An overlooked cause of acute urinary retention in an adolescent girl: A case report

Introduction: Massive hematocolpos resulting from an imperforate hymen is quite a rare cause of acute urinary retention, in an adolescent girl admitted to the emergency department. Materials and methods: A 12-year-old girl suffering from severe inguinal pain and dysuria together with difficulty in urination for about 1 month was admitted to the emergency department for acute urinary retention. On gynecological examination, imperforate hymen was observed to be the cause of the urinary difficulty. Pelvic magnetic resonance imaging revealed a dilated vagina exerting pressure on the bladder outlet suggestive of hematocolpos. Cruciate hymenotomy was performed. The postoperative period and three follow-up visits of the patient up to the 6th month were uneventful. Conclusion: The diagnosis of imperforate hymen can be missed if a genital examination is not performed in adolescent girls presenting to emergency departments with urinary difficulty. The purpose of this paper is to increase awareness among emergency physicians about the probability of imperforate hymen while examining adolescent girls with urinary retention and intermittent lower abdominal pain. © 2008 Springer-Verlag.