Sunday, 30 October 2016

THE SEALED VAGINA


Hehehe... Olorun maje ooo!!!
Sealed vagina ke?
Na so e take happen...

"Kpom kpom kpom..."
"Come in" I responded
It was 2pm in the afternoon and the antenatal patients were still trickling in.

"Docky, Oga docky talk say make I call you"
It was Aruak, the hospital attendant assigned to the M.D's office.
As I hadn't started seeing the lady before me, I excused myself and walked to the M.D's consulting room.
"Dr Orabueze, there's an interesting case I want you to see. Please inspect the vulva of the lady lying on the examination couch"
The lady on the couch was Folake. A sixteen year old girl who presented with inability to menstruate, abdominal pain and lower abdominal swelling. The abdominal pain and swelling started three months ago and were said to recur at certain periods in the month. She has never menstruated and never had sex.
Donning on gloves, I explained the process to Folake, obtained consent from her mother and positioned her properly.
As I parted the labia majora to see what my Oga's eyes saw, my eyes almost jumped off their sockets.
There was no vagina. Let me rephrase, there was no visible vagina. The entire area was completely closed off.
The "should be" vagina was sealed off by a membrane. It was a case of "No leave, No transfer"
Nothing could enter or leave the vagina.
Assessment: IMPERFORATE HYMEN




The hymen is a membrane that partially covers the external opening of the vagina. Besides being valued as proof of virginity in some cultures, the hymen serves no particular purpose in the female body.

Variations in the hymen exsist and cut across a spectrum  ranging from a complete absence of the hymen to it's complete occlusion of the vagina. The most common variation is the crescentic hymen which is seen in most young girls.
Ideally, the hymen has an opening(s) to allow passage of menstrual blood and vaginal secretions. During fetal development,there may be failure of the hymen to perforate thereby leaving a membrane that completely occludes the vagina opening. This gives rise to the condition known as IMPERFORATE HYMEN.

In imperforate hymen, there is complete closure/occlusion/sealing of the external opening of the vagina thereby preventing the flow of menstrual blood and vaginal secretions. It is probably the most common obstructive lesion of the female genital tract and occurrence is usually sporadic (occuring without a reason) though a handful of cases are familial.
This condition may be noticed at birth but more often, it is diagnosed in adolescent females. As a result of the complete occlusion of the vagina, when menstruation starts, blood tends to buildup in the vagina and may extend into the uterus.

The affected female may come to the hospital with the following symptoms/ complaints:
Inability to menstruate (Primary Amenorrhoea)
Presence of a pelvic/ abdominal swelling
Cyclic abdominal pain
Difficulty passing feaces
Difficulty urinating

Treatment of this condition requires a minor surgical procedure which involves resecting the hymen inorder to create space for passage of menstrual blood and vaginal secretions.

It is important to note that THE HYMEN IS NOT A UNIVERSAL MARKER OF VIRGINITY.

Do Stay Safe And Live Well With Dr IB. Cheerios..
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