Neonatal imperforate hymen: A case series

Abstract

Abdelrahman S. Elnour*, Shazali Mohammed Ahmed, Diaaeldin Yassen and Faisal Nugud

Imperforate Hymen (IH) is a rare congenital anomaly of the female genital tract, with an incidence of 0.05%-0.1%, characterized by the complete obstruction of the vaginal opening. While IH is generally isolated anomaly, it can be associated with other genitourinary malformations. IH is often diagnosed during adolescence, neonatal diagnosis is extremely rare, with an incidence of 0.006%. IH diagnosis can be made by inspecting the external genitalia, with abdominal ultrasound aiding in the detection of hydrometrocolpos and urinary tract dilation. Late diagnosis of IH can lead to severe complications such as urinary tract obstruction, hydronephrosis, renal failure, infections, subfertility, and endometriosis. Treatment involves hymenectomy or hymenotomy, allowing effective fluid drainage. Early detection is essential for preventing morbidity. This report presents three cases of neonatal IH, each presenting with abdominal distension and urinary difficulties, one of them complicated with acute kidney injury due to urinary obstruction. Emergency hymenectomy was performed in all cases, resulting in excellent outcomes. This report emphasizes the need for healthcare providers to include IH in the differential diagnosis for female neonates with abdominal mass and urinary issues. Early detection through high index suspicion and thorough genital examinations can prevent complications and improve outcomes.