Imperforate Hymen

Overview


Plain-Language Overview

Imperforate Hymen is a condition where a thin membrane called the hymen completely blocks the opening of the vagina. This affects the female reproductive system and can cause problems when menstrual blood cannot leave the body. Girls with this condition may experience painful abdominal swelling and difficulty urinating once they start menstruating. It is a congenital condition, meaning it is present at birth, but symptoms often appear during puberty. The blockage can lead to a buildup of blood in the vagina and uterus, causing discomfort and potential complications. Diagnosis is usually made by a healthcare provider during a physical exam. Treatment involves a minor surgical procedure to create an opening in the hymen.

Clinical Definition

Imperforate Hymen is a congenital anomaly characterized by a complete failure of the hymenal membrane to perforate during fetal development, resulting in a membranous obstruction of the vaginal introitus. This condition leads to outflow obstruction of menstrual blood, causing hematocolpos and potentially hematometra after menarche. It is the most common obstructive anomaly of the female genital tract and presents clinically with primary amenorrhea, cyclic pelvic pain, and a palpable lower abdominal mass. The obstruction can also cause urinary retention or constipation due to mass effect. Diagnosis is confirmed by physical examination revealing a bulging, bluish hymenal membrane. Early recognition is important to prevent complications such as infection or endometriosis.

Clinical Presentation


Diagnostic Workup


Pathophysiology


Treatments


Prevention


Outcome & Complications


Differential Diagnoses


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