Abstract
Aim This case report is important because it presents an unusual and rare cause of urinary retention caused by hematocolpos due to a congenital vaginal obstruction. Hematocolpos is a medical condition in which there is a vaginal retention of menstrual blood. It is caused by congenital urogenital anomalies like imperforate hymen or by trauma, infection and sexual abuse
Material and Method Case presentation A 12 year old girl, was brought to emergency department with lower abdominal pain, urinary retention and difficulty in urination for about 24 hours. On the objective examination there was nothing to worry about except a vesical globus and abdominal pain during palpation. Vital parameters were normal and after a urinary catheterization in emergency she was hospitalized in Pediatric Nephrology Department. Abdominal ultrasonography revealed a pelvic liquid mass (figure 1). Radiologist suggested CT scan of Abdomen with contrast, which confirmed the presence of hematocolpos and after gynecological examination, imperforate hymen was observed to be the cause. Surgical incision was made over the hymen and applied antibiotics therapy for treating the urinary infection.
Results Laboratory findings WBC = 11,5 K/µL RBC = 4.27x10 000/µL Hgb = 12.4 g/dL PLT = 315K/µL HCT = 36.7% Glucose = 99 mg/dL Urea = 22.9 mg/dL Creatinine = 0.58 mg/dL Total Bilirubine = 3.15 mg/dL ALT = 13U/L AST = 39U/L Electrolytes = normal Urine Examination : presence of urinary infection
Conclusions In case of acute urinary retension and lower abdominal pain in a teenage girl, who has not started her menses yet, the doctor should consider even the presence of imperforate hymen which is a condition that can be easily diagnosed and treated