Imperforate Hymen Treatment

Imperforate Hymen Treatment Options

The hymen is a thin layer of tissue that surrounds and may partly cover the opening of the vagina. Females are born with a hymen. An imperforate hymen is a hymen that completely covers and blocks the opening of the vagina. It is a condition that some girls are born with.

Usually, this condition does not cause problems in babies or in young girls. When a girl gets older and puberty begins, an imperforate hymen may prevent menstrual blood from flowing out of the vagina and may cause other health problems.

To correct this condition, one of the following procedures can be done:

  • Hymenotomy. In this procedure, an incision is made in the hymen to open it.
  • Hymenectomy. In this procedure, part or all of the hymen is removed.

Tell a health care provider about:

  • Any allergies your child has.
  • All medicines your child is taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems your child or family members have had with anesthetic medicines.
  • Any blood disorders your child has.
  • Any surgeries your child has had.
  • Any medical conditions your child has.
  • Any recent illness or fever your child has had.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Bleeding.
  • Infection.
  • Allergic reactions to medicines.
  • Painful scar tissue.
  • Damage to the part of the body that drains urine from the bladder (urethra).
  • Need for a second procedure.

What happens before the procedure?

Staying hydrated

Follow instructions from your child’s health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – your child may continue to drink clear liquids, such as water or clear fruit juice.

Eating and drinking restrictions

Follow instructions from your child’s health care provider about eating and drinking, which may include:

  • 8 hours before the procedure – have your child stop eating foods.
  • 6 hours before the procedure – have your child stop drinking formula or milk.
  • 4 hours before the procedure – stop giving your child breast milk.
  • 2 hours before the procedure – have your child stop drinking clear liquids.

General instructions

  • Ask your child’s health care provider about:
    • Changing or stopping your child’s regular medicines. This is especially important if your child is taking diabetes medicines or blood thinners.
    • Giving medicines such as aspirin and ibuprofen. These medicines can thin your child’s blood. Do not give these medicines unless your child’s health care provider tells you to give them.
    • Giving over-the-counter medicines, vitamins, herbs, and supplements.
  • Your child may be asked to shower with a germ-killing soap.
  • Plan to care for your child for at least 24 hours after you take your child home from the hospital or clinic. This is important.
  • Ask your child’s health care provider what steps will be taken to help prevent infection. These may include:
    • Washing skin with a germ-killing soap.
    • Antibiotic medicine.

What happens during the procedure?

  • An IV may be inserted into one of your child’s veins.
  • Your child will be given one or more of the following:
    • A medicine to help your child relax (sedative).
    • A medicine to numb the area (local anesthetic). This may be applied to the area (topical medicine) or injected into the area.
    • A medicine to make your child fall asleep (general anesthetic).
    • A medicine that is injected into an area of your child’s body to numb everything below the injection site (regional anesthetic).
  • Depending on the type of procedure, the surgeon will make one or more incisions in the hymen.
    • For a hymenotomy, the surgeon will make an incision to create an opening in the hymen.
    • For a hymenectomy, the surgeon may make multiple incisions to remove part or all of the hymen tissue.
  • The cut area will be stitched closed (sutured) with absorbable sutures to prevent bleeding. These sutures dissolve on their own in time and do not need to be removed.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your child’s blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until she leaves the hospital or clinic.
  • Your child’s health care provider will give instructions on how to use a device (dilator) to keep the vagina open during healing.
  • If your child is of driving age, do not let your child drive for 24 hours if she was given a sedative.

Summary

  • The hymen is a thin layer of tissue that surrounds and may partly cover the opening of the vagina. An imperforate hymen completely covers the opening of the vagina.
  • An imperforate hymen can cause health problems and prevent menstrual blood from flowing out of the vagina.
  • Your child’s health care provider can correct the condition by performing a minor surgery.
  • Before the procedure, have your child follow instructions from the health care provider about eating and drinking.

Treatment for Imperforate Hymen, Pediatric, Care After

This sheet gives you information about how to care for your child after the procedure. Your child’s health care provider may also give you more specific instructions. If you have problems or questions, contact your child’s health care provider.

What can I expect after the procedure?

After the procedure, it is common for children to have:

  • Pain or discomfort at the incision site.
  • Pain or cramping in the vagina or lower pelvic area.

Follow these instructions at home:

Medicines

  • Give over-the-counter and prescription medicines only as told by your child’s health care provider. Do not give your child aspirin because it can cause bleeding and is associated with Reye syndrome.
  • Apply a topical cream or ointment to the incision area as told by your child’s health care provider.

Activity

  • Have your child return to her normal activities as told by your child’s health care provider. Ask the health care provider what activities are safe for your child.
  • Do not let your child do any of the following until her health care provider says it is okay:
    • Use tampons.
    • Douche.
    • Have sex.
  • Do not let your child lift anything that is heavier than 5 lb (2.3 kg), or the limit that you are told, until your child’s health care provider says that it is safe.
  • If your child is of driving age:
    • Do not let her drive for 24 hours if she was given a medicine to help her relax (sedative) during the procedure.
    • Do not let her drive or use heavy machinery while taking prescription pain medicine.

General instructions

  • A few days after the procedure, your child may begin taking warm sitz baths 2–3 times a day to help with any discomfort and healing.
  • If your child is taking prescription pain medicine, have her take actions to prevent or treat constipation. Your child’s health care provider may recommend that your child:
    • Drink enough fluid to keep her urine pale yellow.
    • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
    • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
    • Take an over-the-counter or prescription medicine for constipation.
  • Your child may return to her usual diet unless she is having problems with nausea or vomiting.
  • If directed, have your child use a device (dilator) for a few minutes during the day to keep the vagina open during healing. Your child’s health care provider will give specific instructions if this is needed.
  • Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if your child:

  • Has a fever.
  • Has signs of infection, which may include:
    • Abnormal vaginal discharge, such as pus or bad-smelling drainage coming from the vagina.
    • Increased swelling.
    • Increased redness.
    • Increased pain.
  • Develops a rash.
  • Has vaginal bleeding.
  • Has painful or bloody urination.
  • Has frequent vomiting and is unable to eat or drink without vomiting.
  • Has problems with her medicines.

Get help right away if your child:

  • Becomes weak or she faints.
  • Has vaginal bleeding that does not stop.

Summary

  • After the procedure, it is common for children to have pain or discomfort at the incision site.
  • Give over-the-counter and prescription medicines only as told by your child’s health care provider.
  • Watch your child for signs or problems that should cause you to contact your child’s health care provider.
  • Keep all follow-up visits as told by your child’s health care provider.
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