eMedicine Specialties > Pediatrics: Surgery > Gynecology

Imperforate Hymen: Follow-up

Author: Martin I Herman, MD, FACEP, FAAP, Professor, Department of Pediatrics, Division of Critical Care and Emergency Medicine, University of Tennessee Health Sciences Center; President, Pediatric Emergency Services Specialists, PC; Assistant Medical Director of Emergency Services, LeBonheur Children's Medical Center
Coauthor(s): Amulya K Saxena, MD, PhD, Associate Professor, Department of Pediatric and Adolescent Surgery, Medical University of Graz, Austria; Elizabeth A Paton, RN, MSN, NP, CS Nurse Practitioner, Department of Emergency Medicine, Le Bonheur Children's Medical Center
Contributor Information and Disclosures

Updated: Oct 2, 2009

Outcome and Prognosis

Outcome after repair of imperforate hymen is excellent. If findings on an appropriate preoperative evaluation are normal, a patient can be reassured that her genital tract is otherwise normal. The incidence of dyspareunia is also low.

Future and Controversies

Thorough genitourinary examination is essential in girls of all ages from birth through the onset of menarche. If primary amenorrhea is identified or if other structural abnormalities are noted, proper management is essential. By performing these examinations and by promptly diagnosing and treating imperforate hymen, primary care practitioners can help prevent the obstructive symptoms of imperforate hymen and its potential high-risk complications due to delayed care.11 After appropriate evaluation is completed to exclude complicated obstruction of the vaginal tract outflow, management of imperforate hymen is straightforward, and the long-term complications are minimal.

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of former author Arlet Kurkchubasche, MD, to the development and writing of this article.



More on Imperforate Hymen

Overview: Imperforate Hymen
Workup: Imperforate Hymen
Treatment: Imperforate Hymen
Follow-up: Imperforate Hymen
Multimedia: Imperforate Hymen
References
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References

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  4. Congenital abnormalities of the female reproductive tract. In: Mishell DR, Stenchever MA, Droegemueller W, et al, eds. Comprehensive Gynecology. 3rd ed. St Louis, Mo: Mosby-Year Book; 1997.

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  14. El-Messidi A, Fleming NA. Congenital imperforate hymen and its life-threatening consequences in the neonatal period. J Pediatr Adolesc Gynecol. Apr 2006;19(2):99-103. [Medline].

  15. Heger AH, Ticson L, Guerra L, et al. Appearance of the genitalia in girls selected for nonabuse: review of hymenal morphology and nonspecific findings. J Pediatr Adolesc Gynecol. Feb 2002;15(1):27-35. [Medline].

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  17. Rock JA, Zacur HA, Dlugi AM, et al. Pregnancy success following surgical correction of imperforate hymen and complete transverse vaginal septum. Obstet Gynecol. Apr 1982;59(4):448-51. [Medline].

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Further Reading

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Keywords

imperforate hymen, vaginal outflow obstruction, hematocolpos, hematometrocolpos, mucocolpos, pyocolpos, intact hymen, intact hymenal membrane, hymenal obstruction, abdominopelvic pain, primary amenorrhea, hymenotomy

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Contributor Information and Disclosures

Author

Martin I Herman, MD, FACEP, FAAP, Professor, Department of Pediatrics, Division of Critical Care and Emergency Medicine, University of Tennessee Health Sciences Center; President, Pediatric Emergency Services Specialists, PC; Assistant Medical Director of Emergency Services, LeBonheur Children's Medical Center
Martin I Herman, MD, FACEP, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, American Medical Association, and Tennessee Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Amulya K Saxena, MD, PhD, Associate Professor, Department of Pediatric and Adolescent Surgery, Medical University of Graz, Austria
Amulya K Saxena, MD, PhD is a member of the following medical societies: Austrian Society for Pediatric and Adolescent Surgery, European Pediatric Surgeons Association, German Society of Pediatric Surgery, German Society of Surgery, International Pediatric Endosurgery Group, and Tissue Engineering and Regenerative Medicine International Society (TERMIS)
Disclosure: Nothing to disclose.

Elizabeth A Paton, RN, MSN, NP, CS Nurse Practitioner, Department of Emergency Medicine, Le Bonheur Children's Medical Center
Elizabeth A Paton, RN, MSN, NP is a member of the following medical societies: American Academy of Nurse Practitioners, American Academy of Pediatrics, Emergency Nurses Association, and Sigma Theta Tau International
Disclosure: Nothing to disclose.

Medical Editor

Elizabeth Alderman, MD, Director of Fellowship Training Program, Director, Adolescent Ambulatory Service, Clinical Professor, Department of Pediatrics, Division of Adolescent Medicine, Albert Einstein College of Medicine and Montefiore Medical Center
Elizabeth Alderman, MD is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, North American Society for Pediatric and Adolescent Gynecology, and Society for Adolescent Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Wayne Wolfram, MD, MPH, 
Wayne Wolfram, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Pediatrics, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

H Biemann Othersen Jr, MD, Professor of Surgery and Pediatrics, Emeritus Head, Division of Pediatric Surgery, Medical University of South Carolina
H Biemann Othersen Jr, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Association for the Surgery of Trauma, American Burn Association, American Cancer Society, American College of Surgeons, American Medical Association, American Pediatric Surgical Association, American Society for Parenteral and Enteral Nutrition, American Surgical Association, American Thoracic Society, British Association of Paediatric Surgeons, Society for Surgery of the Alimentary Tract, Society of Critical Care Medicine, South Carolina Medical Association, Southeastern Surgical Congress, Southern Medical Association, Southern Society for Pediatric Research, and Southern Thoracic Surgical Association
Disclosure: Nothing to disclose.

Chief Editor

Andrea L Zuckerman, MD, Assistant Professor of Obstetrics/Gynecology and Pediatrics, Tufts University School of Medicine; Division Director, Pediatric and Adolescent Gynecology, Tufts Medical Center
Andrea L Zuckerman, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, Association of Professors of Gynecology and Obstetrics, Massachusetts Medical Society, North American Society for Pediatric and Adolescent Gynecology, and Society for Adolescent Medicine
Disclosure: Nothing to disclose.

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