The optimal timing for a pull-through vaginoplasty (Figure 2b) is when a large hematocolpos
(Figure 2a) is present, as the blood acts as a natural expander of the native vaginal tissue, increasing the amount of tissue available for a primary reanastomosis.
However, the estimated incidence is 0.1 to 0.8% and the condition is usually discovered after menarche by causing progressive dysmenorrhea due to the presence of the transverse vaginal septum which prevents blood flow through the vaginal canal, causing the formation of hematocolpos
She was referred to us with the diagnosis of hematocolpos
with uterus didelphys and an imperforate hymen.
Sometimes even exploratory laprotomy may be needed to guide a probe through the uterine fundus and cervix and to assist in locating a high hematocolpos
. Dilation techniques can be used in lieu of surgery, before surgery in order to improve outcomes and after surgery to prevent strictures, scarring or stenosis of the surgical site.
In the Wunderlich syndrome, the blind hemivagina is developed and filled with a large hematocolpos
. The symptoms and management of these entities are different.
This may lead to hematocolpos
, hematometra, and hematosalpinx.
Se hace el diagnostico de tumoracion abdominal en estudio, probable hematocolpos
e himen imperforado.
The patient has been menstruating internally for many months and now has a large hematocolpos
. Urinary retention develops when the amount of retained blood in the vagina causes acute angulation of the urethrovesical junction.
It can also lead to hematocolpos
, which is an accumulation of blood and blood clots in the uterus and/or vagina resulting from the inability of blood to pass through the vaginal opening.
(6) Nevertheless, vaginal synechiae with complete obliteration of the vaginal canal is rare, and surgery may be required to treat hematocolpos
and recover sexual activity.
MRI was done which was suggestive of uterus didelphys with left hematocolpos
extending into left endocervical canal, renal agenesis and compensatory right renal hypertrophy.
All patients underwent resection of the vaginal septum and drainage of hematocolpos
. Eleven (14%) patients underwent abdominal exploration via laparotomy or laparoscopy.