Hematocolpos with imperforate hemi-vagina and duplicated uterus: diagnosis and treatment

To document the means of diagnosis and treatment of the exceptional malformation hematocolpos with imperforate hemi-vagina and duplicated uterus

Cases of four patients treated at La Marsa University Hospital, in the Department of Obstetrics and Gynecology between 2000 and 2004, were reported. Mean age=17.2 years (range: 15-22 years). Three left hematocolpos and a right one are observed. All patients underwent vaginal conservative surgical treatment (excision of vaginal septum) +/- radical treatment: hemi- colpohysterectomy in case of failure of conservative treatment. The clinical presentation was a primary dysmenorrhea associated with a pelvic collection. An ipsilateral renal agenesis is present in all cases. Sonography is essential to assess the diagnosis of renal anomalies. Pelvic MRI is the most important examination. It accurately localises the different collections and identifies their content. Conservative surgical management was effective in three cases out of four.