of hematometrocolpos due to massive dysfunctional uterine bleeding in a young virgin patient.

Haematocolpos due to imperforate hymen disguised as constipation

“…Haematocolpos may be caused by congenital morphological abnormalities (imperforate hymen, vaginal or cervical atresia, complete transverse vaginal septum) or by acquired obstruction of the lower genital tract (labial adhesion, iatrogenic interventional procedures) 7 …”

“…It is usually an isolated anomaly but it is sometimes associated with other malformations such as gynaecological (vaginal or uterine septum, partial atresia of the vagina, duplicated uterus), urological (renal agenesis, duplicated ureter), anorectal and vertebral abnormalities 5,7 …”

A Case of Haematometra Secondary to Cervical Stenosis after Vesicle Vaginal Fistula Surgical Repair

“…Congenital causes may be due to cervical agenesis, transverse vaginal septum, and imperforate hymen and acquired cause may be iatrogenically as a result of healing by secondary intention with the scared formation [10]. …”

Virginity-sparing management of hematocolpos with imperforate hymen: case report and literature review

“…Hysteroscopic resection of oblique septum Zivkovic et al 6 Case report: 1 case OHVIRA syndrome Lakhi et al 39 Case report: 1 case Hematoureter due to endometriosis with hematocolpos and septum Laparoscopy Bakacak et al 40 Case report: 1 case Hematometrocolpos due to dysfunctional uterine bleeding following progestin use…”