Gyimadu Adam, Sayal Berkan, Guven Suleyman, Gunalp G Serdar
Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, Turkey.
Arch Gynecol Obstet. 2009 Sep;280(3):461-3. doi: 10.1007/s00404-009-0931-5. Epub 2009 Jan 16.
Hematocolpos is rarely presented as a pelvic mass which mechanically compresses the bladder and the urethra thereby causing urinary retention.
A 12-year-old girl referred with the history of lower abdominal pain and retention of urine for 24 h. The patient had not started her menses yet. Three weeks before she also complained of discomfort on passing urine, frequency and urgency and was taken to a local outpatient clinic where she was given antibiotics with the diagnosis of urinary tract infection, she had also the history of intermittent urinary catheterization (three times before) in an emergency department because of acute severe urinary retention. Transabdominal ultrasonography revealed a pelvic semi-solid mass suggestive of hematocolpos. Pelvic examination revealed a pale blue imperforate hymen bulging from the vaginal introitus outwards. A cruciate incision was made over the hymen. Postoperative period was uneventful.
In case of acute severe urinary retention in an adolescent girl, the clinicians should keep in mind that imperforate hymen may be a causative factor and this condition may easily be treated surgically.
处女膜闭锁很少表现为盆腔肿块,该肿块机械性压迫膀胱和尿道,从而导致尿潴留。
一名12岁女孩因下腹痛和尿潴留24小时前来就诊。该患者尚未初潮。三周前,她还诉说排尿时不适、尿频和尿急,被带到当地门诊,诊断为尿路感染并给予抗生素治疗,她也曾因急性严重尿潴留在急诊科进行过三次间歇性导尿。经腹超声检查发现盆腔有一个半实性肿块,提示处女膜闭锁。盆腔检查发现处女膜呈淡蓝色,从阴道开口向外膨出。在处女膜上做了一个十字形切口。术后恢复顺利。
对于青春期女孩急性严重尿潴留的情况,临床医生应牢记处女膜闭锁可能是一个致病因素,且这种情况通过手术很容易治疗。