Hematocolpos

Accumulation of menstrual blood in the vagina

Hematocolpos is a medical condition characterized by the accumulation of menstrual blood in the vagina. This condition typically occurs due to an obstruction that prevents the normal outflow of menstrual fluid. The most common cause of hematocolpos is an imperforate hymen, a congenital disorder where the hymen completely covers the vaginal opening.

Causes

Hematocolpos is primarily caused by anatomical obstructions that impede the normal flow of menstrual blood. These obstructions can include:

• Imperforate hymen: A condition where the hymen, a thin membrane partially covering the vaginal opening, is completely closed, preventing menstrual blood from exiting the body.
• Transverse vaginal septum: A rare congenital anomaly where a horizontal wall of tissue forms within the vagina, blocking the passage of menstrual fluid.
• Vaginal atresia: A condition where the vagina is absent or underdeveloped, leading to obstruction.

Symptoms

The symptoms of hematocolpos can vary depending on the severity of the obstruction and the amount of blood accumulated. Common symptoms include:

• Amenorrhea: Absence of menstrual periods in a female who has reached puberty.
• Pelvic pain: Discomfort or pain in the pelvic region, often due to the pressure of accumulated blood.
• Abdominal distension: Swelling of the abdomen caused by the buildup of menstrual blood.
• Urinary retention: Difficulty in urination due to pressure on the bladder.

Diagnosis

The diagnosis of hematocolpos is typically made through a combination of clinical examination and imaging studies. Key diagnostic methods include:

• Pelvic examination: A physical examination to assess the presence of an imperforate hymen or other obstructions.
• Ultrasound: An imaging technique used to visualize the accumulation of fluid in the vagina and assess the anatomy of the reproductive tract.
• Magnetic resonance imaging (MRI): Provides detailed images of the pelvic organs and can help identify the cause of the obstruction.

Treatment

The treatment of hematocolpos involves relieving the obstruction to allow the normal flow of menstrual blood. Treatment options include:

• Surgical intervention: The most common treatment is surgical incision of the hymen (hymenotomy) to create an opening for menstrual blood to exit. In cases of transverse vaginal septum or vaginal atresia, more complex surgical procedures may be required.
• Post-surgical care: After surgery, patients may require follow-up care to ensure proper healing and to prevent complications such as infection or scarring.

Prognosis

With appropriate treatment, the prognosis for individuals with hematocolpos is generally good. Surgical intervention typically resolves the obstruction, allowing normal menstrual flow and alleviating symptoms. Early diagnosis and treatment are important to prevent complications such as endometriosis or infertility.

Related pages

• Amenorrhea
• Imperforate hymen
• Transverse vaginal septum
• Vaginal atresia