Overview
Hematocolpos is a rare gynecological condition in which menstrual blood accumulates in the vagina due to an obstruction, most commonly caused by an imperforate hymen or other congenital malformations of the female reproductive tract. If untreated, it can lead to pelvic pain, infections, and reproductive complications. In Korea, early diagnosis and advanced surgical treatments are available in major hospitals, ensuring excellent recovery and preservation of reproductive health.
What is Hematocolpos?
Hematocolpos refers to the collection of menstrual blood within the vaginal canal, usually caused by a structural blockage. This condition is often diagnosed in adolescent girls when they begin menstruating but experience absent or obstructed menstrual flow. It is considered a congenital anomaly of the reproductive system, often associated with uterovaginal malformations.
Symptoms
- Primary amenorrhea (no menstrual periods despite normal puberty signs)
- Cyclic pelvic or abdominal pain
- Abdominal swelling or pelvic mass
- Painful urination (dysuria)
- Difficulty with bowel movements
- In severe cases, back pain or urinary retention
Causes
- Imperforate hymen (most common cause)
- Vaginal septum or transverse vaginal septum
- Congenital vaginal atresia or malformations
- Rarely associated with other Müllerian duct anomalies
Risk Factors
- Female adolescents during puberty
- Family history of congenital reproductive malformations
- Genetic or developmental abnormalities affecting the reproductive tract
Complications
- Severe pelvic pain and discomfort
- Infection of retained blood (hematometra or pyometra)
- Infertility if left untreated
- Endometriosis from retrograde menstruation
- Psychological stress due to delayed or abnormal menstruation
Prevention
- Since hematocolpos is a congenital condition, it cannot be prevented.
- Early detection through regular pediatric and adolescent gynecology checkups in Korea is essential.
- Awareness programs for early evaluation of girls with delayed menstruation or pelvic pain.
Treatment Options in Korea
Diagnosis
- Pelvic examination to check for hymenal obstruction
- Ultrasound imaging to confirm retained blood and blockage
- MRI in complex congenital anomalies
- Gynecological consultation in adolescent girls presenting with amenorrhea and pelvic pain
Medical & Surgical Treatments
- Hymenotomy (surgical incision of the hymen) – the most common treatment in Korea for imperforate hymen
- Resection of transverse vaginal septum in congenital cases
- Drainage of accumulated blood to relieve symptoms
- Laparoscopic or open surgery for complex Müllerian anomalies
- Post-operative follow-up to ensure normal menstrual flow and prevent recurrence
Rehabilitation and Support
- Psychological counseling for young patients and families
- Education on menstrual hygiene after surgery
- Fertility counseling if associated with uterine or vaginal anomalies
- Long-term gynecology follow-up to monitor reproductive health
