Recurrent formation of haematocolpos in a young girl with multiple congenital anomalies of the urogenital tract.

An 11-year-old girl, a known case of left crossed fused renal ectopia and sacral hypoplasia presented to the gynaecological OPD in Karachi, Pakistan, in February 2019 with complaints of abdominal pain. On examination, she was found to have a septum covering her vaginal orifice. She was subsequently diagnosed with haematocolpos secondary to imperforate hymen. Incision and drainage was done. However, despite surgical management, she continued to have recurrent formation of haematocolpos for the next two months secondary to multiple complete and partial transverse vaginal septa and post-operative formation of adhesions. Definitive management was done with ultrasound guided needle puncture and drainage, followed by post-operative tampon use to maintain patency.

Herlyn-Werner-Wunderlich syndrome - a rare genitourinary anomaly in females: a series of four cases.

We present case series of four patients with an important syndrome known as Herlyn-Werner-Wunderlich syndrome. Herlyn-Werner-Wunderlich syndrome is a rare congenital anomaly characterised by uterus didelphys with blind hemivagina and ipsilateral renal agenesis. It usually presents after menarche with progressive pelvic pain during menses secondary to haematocolpos. Awareness is necessary to diagnose and treat this disorder properly before complications occur. Magnetic resonance imaging is the preferred modality for the delineation of uterine malformation. When renal anomalies are encountered, a screening should also be made for congenital abnormalities of the reproductive tract and vice versa.

Rare Transverse Vaginal Septum in an Adolescent Girl.

An uncommon malformation of the female genital system is the transverse septum which is often known as the vaginal septum. A problem with the union and channelling of the Mullerian conductors and urogenital sinus is the primary common cause of progressive pathogenesis. This anatomical blockage can block the vagina, which can lead to a hematocolpos that is connected with periodic pelvic discomfort in teenage females immediately after menarche. A thorough clinical gynaecological evaluation, particularly an abdominal or transrectal ultrasound scan, and in even more complicated situations, magnetic resonance imaging is used to determine the presence of a vaginal septum. The surgical intervention must be performed as soon as feasible. We report the management of a case of a 16-year-old girl presented with primary amenorrhea associated with severe pain in the lower abdomen for 2-3 days, which was cyclic in nature and spasmodic in character. She revealed a hematocolpos during the examination, aggravating a full transverse vaginal septum. Removing the hematocolpos and examining the cervix were the steps in the therapy.

A rare cause of acute urinary retention in adolescents: A case of imperforate hymen.

Imperforate hymen is a genital outflow abnormality that can occur in females. It can present with various symptoms and is associated with short- and long-term complications that may affect patients' quality of life. Acute urinary retention in adolescents is a rare occurrence. We report a case of delayed diagnosis of imperforate hymen involving multiple visits to the clinic for urinary symptoms and the subsequent development of acute urinary retention. Awareness of this rare presentation is essential since delayed diagnosis is associated with hydronephrosis, endometriosis and infertility in later life.

Mimics of malignancy caused by concurrent imperforate hymen and transverse vaginal septum: an instructive case and review of the literature.

The coexistence of imperforate hymen and vaginal septum is rare and their ability to mimic malignant manifestations have not been frequently reported. This current case report describes a 13-year-old girl that presented with cyclic abdominal pain for 6 months. She was found to have a huge mass via abdominal plain film X-ray and sonography, with inexplicably high levels of serum carcinoembryonic antigen, cancer antigen (CA)-19-9 and CA-125. Pelvic computed tomography imaging disclosed two huge cystic lesions in the uterine and upper vaginal cavities. Surgical intervention conformed the diagnosis of a concurrent imperforate hymen and transverse vaginal septum, echoing the imaging findings of haematocolpometra. Her tumour marker levels gradually returned to normal after surgery. This rare case of concomitant imperforate hymen and transverse vaginal septum highlights that haematocolpometra, a benign disease that might mimic malignancy, should be taken into consideration in any adolescent females with an abdominal mass and amenorrhoea to ensure an early diagnosis and timely appropriate management.

Tabique vaginal transverso: revisión bibliográfica a propósito de un caso / Transverse vaginal septum: case report and literature review

El tabique vaginal transverso es una malformación genital femenina muy infrecuente con una etiología desconocida y un manejo clínico aún por discernir. Presentamos el caso de una mujer de 17 años que presentaba estrechez del introito vaginal asociada a una intensa dismenorrea, con el diagnóstico final de esta entidad tras una exploración bajo anestesia. El conocimiento de esta anomalía junto con sus hallazgos clínicos y posibles entidades extragenitales asociadas permiten realizar un apropiado diagnóstico de sospecha y una correcta clasificación, lo que conlleva un manejo terapéutico más óptimo.(AU)

Transverse vaginal septum is a rare female genital malformation of unknown aetiology, and for which there is still no clear clinical management. The case is presented of a 17-year-old woman who had a narrow vaginal introitus associated with intense dysmenorrhoea. She was diagnosed with this disorder after an examination under anaesthesia. The knowledge of this anomaly, as well as its symptomatology and associated extra-genital pathologies, can lead to an appropriate suspected diagnosis and correct classification, and to a more optimal therapeutic management.(AU)

Imperforate hymen presenting as acute urinary retention in a 14-year-old nigerian girl.

Acute urinary retention in adolescent females is rare, just like imperforate hymen. We present a case of acute urinary retention secondary to imperforate hymen in a 14-year-old Nigerian girl. Its diagnosis and treatment are discussed with a brief review of literature. We highlight the need for a thorough evaluation in the female patient presenting with acute urinary retention, and also the need to provide better health facilities in rural areas in developing countries such as ours.