A 20-year-old woman with primary amenorrhea, normal height, normal breast and pubic hair development, and cyclical lower abdominal pain. Examination reveals a bulging, bluish membrane at the introitus. What is the definitive management?

• A Hormone replacement therapy
• B McDonald cerclage
• C Vaginoplasty with dilator therapy
• D Incision and drainage with hymenotomy ✓

Explanation

Imperforate hymen presents with primary amenorrhea, normal secondary sexual characteristics, and cyclical pain due to hematocolpos. The bulging bluish membrane is pathognomonic. Simple cruciate incision of the hymen (hymenotomy) allows drainage of retained menstrual blood and is curative. Vaginoplasty is reserved for transverse vaginal septum or MRKH syndrome.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.