Successful management of giant hydrocolpos in a limited-resource setting

Abstract

Abdominal distention and urinary retention are rare manifestations in newborns. The differential diagnosis of a female neonate presenting these signs, especially when combined, should include hydrocolpos due to imperforate hymen. The prognosis of imperforate hymen is generally good, although it can be associated with serious nephro-urologic and infectious complications. Early diagnosis and drainage of hydrocolpos allow prevention and/or improvement of these possible complications. In limited-resource settings, diagnostic imaging is more difficult to obtain, and, therefore, increased caution and an accurate physical exam with perineal inspection are essential. We report the case of a 8-day-old female neonate showing abdominal distention and urinary retention. She had a final diagnosis of imperforate hymen with giant hydrocolpos, complicated by obstructive uropathy and following urosepsis and bladder perforation.

Case report: Hydrometrocolpos conditioning recurrent urinary tract infections

“…Finally, there are many innovative methods using different instruments described such as laparoscopic long bipolar forceps, harmonic scalpel, LigaSure (Medtronic Inc., Doral, FL), GIA, and Endo GIA device (11)(12)(13)(14). In critical cases, with the development of acute kidney failure, bladder injury, urinary leakage into the abdominal cavity, or other abdominal complications, laparotomy is recommended (15).…”

Hydrometrocolpos in an infant with urological complications: a rare case and review of literature

“…Hydrometrocolpos is the accumulation of secretions in both the vaginal and uterine cavity. It is a rare condition with an incidence of around 0.006% per year in full-term babies [ 1 , 2 ]. It is caused by the failure of drainage of cervical/vaginal mucous secretions as a result of distal vaginal obstruction.…”

Congenital vaginal obstruction in a newborn

“…The fluid itself consists of cervical and endometrial mucus, and in severe cases, the fluid might accumulate up to the uterus, and the term hydrometrocolpos is used. It has an estimated incidence of ~0.006% per year in full-term newborns [1]. Several anomalies were associated with this condition, such as imperforate anus or persistent urogenital sinus.…”

“…Several anomalies were associated with this condition, such as imperforate anus or persistent urogenital sinus. It was also found to be part of a genetic syndrome, such as Bardet-Biedl, McKusick-Kaufman, and Pallister-Hall [1].…”

“…The clinical features in the newborn period are dominated by the lower abdominal mass with compression of adjacent structures, commonly the urinary bladder. Urinary retention is rare in children, especially in newborns, and its association with abdominal distention in a female neonate should raise the suspicion of hydrocolpos [1]. Physical examination may be completely normal in cases of vaginal septum and a complete pelvic examination with vaginoscopy may be necessary [3].…”