BACKGROUND:

Imperforate hymen constitutes an unusual congenital anomaly, due to a failure in the canalization of the urogenital sinus. This entity usually manifests after puberty as primary amenorrhea, cyclical abdominal pain, and abdominal distension. Retention of urine is an infrequent form of debut, which can lead to a compromise in bladder function and subsequent kidney damage.

OBJECTIVE:

To report a case of acute urinary retention in a 12-year-old girl caused by the presence of hematocolpos secondary to imperforate hymen.

CLINICAL CASE:

A 12-year-old premenarchal female presented with abdominal pain and genital discomfort, accompanied by anuria of at least 12 hours of evolution. Physical examination revealed a palpable distended bladder and an imperforate hymen with a bluish and bulging appearance. Ultrasound examination revealed the presence of a 130x89 mm hematocolpos and a 38x10 mm hematometra. After urinary catheterization, a stellate hymenotomy was performed with complete resolution of the condition and restoration of vesico-urethral function.

CONCLUSIONS:

Early diagnosis and surgical treatment have a key role in the prevention of medium and long term uro-gynecological complications. Obstructive hematocolpos must be considered as one of the first diagnostic possibilities when cyclical abdominal pain and urinary retention occurs in the pediatric patient.