Estimated prevalence: 1/16,000 births. An obstacle to the outflow of vaginal fluids leads to their accumulation upstream and results in:

-        hydrocolpos: if the distention only involves the vagina

-        hydrometrocolpos: if the distension involves the vagina and the uterus, and sometimes the fallopian tubes

-        hematocolpos: if the retained secretions in the vagina are mainly blood (after puberty).

Possible causes are:

-        an imperforated hymen

-        a vaginal malformation: segmental atresia, septum, double vagina

-        an uterine malformation: bicornuate

-        an urogenital sinus

-        an obstructive anomalies of the mullerian ducts

-        a complex anorectal malformation

Clinical picture:

• in the neonatal period:

-        abdominal or perineal mass associated with a hymeneal imperforation or anorectal malformation

-        sometimes digestive occlusion or ureterohydronephrosis

-        sometimes intraabdominal perforation

• in the adolescence: depending on the size of the mass, in addition to a total or partial amenorrhea.

-        painful menstrual retentions

-        dysuria, acute urinary retention

-        obstinate constipation

Treatment: X type hymenotomy in case of imperforated hymen; tube drainage and later more complex surgical reparation in other situations

Anesthetic implications:

during the neonatal period: semi-urgent surgical indication (risk of sepsis) with abdominal distension and possible functional renal failure; during adolescence: surgery in the lithotomy position, psychological aspects.

References :

-        Sidatt M, Wedih AOUSM, Boubaccar AO, Litime AOE, Feil A, Moussa AO.
Hydrocolpos et hydrometrocolpos du nouveau-né.
Arch Pédiatr 2013 ; 176-80.

Updated: September 2017