Distribution of Children with Imperforate Hymen to Pediatric Surgery or Gynecology Outpatient Clinics in a Maternity and Children's Hospital: A 10-Year Retrospective Study

INTRODUCTION: Imperforate hymen is the most prevalent female genital tract obstructive congenital abnormality. This study was conducted to determine children who underwent surgery due to imperforate hymen first applied or referred which department at a maternity and children's hospital. The main aim is to emphasize in order to reduce the age of diagnosis to a younger age with the importance of a comprehensive physical examination because of the important complications related with delayed diagnosis.
METHODS: The medical records of children who underwent surgery for imperforate hymen between January 2014-2024 were retrospectively reviewed.
RESULTS: Of the 32 patients who underwent surgery for imperforate hymen at our hospital over a ten-year period, the mean age at surgery was 116±69 months (min: 1 month, max: 192 months).
Thirteen patients of 32 (40.6%) underwent surgery in department of Pediatric Surgery; six of these 13 cases (46%) were neonates. Among those presenting to pediatric surgery, four had prenatally diagnosed hydrocolpos, five cases were identified during the first postnatal physical examination. Four adolescents applied directly to pediatric surgery for primary amenorrhea, abdominal pain, and an abdominal cystic mass. Nineteen patients of 32 (59.4%) underwent surgery in the department of the Gyneocology & Obstetrics. The primary reason for referral to department of the gyneocology & obstetric was primary amenorrhea, and the secondary reason was pelvic pain.


DISCUSSION AND CONCLUSION: A comprehensive physical examination can help to bring the diagnosis of hymen imperforatus to an earlier age. If a cystic structure is seen on prenatal or postnatal ultrasound that raises suspicion of hydrometrocolpos.

Keywords: Adolescent, Neonate, Imperforate hymen