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Bannour B, Abbassi H, Guerbej E, Bannour I, Boughizane S. Prenatal diagnosis of isolated fetal hydrometrocolpos: A case report. Radiol Case Rep 2024; 19:6147-6151. [PMID: 39376953 PMCID: PMC11456795 DOI: 10.1016/j.radcr.2024.08.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Revised: 08/26/2024] [Accepted: 08/28/2024] [Indexed: 10/09/2024] Open
Abstract
A rare congenital condition known as hydrometrocolpos (HMC) is characterized by the buildup of secretions in the vagina and uterus as a result of distal obstruction; this condition is frequently linked to imperforate hymen. This case report presents a prenatal diagnosis of isolated HMC in a 30-year-old primigravida, detected at 36 weeks gestation. Initial ultrasound revealed a large cystic mass, confirmed by fetal magnetic resonance imaging to be HMC. Postnatal examination of the new born confirmed imperforate hymen and HMC, which was effectively treated with hymenotomy, resulting in early resolution. This case underscores the importance of prenatal imaging in the early identification and management of HMC to prevent potential complications.
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Affiliation(s)
- Badra Bannour
- Obstetrics and Gynecology Department, University Hospital Farhat Hached of Sousse, University of Sousse, Sousse, Tunisia
| | - Hafedh Abbassi
- Obstetrics and Gynecology Department, University Hospital Farhat Hached of Sousse, University of Sousse, Sousse, Tunisia
| | - Ekram Guerbej
- Obstetrics and Gynecology Department, University Hospital Farhat Hached of Sousse, University of Sousse, Sousse, Tunisia
| | - Imen Bannour
- Obstetrics and Gynecology Department, University Hospital Farhat Hached of Sousse, University of Sousse, Sousse, Tunisia
| | - Sassi Boughizane
- Obstetrics and Gynecology Department, University Hospital Farhat Hached of Sousse, University of Sousse, Sousse, Tunisia
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Hydro-metro-colpos diagnosed in utero. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2022. [DOI: 10.1016/j.epsc.2021.102172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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A rare case of hydrometrocolpos from persistent urogenital sinus in patient affected by adrenogenital syndrome. J Ultrasound 2018; 21:249-252. [PMID: 29502244 DOI: 10.1007/s40477-018-0290-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 02/21/2018] [Indexed: 10/17/2022] Open
Abstract
Persistent urogenital sinus (PUGS) is a congenital pathological condition characterized by an abnormal communication between the urethra and vagina, which has an estimated incidence of 0.6/10,000 female births. It could be the only known malformation or part of a syndrome. PUGS is commonly shown by a pelvic mass, related to a distended bladder, hydrometrocolpos which is due to an obstruction leading to the dilation of the vagina and uterus (i.e., imperforate hymen, transverse vaginal septum or atresia, and PUGS) or both. We present a case of female patient with classical congenital adrenal hyperplasia, diagnosed on the 7th day of life, with ambiguous genitalia, untreated surgically only with hormone therapy by parental decision. The patient, at the age of 5 years and 5 months, came to our observation for a pelvic ultrasound, which revealed retrovesical neoformation with anechoic content and regular walls. We performed the ultrasound examination that showed the dilation of the cervix and the vaginal canal with anechoic finely corpuscolated content in the declining portion, compatible with hydrometrocolpos from probable persistence of the urogenital sinus. The voiding cystourethrography (VCUG) confirmed the ultrasound diagnosis, with evidence of urogenital sinus. In conclusion, ultrasound is the first diagnostic tool, but need to be completed by other technical procedures, which VCUG or magnetic resonance imaging to observe the site of fusion of the urinary and genital tract.
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Khanna K, Sharma S, Gupta DK. Hydrometrocolpos etiology and management: past beckons the present. Pediatr Surg Int 2018; 34:249-261. [PMID: 29177625 DOI: 10.1007/s00383-017-4218-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2017] [Indexed: 10/18/2022]
Abstract
Hydrometrocolpos is a rare condition in which the uterus and the vagina are grossly distended with a retained fluid other than pus or blood. It may present during the neonatal period or later at puberty. Most cases reported earlier were stillbirths and were diagnosed only on autopsy. Antenatal diagnosis is now possible with the advent of ultrasound. An early diagnosis and speedy management is the key to survival. Many previous case reports have focused on the varied clinical presentations, multiple causes, associated syndromes and/or the radiological diagnosis of this condition. However, management options for different types of hydrometrocolpos have not yet been concisely discussed. We have reviewed the literature and tried to summarize the management options applicable to most case scenarios of hydrometrocolpos.
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Affiliation(s)
- Kashish Khanna
- Department of Pediatric Surgery, All India Institute of Medical Sciences, R. No 4002, 4th floor, Ansari Nagar, New Delhi, 110029, India
| | - Shilpa Sharma
- Department of Pediatric Surgery, All India Institute of Medical Sciences, R. No 4002, 4th floor, Ansari Nagar, New Delhi, 110029, India
| | - D K Gupta
- Department of Pediatric Surgery, All India Institute of Medical Sciences, R. No 4002, 4th floor, Ansari Nagar, New Delhi, 110029, India.
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Capito C, Belarbi N, Paye Jaouen A, Leger J, Carel JC, Oury JF, Sebag G, El-Ghoneimi A. Prenatal pelvic MRI: additional clues for assessment of urogenital obstructive anomalies. J Pediatr Urol 2014; 10:162-6. [PMID: 24054781 DOI: 10.1016/j.jpurol.2013.07.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 07/23/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Ultrasound prenatal evaluation of pelvic cystic mass can be challenging. After having ruled out a cloaca anterior to a large hydrocolpos, it is important to differentiate between combined urogenital anomalies such as urogenital sinus and isolated genital anomalies. PATIENTS AND METHODS We reviewed the charts of 13 women referred for a third trimester pelvic MRI for cystic pelvic mass discovered in second trimester ultrasound. We evaluated MRI compared with postnatal surgical findings in order to determine clues for improving prenatal diagnoses. RESULTS MRI excluded the diagnosis of cloacal malformation in nine cases with no false negative. Once a cloaca is ruled out, a different signal between the bladder and the hydrocolpos on T2 sequences is in favor of an isolated genital obstruction. In contrast, in case of urogenital sinus, the vagina is filled with a mixture of genital secretions and urine, which gives it an MRI signal similar to the bladder on T2 sequences. CONCLUSION Third trimester fetal MRI is an essential exam for characterization of pelvic cystic mass diagnosed by ultrasound. This exam appears valuable for invalidating the diagnosis of cloacal malformation and for differentiating between isolated genital obstruction and urogenital sinus.
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Affiliation(s)
- Carmen Capito
- AP-HP, Hôpital Robert Debré, Service de Chirurgie Viscérale et d'Urologie Pédiatriques, centre de référence de maladies endocriniennes Rares de la Croissance, F-75019 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, F-75019 Paris, France.
| | - Nadia Belarbi
- AP-HP, Hôpital Robert Debré, Service de Radiologie Pédiatrique, Paris, France.
| | - Annabel Paye Jaouen
- AP-HP, Hôpital Robert Debré, Service de Chirurgie Viscérale et d'Urologie Pédiatriques, centre de référence de maladies endocriniennes Rares de la Croissance, F-75019 Paris, France.
| | - Juliane Leger
- Université Paris Diderot, Sorbonne Paris Cité, F-75019 Paris, France; AP-HP, Hôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique et Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F-75019 Paris, France; Institut National de la Santé et de la Recherche Médicale Unité UMR 676, F-75019 Paris, France.
| | - Jean-Claude Carel
- Université Paris Diderot, Sorbonne Paris Cité, F-75019 Paris, France; AP-HP, Hôpital Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique et Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F-75019 Paris, France; Institut National de la Santé et de la Recherche Médicale Unité UMR 676, F-75019 Paris, France.
| | - Jean-François Oury
- Université Paris Diderot, Sorbonne Paris Cité, F-75019 Paris, France; AP-HP, Hôpital Robert Debré, Service de Gynécologie, Obstétrique et Diagnostic Prénatal, F-75019 Paris, France.
| | - Guy Sebag
- AP-HP, Hôpital Robert Debré, Service de Radiologie Pédiatrique, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, F-75019 Paris, France.
| | - Alaa El-Ghoneimi
- AP-HP, Hôpital Robert Debré, Service de Chirurgie Viscérale et d'Urologie Pédiatriques, centre de référence de maladies endocriniennes Rares de la Croissance, F-75019 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, F-75019 Paris, France.
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Lecarpentier E, Dreux S, Blanc T, Schaub B, Ville Y, Mandelbrot L, Ghoneimi AE, Oury JF, Muller F. Biochemical analysis of cystic fluid in the diagnosis of fetal intra-abdominal masses. Prenat Diagn 2012; 32:627-31. [DOI: 10.1002/pd.3871] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Edouard Lecarpentier
- Gynécologie Obstétrique; Hôpital Robert Debré, AP-HP, Université Paris-Diderot; Paris France
| | - Sophie Dreux
- Biochimie-Hormonologie; Hôpital Robert Debré, AP-HP; Paris France
| | - Thomas Blanc
- Chirurgie Viscérale et Urologie Pédiatrique; Hôpital Robert Debré, AP-HP, Université Paris-Diderot; Paris France
| | - Bruno Schaub
- Gynécologie Obstétrique; Centre Hospitalier Universitaire; Fort-de-France France
| | - Yves Ville
- Gynécologie Obstétrique; Hôpital Necker Enfants Malades, AP-HP; Paris France
| | | | - Alaa El Ghoneimi
- Chirurgie Viscérale et Urologie Pédiatrique; Hôpital Robert Debré, AP-HP, Université Paris-Diderot; Paris France
| | - Jean-François Oury
- Gynécologie Obstétrique; Hôpital Robert Debré, AP-HP, Université Paris-Diderot; Paris France
| | - Françoise Muller
- Biochimie-Hormonologie; Hôpital Robert Debré, AP-HP; Paris France
- Université Versailles Saint Quentin; Versailles France
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Gupta P, Sharma R, Kumar S, Gadodia A, Roy KK, Malhotra N, Sharma JB. Role of MRI in fetal abdominal cystic masses detected on prenatal sonography. Arch Gynecol Obstet 2009; 281:519-26. [DOI: 10.1007/s00404-009-1190-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2009] [Accepted: 07/16/2009] [Indexed: 11/30/2022]
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Liu YP, Chen CP. Fetal MRI of hydrometrocolpos with septate vagina and uterus didelphys as well as massive urinary ascites due to cloacal malformation. Pediatr Radiol 2009; 39:877. [PMID: 19277627 DOI: 10.1007/s00247-009-1206-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Revised: 01/13/2009] [Accepted: 01/14/2009] [Indexed: 11/29/2022]
Affiliation(s)
- Yu-Peng Liu
- Mackay Medicine, Nursing, Management College and Mackay Memorial Hospital, No 92, Sec. 2, Chung-Shan North Road, Taipei, 104, ROC.
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Subramanian S. Importance of rectal signal on fetal magnetic resonance imaging in patients having hydrometrocolpos. Taiwan J Obstet Gynecol 2008; 47:375. [PMID: 18936015 DOI: 10.1016/s1028-4559(08)60150-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Yıldırım G, Gungorduk K, Aslan H, Sudolmus S, Ark C, Saygın S. Prenatal diagnosis of imperforate hymen with hydrometrocolpos. Arch Gynecol Obstet 2008; 278:483-5. [DOI: 10.1007/s00404-008-0603-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2007] [Accepted: 02/07/2008] [Indexed: 11/24/2022]
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