Hematocolpos

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Hematocolpos
Specialty Gynecology

Hematocolpos is a medical condition in which the vagina is pooled with menstrual blood due to multiple factors leading to the blockage of menstrual blood flow. The medical definition of hematocolpos is "an accumulation of blood within the vagina". It is often caused by the combination of menstruation with an imperforate hymen. [1] [2] It is sometimes seen in Robinow syndrome, uterus didelphys, or other vaginal anomalies.

Contents

A related disorder is hematometra, where the uterus fills with menstrual blood. [3] It presents after puberty as primary amenorrhea, recurrent pelvic pain with a pelvic mass. This can be caused by a congenital stenosis of the cervix, or by a complication of a surgical treatment. [4] Mucometrocolpos is the accumulation of mucous secretions behind an imperforate hymen. [5] [6] Mucometrocolpos can sometimes cause abdominal distention. [7] [8] [9] [10]

Symptoms

Causes

There are four possible causes of hematocolpos [12]

Treatment

As the causes for Hematocolpos are diverse, there are different surgical treatments which needs to be undertaken to cure it. Surgical interventions for congenital cervical atresia range from complete hysterectomy with canalization to conservative options, such as uterine cavity catheterization. [15]

For the women who have an imperforate hymen, a minor surgery is required incising the extra hymen membrane. It is generally treated surgically, with a hymenotomy or other surgery to remove any tissue that blocks the menstrual flow. Also, post surgery, the patient is required to insert dilators into the vagina for a few minutes each day for a few days post the surgery to avoid the incision being closed on its own. Once the patient has recovered from the surgery- that is, there are no burning sensation around the vaginal, they can have regular periods, normal sexual intercourse. Unlike an imperforate hymen which can be easily corrected, surgical correction of a transverse septum can be difficult if the surgery is not carefully planned. Postoperative complications, such as vaginal stenosis and re-obstruction can occur, especially when the septum is thick. The thickness and location of the septum is most commonly evaluated by transperineal ultrasound or MRI before attempting its resection. [18]

References

  1. Kloss, Brian T.; Nacca, Nicholas E.; Cantor, Richard M. (6 May 2010). "Hematocolpos secondary to imperforate hymen". International Journal of Emergency Medicine. 3 (4): 481–482. doi:10.1007/s12245-010-0171-2. PMC   3047835 . PMID   21373333.
  2. TOMPKINS, PENDLETON (2 September 1939). "The Treatment of Imperforate Hymen with Hematocolpos". Journal of the American Medical Association. 113 (10): 913–916. doi:10.1001/jama.1939.02800350023007.
  3. Smith, Roger Perry (2008-01-01). Netter's Obstetrics and Gynecology. Elsevier Health Sciences. ISBN   978-1416056829.
  4. Verma, SK; Baltarowich, OH; Lev-Toaff, AS; Mitchell, DG; Verma, M; Batzer, F (Jul 2009). "Hematocolpos secondary to acquired vaginal scarring after radiation therapy for colorectal carcinoma" (PDF). Journal of Ultrasound in Medicine. 28 (7): 949–53. doi: 10.7863/jum.2009.28.7.949 . PMID   19546336. S2CID   11759668.
  5. Yapar, E. G.; Ekici, E.; Aydogdu, T.; Senses, E.; Gökmen, O. (1996-12-18). "Diagnostic problems in a case with mucometrocolpos, polydactyly, congenital heart disease, and skeletal dysplasia". American Journal of Medical Genetics. 66 (3): 343–346. doi:10.1002/(SICI)1096-8628(19961218)66:3<343::AID-AJMG19>3.0.CO;2-M. ISSN   0148-7299. PMID   8985498.
  6. Babcock, Diane S. (January 1989). Neonatal and pediatric ultrasonography. Churchill Livingstone. ISBN   9780443086069.
  7. Saclarides, Theodore J.; Myers, Jonathan A.; Millikan, Keith W. (2015-01-02). Common Surgical Diseases: An Algorithmic Approach to Problem Solving. Springer. ISBN   9781493915651.
  8. Kaiser, Georges L. (2012-12-13). Symptoms and Signs in Pediatric Surgery. Springer Science & Business Media. ISBN   9783642311611.
  9. Stevenson, Roger E. (2015-10-27). Human Malformations and Related Anomalies. Oxford University Press. ISBN   9780199386031.
  10. Dosedla, Erik; Kacerovsky, Marian; Calda, Pavel (2011-03-01). "Prenatal diagnosis of hydrometrocolpos in a down syndrome fetus". Journal of Clinical Ultrasound. 39 (3): 169–171. doi:10.1002/jcu.20785. ISSN   1097-0096. PMID   21387330. S2CID   11211408.
  11. 1 2 3 4 5 6 7 Kotter, Haleigh; Weingrow, Daniel; Canders, Caleb (2017-07-28). "Hematometrocolpos in a Pubescent Girl with Abdominal Pain". Clinical Practice and Cases in Emergency Medicine. 1 (3): 218–220. doi:10.5811/cpcem.2017.3.33369. ISSN   2474-252X. PMC   5965174 . PMID   29849312.
  12. "Most common cause of hematocolpos (LQ)A cervical atresiaB vaginal atresiaC transverse vaginal septumD imperforate hymen - Flash cards Miscellaneous - Dr. Bhatia Medical Coaching Institute Pvt. Ltd. - Dr Bhatia Medical Coaching Institute". GradeStack Courses. Retrieved 2018-10-27.
  13. "Imperforate hymen: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 2019-09-21.
  14. Piersma DJ, Lashley EELO, Hellebrekers BWJ. Uitblijvende menses na gebruik van vaginale kruiden.|journal=Nederlands Tijdschrift voor Obstetrie & Gynaecologie. 2012;125:305-6
  15. 1 2 Xie, Zhihong; Zhang, Xiaoping; Liu, Jiandong; Zhang, Ningzhi; Xiao, Hong; Liu, Yongying; Li, Liang; Liu, Xiaoying (2014-02-21). "Clinical characteristics of congenital cervical atresia based on anatomy and ultrasound: a retrospective study of 32 cases". European Journal of Medical Research. 19 (1): 10. doi: 10.1186/2047-783X-19-10 . ISSN   0949-2321. PMC   3996070 . PMID   24555664.
  16. Saxena, Amulya K (2021-11-09). "Vaginal Atresia: Practice Essentials, Anatomy, Pathophysiology". Medscape Reference. Retrieved 2024-08-06.
  17. "Transverse Vaginal Septum | Boston Children's Hospital". www.childrenshospital.org. Retrieved 2019-09-21.
  18. https://www.fertstert.org/article/S0015-0282(09)03790-X/fulltext [ bare URL ]