ACR Codes: 8.1
Hydrocolpos is defined as accumulation of mucus or nonsanguineous fluid in the vagina. Hydrometrocolpos occurs when this material accumulates in the uterus as well. Isolated accumulation in uterus without accumulation in vagina is termed hydrometra.
Key points:
1. Imperforate hymen is the most common anatomic disorder during the pubertal period.
2. Clinical presentation:
• Adolescent female with complaints of vague abdominal pain
• May also present with constipation, urinary retention, and/or back pain
• May be identified in the neonatal period
• Occasionally complain of monthly exacerbations
• History of primary amenorrhea
• Secondary sexual characteristics developed normally
3. Physical exam findings:
• Tenderness and fullness midline on palpation of lower abdomen
• Pelvic exam often revealing bulging of hymen
• Color of hymen commonly described as bluish
4. Radiologic findings:
• Plain films may reveal a midline, lower abdominal mass
• On ultrasound, hydrocolpos appears as echogenic dilation of the vagina
-Tubular midline mass arriving from pelvis
-Mass is cystic appearing
-Echoes scattered (suggesting cellular debris, mucoid material or blood)
-Anatomy of kidneys and uterus also examined for dilation
• MRI with cross-sectional imaging may help identify origin of mass
5. Treatment: Surgery intervention necessary to create patent hymen
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Disease Topic 9443 
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