Murat AYAR, Şule DEMİR, Aykut ÇAĞLAR
Trends in Pediatrics - 2026;7(2):151-155
Acute urinary retention is an uncommon clinical condition in childhood and adolescence and is typically linked to neurological, infectious, or structural causes. Hematometrocolpos secondary to imperforate hymen is a well-recognized gynecologic condition that may be overlooked and may present with urinary retention, particularly in adolescents. We report the case of a 12-year-old girl with no significant past medical history who presented to the pediatric emergency department with suprapubic pain and an inability to void. Despite clear pubertal development (Tanner stage IV), she had primary amenorrhea. Pelvic imaging demonstrated a large fluid-filled mass consistent with hematometrocolpos due to an imperforate hymen. Hymenotomy was performed with drainage of approximately 500 mL of retained menstrual blood. The postoperative course was uneventful, and spontaneous menstruation began three weeks later. This case highlights the educational value of recognizing gynecologic causes of urinary retention, particularly in emergency settings where the diagnosis may be missed due to the predominance of urologic and neurologic considerations. A careful physical examination in pubertal girls presenting with acute urinary retention, especially in the presence of primary amenorrhea and cyclic abdominal pain, is essential to ensure early diagnosis and to avoid unnecessary investigations and delays in management.
