| Cryptomenorrhea | |
|---|---|
| Specialty | Gynecology |
Cryptomenorrhea orcryptomenorrhoea, is a medical condition in whichmenstrual bleeding occurs but remains hidden due to a congenital septum oratresia blocking the vagina, resulting in symptoms of menstruation without external bleeding.[1] It is commonly seen in cases ofimperforate hymen.[2][3] Specifically theendometrium is shed, but a congenital obstruction such as avaginal septum or on part of thehymen retains the menstrual flow. A patient with cryptomenorrhea will appear to haveamenorrhea but will experience cyclic menstrual pain. The condition issurgically correctable.
The patient usually presents at the age of puberty when the commencement of menstruation blood gets collected in the vagina and gives rise to symptoms.
Eugonadotropic primary amenorrhea and cyclical lower abdominal pain are the chief presenting complaints of hematocolpos. Patient may be brought in emergency urinary retention.
The only symptoms that may occur in some cases aredysmenorrhea or cyclicabdominal pain.[4]
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Cryptomenorrhea can be easily diagnosed using ultrasound. The vagina is commonly seen filled with blood and the uterus usually appears pushed upward.
A simple cruciate incision followed by excision of tags of hymen allows drainage of the retained menstrual blood. A thicker transverse vaginal septum can be treated with Z-plasty. A blind vagina will require a partial or complete vaginoplasty. Hematosalpinx may require laparotomy or laparoscopy for removal and reconstruction of affected tube.
Infertility may require assisted reproductive techniques.