Page 166 - Abstract Book KONIKA 18

Emergency & Pediatric Intensive Care

P-EPIC-012
Imperforate Hymen Presenting with Hematocolpos
causing Acute Urinary Retention in an Adolescent Girl: A Case Report

2
Raisa Cecilia Sarita , Nana Agustina , I Gusti Ayu Nyoman Partiwi 1
1
2
Department of Child Health and Department of Obstetrics and Gynaecologist ,
1
Bunda Women and Children Hospital, Jakarta, Indonesia
Abstract
Background Hematocolpos is the accumulation of menstrual blood within vagina due to a present of
anatomical obstruction, usually an imperforate hymen, which may compress the bladder and urethra causing
acute urinary retention. This condition may easily missed by physician in emergency settings hence may lead
to inappropriate management. Objective to increase the awareness of differential diagnosis of acute urinary
retention in adolescent girls. Case A 13 year-old girl was admitted to emergency department with chief
complaint of sudden onset of acute urinary retention. She had episodes of lower abdominal pain and dysuria
since 4 days prior to admission. On examination, there was palpable distended bladder and a pale-blue bulging
mass protruded from introitus vagina outwards. Foley catheter was placed which led to symptoms relief and
passage of 1200 ml urine. Further history taking found that the patient has not menarche yet and ultrasound
conducted by obstetric and gynecologic specialist found distended vagina with fluid content suggestive to
hematocolpos due to imperforate hymen. Hymenotomy was performed by making a 1 cm incision over the
hymen, resulting in passage of 600 mL of dark, red, blood. Patient was discharged on the same day after
procedure and postoperative follow-up found no difficulty in urination. Conclusion Imperforate hymen
should be considered as differential diagnosis of acute urinary retention in young girls. Hymenotomy is a
simple procedure as definitive management.
Keywords: urinary retention; hematocolpos; imperforate hymen

Before surgery After hymenotomy

118 KONIKA XVIII Abstract Book