Microperforate Hymen Presenting as Vaginismus: Management and Literature Review

Abstract

Microperforate hymen is a rare anomaly which affects the quality of life and sexual activity of young women. We present a surgical technique for the treatment of microperforate hymen. We report a 30-year-old nulliparous lady who presented with vaginismus, intermenstrual bleeding and menorrhagia. Physical examination revealed a pinpoint hymenal membrane opening at 12 o’clock position. The patient underwent hymenectomy and hysteroscopy with dilatation and curettage. Two Foley catheters were used: one was inserted into the urethra, the other into the vagina via the hymenal opening. Bulb of the vaginal catheter was inflated to demarcate hymenal membrane from urethra to prevent urethra injury during the hymenectomy. A cruciate incision was made over hymen membrane. Recovery was unremarkable, and patient was able to have sexual intercourse. This case highlights the importance of performing a thorough genital examination to identify anomalies. Early surgical intervention prevents complications and improve affected women’s quality of life.