Management and Prevention of Postoperative Complications in a Neonate with a Symptomatic Imperforate Hymen.

Document Type

Article

Publication Date

8-2019

Identifier

DOI: 10.1016/j.jpag.2019.04.003

Abstract

BACKGROUND: Untreated symptomatic imperforate hymens at birth can result in renal complications and ascending infection. Although guidelines recommend incision and drainage, little is discussed regarding postoperative management and surveillance.

CASE: A 2-day-old infant with symptomatic imperforate hymen (hydrometrocolpos and hydronephrosis) underwent incision and drainage using sterile technique. On postoperative day 19 she developed hymen reclosure, fluid reaccumulation, and concern for sepsis. After stabilization, redrainage was performed in the operating room with interrupted suture placement around an annular incision. She rapidly improved. Serial postoperative follow-up was performed to ensure ongoing patency of the hymen during healing.

SUMMARY AND CONCLUSION: Neonatal hymenotomies can have postoperative complications. We recommend consideration of annular suture placement and close follow-up, because of risk for reclosure and rapid deterioration from infection in this age range.

Journal Title

Journal of pediatric and adolescent gynecology

Volume

32

Issue

4

First Page

429

Last Page

431

MeSH Keywords

Colpotomy; Female; Humans; Hymen; Infant, Newborn; Menstruation Disturbances; Postoperative Care; Postoperative Complications; Pregnancy; Suture Techniques

Keywords

Hymenectomy complications; Neonatal imperforate hymen; Symptomatic imperforate hymen

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