Hematocolpos causing severe urinary retention in an adolescent girl with imperforate hymen: an uncommon presentation

Hematocolpos is rarely presented as a pelvic mass which mechanically compresses the bladder and the urethra thereby causing urinary retention.

A 12-year-old girl referred with the history of lower abdominal pain and retention of urine for 24 h. The patient had not started her menses yet. Three weeks before she also complained of discomfort on passing urine, frequency and urgency and was taken to a local outpatient clinic where she was given antibiotics with the diagnosis of urinary tract infection, she had also the history of intermittent urinary catheterization (three times before) in an emergency department because of acute severe urinary retention. Transabdominal ultrasonography revealed a pelvic semi-solid mass suggestive of hematocolpos. Pelvic examination revealed a pale blue imperforate hymen bulging from the vaginal introitus outwards. A cruciate incision was made over the hymen. Postoperative period was uneventful.

In case of acute severe urinary retention in an adolescent girl, the clinicians should keep in mind that imperforate hymen may be a causative factor and this condition may easily be treated surgically.