Hymen Atresia Under the Mask of Acute Urinary Retention in an Eleven-Year-Old Girl: A Case Report

Atresia of the hymen is a rare congenital anomaly of the female genital organs, which is usually diagnosed in adolescence after the onset of menarche. In some cases, diagnosis is difficult due to non-specific symptoms that can imitate diseases of other organs and systems. The article describes a clinical case of an 11-year-old patient who had been bothered by pain during urination for a week. In the last 24 hours, she was unable to urinate on her own. The girl was taken to the N.F. Filatov Children's City Clinical Hospital in Moscow by an ambulance team. The initial diagnosis did not identify any obvious urological causes for this condition, which required an extended examination. Anamnesis data (absence of menarche), gynecological examination and ultrasound examination revealed an enlarged vagina filled with menstrual blood - hematocolpos as the main cause of mechanical compression of the urethra and the development of acute urinary retention. And the basis for the development of this pathology was a congenital defect - atresia of the hymen. A urethral catheter was inserted into the patient, 750 ml of urine was released. The next day, under general anesthesia, a cruciate dissection of the hymen was performed, 300 ml of hemorrhagic contents were evacuated, and the vagina was sanitized. A Foley catheter was inserted, which was removed on the 3rd day. In the postoperative period, the patient received a short course of antibacterial therapy. Urination was restored. She was discharged from the hospital on the 5th day in a satisfactory condition under the supervision of a pediatric gynecologist. The purpose of this article is to increase the awareness of surgical doctors about the likelihood of an imperforate hymen when examining adolescent girls with urinary retention and periodic pain in the lower abdomen. In our case, an examination by a gynecologist and an ultrasound examination of the pelvic organs made it possible to confirm the presence of hematocolpos and operate on the patient in a timely manner.