Concomitant Septate Hymen and Bicornuate Uterus: Emphasizing the Need for Thorough Internal Genital Tract Evaluation

Congenital anomalies of the hymen are uncommon, and their co-occurrence with congenital uterine anomalies is considered even rarer. This case report describes a patient with a septate hymen combined with a bicornuate uterus. A teenage girl presented to the emergency department with a retained intravaginal tampon. Local examination revealed a septate hymen, and hymenectomy was performed. Over the following years, multiple transabdominal pelvic ultrasounds were performed because of persistent functional hypothalamic amenorrhea, revealing no underlying abnormalities of the internal genital tract. However, several years later, a transvaginal ultrasound performed after the insertion of an intrauterine device suggested the presence of a uterine anomaly. The diagnosis of a bicornuate uterus was confirmed by magnetic resonance imaging and hysteroscopy. Thus, this clinical case highlights the necessity of a thorough internal genital tract evaluation in females diagnosed with congenital hymenal anomalies.