Microperforated hymen: a case of delayed diagnosis
Although the incidence of microperforated hymen (MH) is unclear, this hymenal subocclusive anomaly is considered a rare entity. Differently from imperforated hymen, MH may be asymptomatic until puberty when the women’s quality of life is jeopardized. Depending on the size of the microperforation, MH...
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University of São Paulo
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doaj-278977c0d52c44dc8639a76adec36bea2020-11-25T00:30:01ZengUniversity of São PauloAutopsy and Case Reports2236-19602014-09-014388497Microperforated hymen: a case of delayed diagnosisOlívia Maria Ferraz Ferrarini0Lívia Oliveira Munhoz1Ricardo Santos Simões2Pérsio Yvon Adri Cezarino3Mauricio Paulo Ângelo Mieli4Paulo Francisco Ramos Margarido5Fábio José Guida6Edmund Chada Baracat7Medical School – Universidade de São Paulo, São Paulo/SPDepartment of Gynecology – Hospital das Clínicas – Faculdade de Medicina – Universidade de São Paulo, São Paulo/SPDepartment of Obstetrics – Hospital Universitário – Universidade de São Paulo, São Paulo/SPDepartment of Obstetrics – Hospital Universitário – Universidade de São Paulo, São Paulo/SPDepartment of Obstetrics – Hospital Universitário – Universidade de São Paulo, São Paulo/SPDepartment of Obstetrics – Hospital Universitário – Universidade de São Paulo, São Paulo/SPDiagnostic Imaging Service – Hospital Universitário – Universidade de São Paulo, São Paulo/SPClinical Division of Gynaecological – Faculdade de Medicina – Universidade de São Paulo, São Paulo/SPAlthough the incidence of microperforated hymen (MH) is unclear, this hymenal subocclusive anomaly is considered a rare entity. Differently from imperforated hymen, MH may be asymptomatic until puberty when the women’s quality of life is jeopardized. Depending on the size of the microperforation, MH’s clinical features me be very similar to those found in imperforated hymen cases. However, MH may present infectious complications since the accumulated secretion retained in the vaginal canal has contact with the external environment and therefore represents a source of entry for infectious agents. The authors report a case of a 28-year-old woman who sought the gynecologist complaining of inability to have vaginal intercourse. She referred normal menses, but in fact, although regular, bleeding was filiform and was exteriorized only through the right side of the vagina. Physical examination and imaging disclosed a microperforation of the hymenal membrane at 10 o’clock position. Hymenotomy under general anesthesia was undertaken. Outcome was favorable and the patient could thenceforth have a normal life. We conclude that this anomaly may be overlooked, interfering on its incidence determination. The delayed onset of symptoms and psychological embarrassing aspects, which postpone gynecological consultation, may contribute for misdiagnoses. We call attention to a mandatory detailed anamnesis and thorough physical examination to diagnose this anomaly before the puberty, when complications are less frequent and treatment is advisable.http://www.revistas.usp.br/autopsy/article/view/98479HymenDysmenorrheaDyspareuniaSurgical ProceduresOperative |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Olívia Maria Ferraz Ferrarini Lívia Oliveira Munhoz Ricardo Santos Simões Pérsio Yvon Adri Cezarino Mauricio Paulo Ângelo Mieli Paulo Francisco Ramos Margarido Fábio José Guida Edmund Chada Baracat |
spellingShingle |
Olívia Maria Ferraz Ferrarini Lívia Oliveira Munhoz Ricardo Santos Simões Pérsio Yvon Adri Cezarino Mauricio Paulo Ângelo Mieli Paulo Francisco Ramos Margarido Fábio José Guida Edmund Chada Baracat Microperforated hymen: a case of delayed diagnosis Autopsy and Case Reports Hymen Dysmenorrhea Dyspareunia Surgical Procedures Operative |
author_facet |
Olívia Maria Ferraz Ferrarini Lívia Oliveira Munhoz Ricardo Santos Simões Pérsio Yvon Adri Cezarino Mauricio Paulo Ângelo Mieli Paulo Francisco Ramos Margarido Fábio José Guida Edmund Chada Baracat |
author_sort |
Olívia Maria Ferraz Ferrarini |
title |
Microperforated hymen: a case of delayed diagnosis |
title_short |
Microperforated hymen: a case of delayed diagnosis |
title_full |
Microperforated hymen: a case of delayed diagnosis |
title_fullStr |
Microperforated hymen: a case of delayed diagnosis |
title_full_unstemmed |
Microperforated hymen: a case of delayed diagnosis |
title_sort |
microperforated hymen: a case of delayed diagnosis |
publisher |
University of São Paulo |
series |
Autopsy and Case Reports |
issn |
2236-1960 |
publishDate |
2014-09-01 |
description |
Although the incidence of microperforated hymen (MH) is unclear, this hymenal subocclusive anomaly is considered a rare entity. Differently from imperforated hymen, MH may be asymptomatic until puberty when the women’s quality of life is jeopardized. Depending on the size of the microperforation, MH’s clinical features me be very similar to those found in imperforated hymen cases. However, MH may present infectious complications since the accumulated secretion retained in the vaginal canal has contact with the external environment and therefore represents a source of entry for infectious agents. The authors report a case of a 28-year-old woman who sought the gynecologist complaining of inability to have vaginal intercourse. She referred normal menses, but in fact, although regular, bleeding was filiform and was exteriorized only through the right side of the vagina. Physical examination and imaging disclosed a microperforation of the hymenal membrane at 10 o’clock position. Hymenotomy under general anesthesia was undertaken. Outcome was favorable and the patient could thenceforth have a normal life. We conclude that this anomaly may be overlooked, interfering on its incidence determination. The delayed onset of symptoms and psychological embarrassing aspects, which postpone gynecological consultation, may contribute for misdiagnoses. We call attention to a mandatory detailed anamnesis and thorough physical examination to diagnose this anomaly before the puberty, when complications are less frequent and treatment is advisable. |
topic |
Hymen Dysmenorrhea Dyspareunia Surgical Procedures Operative |
url |
http://www.revistas.usp.br/autopsy/article/view/98479 |
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