Long-term follow-up of women who underwent surgical correction for imperforate hymen

Abstract.

The aim of this study was to demonstrate the clinical results of postoperative evaluation for a consecutive series of cases of imperforate hymen presenting at a tertiary medical center during an over 14-year period. We retrospectively reviewed the clinical records of 15 patients with imperforate hymen that had undergone hymenectomy between 1987 and 1998. After completing a questionnaire via a telephone interview regarding sexuality, fertility, menstrual problems, micturition and defecation after surgical correction, those patients were persuaded to come back to the hospital for further gynecological surveys during 2002. The mean postoperative follow-up was 8.5 years (range, 4–14 years). The mean age at diagnosis was 13.2 years (range, 11–16). The most common clinical symptom was cryptomenorrhea (15), followed by pelvic pain (11), palpable abdominal mass (9), urinary retention and other voiding problems (8) and problems of defecation (4). None admitted intercourse attempts before. Two patients also had uterine anomalies, but none had urinary tract or bowel anomalies. During the follow-up period, we found that the majority of patients had irregular menstrual cycles and were worried about their future fertility. Six patients suffered from dysmenorrhea; of 11 patients who began having intercourse two later delivered babies, and none complained of sexual dysfunction. After hymenectomy, the women with imperforate hymen were markedly relieved of cryptomenorrhea, and problems of micturition and defecation also greatly improved. Although complaints of irregular menstruation and dysmenorrhea gradually evolved as the center of attention during follow-up, most patients fared well in terms of fertility and sexual function.