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Hydrometrocolpos

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Pediatric Surgery

Abstract

The rarity and variable presentation of congenital obstruction of the vagina can lead to delayed diagnosis and erroneous management. It is important to be aware of the differential diagnoses and associated anomalies, including the consideration of hydrocolpos (vaginal obstruction) or hydrometrocolpos (indicating uterine involvement), in a female newborn with an abdominal mass and urinary obstruction. A thorough physical genital examination and appropriate imaging can aid in achieving the correct diagnosis. Ultrasonography and magnetic resonance imaging are diagnostic modalities of choice and can reveal associated renal anomalies and the anatomy of complex lesions, although further evaluation may require voiding cystourethrogram. Delayed diagnosis may impair the normal functions of the urogenital system and cause compression of surrounding structures. Interventions range from less complex, such as drainage of imperforate hymen, to more complex reconstructive vaginoplasty through a multidisciplinary team. Early surgical intervention will reduce long-term morbidity.

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References

  1. Okoro PE, Obiorah C, Enyindah CE. Experience with neonatal hydrometrocolpos in the Niger Delta area of Nigeria: upsurge or increased recognition? Afr J Paediatr Surg. 2016;13(4):161–5.

    Article  Google Scholar 

  2. Ameh EA, Mshelbwala PM, Ameh N. Congenital vaginal obstruction in neonates and infants: recognition and management. J Pediatr Adolesc Gynecol. 2011;24(2):74–8.

    Article  Google Scholar 

  3. Tilahun B, Woldegebriel F, Wolde Z, Tadele H. Hydrometrocolpos presenting as a huge abdominal swelling and obstructive uropathy in a 4 day old newborn: a diagnostic challenge. Ethiop J Health Sci. 2016;26(1):89–91.

    Article  Google Scholar 

  4. Khan RA, Ghani I, Wahab J. Hydrometrocolpos due to persistent urogenital sinus mimicking neonatal ascites. Iran J Pediatr. 2008;18(1):67–70.

    Google Scholar 

  5. Romero R, et al. Prenatal diagnosis of congenital anomalies. Norwalk: Appleton and Lange; 1988. p. 307–9.

    Google Scholar 

  6. Messina M, Severi FM, Bocchi C, et al. Voluminous perinatal mass: a case of congenital hydrometrocolpos. J Matern Fetal Neonatal Med. 2004;15:135.

    Article  CAS  Google Scholar 

  7. Tseng JJ, et al. Prenatal diagnosis of isolated fetal hydrocolpos secondary to congenital imperforate hymen. J Chin Med Assoc. 2008;71(6):325–8.

    Article  Google Scholar 

  8. Miller RJ, Breech LL. Surgical correction of vaginal anomalies. Clin Obstet Gynecol. 2008;51(2):223–36.

    Article  Google Scholar 

  9. Pena A, et al. Surgical management of cloacal malformations: a review of 339 patients. J Pediatr Surg. 2004;39(3):470–9.

    Article  Google Scholar 

  10. Sadler TW. Langman’s medical embryology. 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2006, Chap. 15. p. 229–56.

    Google Scholar 

  11. DeUgarte CM, et al. Embryology of the urogenital system and congenital anomalies of the female genital tract (Chap. 4). In: DeCherney AH, et al., editors. Current diagnosis and treatment: obstetrics and gynecology. 10th ed. New York: McGraw-Hill; 2007. Available at http://www.accessmedicine.com/content.aspx?aID=2382989.

    Google Scholar 

  12. Schorge JO, et al. Anatomic disorders (Chap. 18). In: William’s gynecology. McGraw-Hill; 2008. Available at http://www.accessmedicine.com/content.aspx?aID=3157418. Surgeries for benign gynecologic conditions (Chap. 41). Available at http://www.accessmedicine.com/content.aspx?aID=3166442.

  13. David A, Bitoun P, Lacombe D, Lambert J, Nivelon A, Vigneron J, et al. Hydrometrocolpos and polydactyly: a common neonatal presentation of Bardet-Biedl and McKusick-Kaufman syndromes. J Med Genet. 1999;36:599–603.

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Tekin I, Ok G, Genc A, Tok D. Anaesthetic management in McKusick-Kaufman syndrome. Pediatr Anesth. 2003;13:167–70.

    Article  Google Scholar 

  15. Lueth E, Wood KE. McKusick Kaufman syndrome, complications arising at puberty. J Pediatr Adolesc Gynecol. 2014;27:e125–6.

    Article  Google Scholar 

  16. Kos S, Roth K, Korinth D, Zeilinger G, Eich G. Hydrometrocolpos post axial polydactyly, and hypothalamic hamartoma in a patient with confirmed Pallister-Hall syndrome: a clinical overlap with McKusick-Kaufman syndrome. Pediatr Radiol. 2008;38:902–6.

    Article  Google Scholar 

  17. Shimada K, Hosokawa S, Matsumoto F, Johnun K, Naitoh Y, Harado Y. Urology management of cloacal anomalies. Int J Urol. 2001;81:282–9.

    Article  Google Scholar 

  18. Shono T, Teguchi T, Suita S, Nakanami N, Nekane H. Prenatal ultrasonographic and magnetic resonance imaging findings of congenital cloacal anomalies associated with meconium peritonitis. J Pediatr Surg. 2007;42:681–4.

    Article  Google Scholar 

  19. Laufer MR. Diagnosis and management of congenital anomalies of the vagina. Available at http://www.uptodate.com. Accessed 2008.

  20. Spencer R, Levy DM. Hydrometrocolpos: report of three cases and review of the literature. Ann Surg. 1962;155(4):558–71.

    Article  CAS  Google Scholar 

  21. Dhombres F, et al. Contribution of prenatal imaging to the anatomical assessment of fetal hydrocolpos. Ultrasound Obstet Gynecol. 2007;30:101–4.

    Article  CAS  Google Scholar 

  22. Hayashi S, et al. Prenatal diagnosis of fetal hydrometrocolpos secondary to cloacal anomaly by magnetic resonance imaging. Ultrasound Obstet Gynecol. 2005;26:577–9.

    Article  CAS  Google Scholar 

  23. Valentini AL, et al. Persistent urogenital sinus: diagnostic imaging for clinical management. What does the radiologist need to know? Am J Perinatol. 2016;33:425–32.

    PubMed  Google Scholar 

  24. Visnjic S, Bastic M, Marcec M, Mesic M. Short-term “double natural orifice catheterization”: non-operative management of hydrocolpos in persistent cloaca patients-case series. J Pediatr Surg. 2018;53:718–21.

    Article  Google Scholar 

  25. Khanna K, Sharma S, Gupta DK. Hydrometrocolpos etiology and management: past beckons the present. Pediatr Surg Int. 2018;34:249–61.

    Article  Google Scholar 

  26. Powell DM, Newman KD, Randolph J. A proposed classification of vaginal anomalies and their surgical correction. J Pediatr Surg. 1995;30(2):271–5.

    Article  CAS  Google Scholar 

  27. Rock JA, et al. Pregnancy success following surgical correction of imperforate hymen and complete transverse vaginal septum. Obstet Gynecol. 1982;59:448–52.

    CAS  PubMed  Google Scholar 

  28. Joki-Erkkila MM, Heinonen PK. Presenting and long-term clinical implications and fecundity in females with obstructing vaginal malformations. J Pediatr Adolesc Gynecol. 2003;16:307–12.

    Article  Google Scholar 

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

    Article  CAS  Google Scholar 

  30. Cunningham FG, Leveno KJ, Bloom SL, et al. Williams obstetrics. 22nd ed. New York: McGraw-Hill; 2005. p. 685.

    Google Scholar 

  31. Nazir Z, et al. Congenital vaginal obstructions: varied presentation and outcome. Pediatr Surg Int. 2006;22:749–53.

    Article  Google Scholar 

Suggested Reading

  • Ahment G, et al. Prenatal ultrasonographic features of persistent urogenital sinus with hydrometrocolpos and ascites. Gynecol Obstet. 2008;278:493–6.

    Google Scholar 

  • Arena F, et al. The neonatal management and surgical correction of urinary hydrometrocolpos caused by a persistent urogenital sinus. BJU Int. 1999;84:1063–8.

    Article  CAS  Google Scholar 

  • Ekenze SO, Ezegwui HU. Hydrometrocolpos from a low vaginal atresia: an uncommon cause of neonatal intestinal and urinary obstruction. Afr J Paediatr Surg. 2008;5(1):43–5.

    Article  Google Scholar 

  • Khanna K, Sharma S, Gupta DK. Hydrometrocolpos etiology and management: past beckons the present. Pediatr Surg Int. 2018;34:249–61.

    Article  Google Scholar 

  • Pena A, Levitt M. Surgical management of cloacal malformations. Semin Neonatol. 2003;8:249–57.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, University Hospital of Treichville, Abidjan, Côte d’Ivoire

    Bankole S. Rouma

  2. CHU de Treichvill, Abidjan, Côte d’Ivoire

    Bankole S. Rouma

  3. Department of Urology, Boston Children’s Hospital, Boston, MA, USA

    Julia B. Finkelstein

  4. Department of Pediatric Surgery, Nationwide Children’s Hospital, Columbus, OH, USA

    Jennifer H. Aldrink

  5. Division of Pediatric Surgery, Department of Surgery, New York University School of Medicine, Hassenfeld Children’s Hospital at NYU Langone, New York, NY, USA

    Howard B. Ginsburg

Authors
  1. Bankole S. Rouma
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  2. Julia B. Finkelstein
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  3. Jennifer H. Aldrink
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  4. Howard B. Ginsburg
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Corresponding author

Correspondence to Jennifer H. Aldrink .

Editor information

Editors and Affiliations

  1. Division of Pediatric Surgery, Department of Surgery, National Hospital, Abuja, Nigeria

    Emmanuel A. Ameh

  2. Professor of Surgery & Pediatrics, Rady Children’s Hospital, University of California San Diego, San Diego, CA, USA

    Stephen W. Bickler

  3. Department of Pediatric Surgery, University of Oxford, Oxford, UK

    Kokila Lakhoo

  4. Department of Pediatric Surgery, Nationwide Children’s Hospital, and Department of Surgery, Ohio State University, Colombus, OH, USA

    Benedict C. Nwomeh

  5. Department of Pediatric Surgery, Montreal Children’s Hospital, Montreal, QC, Canada

    Dan Poenaru

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Rouma, B.S., Finkelstein, J.B., Aldrink, J.H., Ginsburg, H.B. (2020). Hydrometrocolpos. In: Ameh, E.A., Bickler, S.W., Lakhoo, K., Nwomeh, B.C., Poenaru, D. (eds) Pediatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-41724-6_115

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  • DOI: https://doi.org/10.1007/978-3-030-41724-6_115

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-41723-9

  • Online ISBN: 978-3-030-41724-6

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