Hymen atresia
Contents:
Description:
Hymen atresia – full overgrowing, the impassability of a hymenal partition interfering an exit outside of vulval and menstrual allocations. It is more often shown during the pubertal period; it is characterized by a false amenorrhea, pains, a hematocolpos, sometimes – gematometry and a hematosalpinx, impossibility of implementation of the sexual intercourse. The atresia of a hymen can become complicated piogematometry and piogematosalpinksy. Treatment of an atresia of a hymen consists in a crosswise section of a gimen.
Hymen atresia reasons:
Primary (inborn) atresia of a gimen is defect of pre-natal development. Formation of a hymen comes on the 19th week of pre-natal development from distal departments of the paramezonefralny channel with the subsequent formation of openings in a hymenal partition. At disturbance of these processes the hymen atresia develops.
The secondary atresia of normally created hymen can be connected with effects of children's infections (measles, scarlet fever, diphtheria etc.), a specific and nonspecific vulvovaginitis, processes of scarring or a spaykoobrazovaniye.
Hymen atresia symptoms:
At girls in a premenarkha the hymen atresia usually is not shown clinically. In rare instances accumulation of a secret in a vagina (a hydrocolpocele, мукокольпос) causes pressure upon the next bodies, causing clinic of frustration of an urination.
Simtomatika at a hymen atresia usually matches the beginning of periods. In the absence of menstrual allocations girls have cyclically repeating spastic back pains and a stomach bottom. In view of lack of a possibility of an exit outside menstrual blood accumulates in a limited gimeny vagina, stretching its walls - the hematocolpos is formed. Further at an atresia of a hymen there can be accumulation of blood in a cavity and pipes of a uterus (a gematometr and a hematosalpinx).
Diagnosis:
At development of a mukokolpos in girls survey of outside genitalias reveals protrusion of a hymen between vulvar lips in the form of tumorous formation of a yellowish-grayish shade size about cherry or pigeon egg.
At an atresia of a hymen of the patient of pubertal age show complaints to regular, monthly pains of arching skhvatkoobrazny character, in lower parts of a stomach, absence of menstrual bleedings.
At survey on a chair the normal structure and development of external genitals and lack of an entrance to a vagina is found. The hematocolpos looks as tumorous, cyanotic color protrusion of a hymen from a sexual crack. At a hymen atresia through a rectum the stretched vagina of a tugoelastichesky consistence decides on an uneven surface. At a rectoabdominal research the uterus is palpated above a bosom in the form of a painful elastic tumor.
Treatment of an atresia of a hymen:
At an atresia of a gimen the section of a fibrozirovanny hymen (a hymenotomy, a surgical defloration) is made.
After preparation of a crotch and a surgery field carry out infiltration of a hymen of 0,5% novocaine solution. Having parted vulvar lips, the hymen in the place of protrusion longwise is cut between clips. Through an operational section evacuate blood clots and liquid blood. The slit is prolonged down and up to the basis, supplementing with its crosswise cross section a gimen. The vagina is completely exempted from bloody masses. For the prevention of a repeated atresia of a hymen of edge of a section twist with separate catgut seams.
If the atresia of a hymen is followed by a hematosalpinx, the first stage of operation carries out a laparotomy, and then – a hymenotomy. For an exception of the ascending infection it is not recommended to syringe and tampon a vagina.
