Management of Imperforate Hymen

Immediate Action Required

• The American Academy of Pediatrics recommends prompt gynecologic referral for any pubertal female with imperforate hymen to prevent accumulation of blood in the vagina and upper genital tract 2
• Urgent referral to a gynecologist for surgical hymenotomy is required to drain the accumulated menstrual blood and prevent serious complications including infection and tubo-ovarian abscess in a patient with cyclical pain and fluid in the pouch of Douglas 1, 2

Pre-Surgical Evaluation and Diagnosis

• The American Academy of Pediatrics recommends assessing the hymen for patency and configuration during routine well-child visits, specifically looking for imperforate, microperforate, or cribriform hymen 2