Title: Imperforate hymen<br/>Author: Jenny Guyther<br/><a href='http://umem.org/profiles/faculty/314/'>[Click to email author]</a><hr/><p>
Definition: Congenital anomaly where the hymen is completely obstructing the vaginal opening</p>
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Demographic: Incidence 0.05-0.1% of females</p>
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History: Most are asymptomatic and diagnosed on physical exam or incidentally when there is lack of menarche. Symptoms in adolescents can include: Abdominal pain (50%), urinary retention (20%), abnormal menstruation (14%), dysuria (10%), frequency, renal failure, UTI and back pain.</p>
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Physical exam: bulging, blueish hymenal membrane</p>
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Complications: Late detection can lead to infections, fertility problems, endometriosis, hydronephrosis, and rarely renal failure</p>
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ED treatment: If abdominal pain is significant or there is urinary obstruction, a urinary foley can be placed. GYN should be consulted.</p>
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Definitive treatment: Hymenectomy, hymenotomy, carbon dioxide laser treatments or foley insertion through the hymen (done by a specialist).</p>
<fieldset><legend>References</legend>
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<span style="font-family: Calibri, sans-serif; font-size: 14.6667px;">Lee K, Hong J, Jung H et al. Imperforate Hymen: A Comprehensive Systematic Review. </span><i style="font-family: Calibri, sans-serif; font-size: 14.6667px;">J Clin Med</i><span style="font-family: Calibri, sans-serif; font-size: 14.6667px;"> 2019; 8(56): 1-14.</span></p>
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