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Cryptomenorrhea

Definition: Occurrence of menstrual symptoms without external bleeding. Menstrual blood fails to come out from genital tract due to obstruction in the outflow passage.
 

Causes

 

Congenital

Acquired

• Imperforate hymen (M/c cause)

• Transverse vaginal septum

Cervical stenosis following:

• Amputation

• Cauterization

• Conization

 

Symptoms

 

Patient Chromosome number is 46XX

                     

i.e. Gonads = ovaries '(normal)

                     

 Estrogen (normal)

                     

Secondary sex characteristics (normal)
 

In Cryptomenorrhea

  • A female with normal secondary sexual characteristics complains of primary amenorrhea
  • H/o cyclical abdominal pain is present
  • Patient may complain of urinary symptoms as hematocolpos can cause pressure symptoms.
  • O/E - A tumor, dull on percussion is found in lower abdomen (partly due to distended vagina & partly due to overfill bladder).

Local Examination

 

On separating labia, bluish bulging hymen is seen. Per Rectal examination shows uterus is present.

 

Management

 

Urgent surgical management by giving a cruciate incision on the hymen (the collected blood automatically drains out).





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