Imperforate Hymen: Causes, Symptoms, Treatment, Surgery, Hymenotomy

The malformation of female genital tract is termed as Imperforate Hymen, which leads to major complications in the normal menstrual cycle of the female. Besides that, abdominal pain is quite a common symptom of Imperforate Hymen and the treatment for this is mainly surgical procedure in which the thick hymen membrane is removed.

The thin membrane covering the opening of vagina is called hymen and when it becomes imperforated, it blocks the vagina causing various complications for the female. Imperforate Hymen is an abnormality, which is developed in the female fetus and leads to blockage of the vagina. Being a congenital disorder, there are many complications which arise with Imperforate Hymen. The manifestation of Imperforate Hymen becomes evident with a translucent membrane that bulges at the entrance of vagina leading to pain in the pelvis. Arising complications of Imperforate Hymen includes blockage and accumulation of menstrual blood not only in vagina, but uterus as well.

There are no such specific causes which can state why Imperforate Hymen occurs. Failure of perforation of hymen during the fetal development leads to development of imperforate hymen. Imperforate hymen is something with which a girl child is born with. So no reasons can be stated for its occurrence.

As the opening of vagina is blocked, the health of the girls suffering from Imperforate Hymen becomes complicated and leads to the development of following symptoms:

• Stomach pain that becomes massive with time.
• Trouble in urinating and emptying the bladder.
• Even hindrance is observed in bowel movements which are not regulated.
• There will be fullness in the lower part of the belly.
• Back pain becomes a common thing.

There is no specific age when Imperforate Hymen is diagnosed, as the girl child has this thick hymen since birth. But more particularly, stage at which a girl is diagnosed with imperforate hymen is generally during menstruation when blood gets accumulated within this layer of hymen inside the vagina and even uterus.

Imperforate Hymen occurs when the hymen fails to get perforated during childhood or birth and during the growing up process, there are more chances of complications arising at some later stage. Imperforated hymen is diagnosed when there are problems arising during menstruation in which there is obstruction of the blood in the vagina.
Another problem arising out of imperforated hymen is that, there is acute abdominal pain which comes out to be a major deterrent in performing general movements by the patient. Some procedures used for diagnosing Imperforate Hymen include:

• Transrectal ultrasound (TRUS).
• Transperineal ultrasound (TPUS).
• Transabdominal ultrasound.

Through physical examination of vagina, the hymen’s appearance can be gauged which covers the vagina as a whole leading to obstruction of blood during menstruation along with other physical problems.

As imperforate hymen defect is present in babies since birth, there are methods to identify the problem in neonatal hymen. The sooner this problem gets detected, the better it is for the health of the child. So one needs to have a complete knowledge about Imperforate Hymen, especially as a parent you need to understand different tests and medical procedures through which imperforate hymen can be detected.

Among adolescent girls, hymen presence is detected via above methods of ultrasound. In newborn babies, the diagnosis can be a bit different. It is through physical examination of pelvis or hymen that imperforate hymen is diagnosed. Also, fetal ultrasound helps in finding out problems related with imperforate hymen which can create major obstructions in future.

Many studies have been conducted to find out treatments available for imperforate hymen and presently some traditional methods are used for treating the symptoms and complications arising out Imperforate Hymen. For instance, in case of adolescent girls, it is a bit easier to treat this complication of obstructed blood flow during menstruation. This obstruction becomes very problematic with time giving rise to severe pain in abdomen and pelvic region, which needs to be administered in an immediate manner.

One tested and tried method for treating imperforate hymen problem is finding a way to stop the menstruation blood flow. Suppression of menstruation cycle will result in lesser blood flow, which helps in suppressing pain. This is done with the help of contraceptive pills and which prove to be an effective method in making the person deal really well with the arising pain.

The relief obtained from the use of oral contraceptive is symptomatic and there are many studies done on a continuous basis for the same. Besides using the contraceptive pills, anti-inflammatory drugs are also given to get quick relief in pain. Another alternative treatment tried for suppressing the symptoms of imperforate hymen for temporary relief is by using narcotic analgesics. So there are ways out for mitigating the symptoms of Imperforate Hymen that can prove to have major benefits for the patient suffering from this condition.

Surgeries for imperforate hymen are carried out when symptoms are causing major problems for the girl suffering from this obstructive ailment. Surgical procedures available for newborn babies and adolescent girls differ depending upon the age at which the imperforate hymen is diagnosed.

Surgery for Newborn Babies: This is termed as neonatal care in which imperforate hymen problem is identified at an early stage. In such a case, surgery is not deemed to be a good option for newborn baby and the doctors recommend waiting till the patient gets older to perform surgery.

Surgery for Adolescent Girls: There are some major problems which occur during adolescent girls and imperforate hymen is very complicated with menarche. When menstruation starts, there is obstruction of menstrual blood, which leads to pain and stiffness in the body, which often becomes unbearable with time. Pain due to Imperforate Hymen becomes persistent and lasts for a very long time thus making it tough for the girl to withstand it leading to an inability to continue with normal day-to-day activities. Surgical methods are generally the last resort in such cases, which help in giving a big relief to the patient.

One needs to note that in case of imperforate hymen problem during adolescence, carrying out surgery involves pre-operative procedures.

In case of imperforate hymen, surgery is carried to open up membrane of hymen and is termed as hymenotomy. In other cases, operative procedures known as laparoscopy is carried out in which adhesions in pelvic region are also dealt with.

Scarring of the vaginal area is seen as a major problem from hymenotomy and intra-operative details of the surgery are carried out for imperforate hymen to avoid scarring. The portion of the blood which gets accumulated in the vaginal part is evacuated with the help of surgical pumps to clear off the area in a better way.

The incision made during the surgery needs to be taken care of to enable a speedy recovery. There are ways in which imperforate hymen problem can be dealt effectively with, but one must know about the surgical procedures and associated risks.