Distribution of children with imperforate hymen between pediatric surgery and gynecology outpatient clinics in a maternity and children’s hospital: A 10-year retrospective study

INTRODUCTION: Imperforate hymen is the most prevalent congenital obstructive abnormality of the female genital tract. This study was conducted to determine which department children who underwent surgery for imperforate hymen first presented to or were referred to at a maternity and children’s hospital. The primary aim was to emphasize the importance of a comprehensive physical examination in reducing the age at diagnosis because of the serious complications associated with delayed diagnosis.
METHODS: The medical records of children who underwent surgery for imperforate hymen between January 2014 and 2024 were retrospectively reviewed.
RESULTS: Of the 32 patients who underwent surgery for imperforate hymen at our hospital over a 10-year period, the mean age at surgery was 116±69 months (minimum: 1 month, maximum: 192 months). Thirteen of the 32 patients (40.6%) underwent surgery in the Department of Pediatric Surgery; six of these 13 patients (46%) were neonates. Among the patients presenting to pediatric surgery, four had prenatally diagnosed hydrocolpos, and five were diagnosed during the first postnatal physical examination. Four adolescents presented directly to pediatric surgery with primary amenorrhea, abdominal pain, and an abdominal cystic mass. Nineteen of the 32 patients (59.4%) underwent surgery in the Department of Gynecology and Obstetrics. The primary reason for referral to the Department of Gynecology and Obstetrics was primary amenorrhea, followed by pelvic pain.
DISCUSSION AND CONCLUSION: A comprehensive physical examination can facilitate the diagnosis of imperforate hymen at an earlier age, particularly when a cystic structure suggestive of hydrometrocolpos is detected on prenatal or postnatal ultrasonography.

Keywords: Adolescent, imperforate hymen, neonate.