Hymenal atresia – a rare congenital anomaly with the risk of late diagnosis

Abstract

Summary: Hymenal atresia is the most common type of gynatresia which presents by imperforate hymen and hematokolpos. In newborn age, hymenal atresia is revealed in girls with mucocolpos but usually it is not detected until adolescence. In girls before menarche with already developed secondary sexual characteristics it is often identified by cyclic pain at monthly intervals or by the sudden pain and tumor behind the pubic symphysis. Typically, bulging blueish hymen is visually revealed during the gynecological examination. Hymenotomy and hymenectomy are simple and effective treatment methods that immediately relieve all the symptoms and ensure definitive solution of hymenal atresia. The examination by the specialist in pediatric and adolescent gynecology should be an integral part of diagnostic algorithm in the girls at the age of assumed menarche suffering from the recurrent lower abdomen pain with a simultaneous tumor in the deep pelvis. Moreover, in adolescent girls with the above symptoms, other more serious congenital malformations of the genitals such as vaginal agenesis, transverse vaginal septum with partial hematocolpos and cervical and vaginal atresia should be excluded.