The hymen is named after the God of marriage “Hymenaios” in classical Greek mythology; the word “hymen” is usually synonymous with virgin membrane. Human female is the only primate member to possess a hymen. Variants in hymenal configuration are often seen varying from hymen semilunaris, anularis, cribriformis, septus, fimbriatus, navicularis. Estrogen withdrawal at an older age may convert some of the annular types into this crescentric-shaped configuration.
Hymen imperforatus is an external congenital genital anomaly when a nonperforated membrane of the hymenal tissue covers the entrance into the vagina, the membrane composed of vaginal epithelium and epithelium of the urogenital sinus interposed by mesoderm. Imperforation of hymenal tissue may also be present in variations as microperforate, septate, stenotic, or cribriform hymen. In hydrocolpos, the newborn may present with a whitish bulging mass filling the introitus (hydrocolpos or mucocolpos); rarely, the vaginal content may be infected, and the neonate may present with a distended vagina and uterus with pure pus; especially if a fistula with the urogenital sinus is present, this is called pyocolpos; neonatal hydrometrocolpos is a hydrocolpos with extensive retained fluid resulting in gross distension of the uterus and vagina with fluid due to congenital vaginal outflow obstruction. Hematocolpos is defined as an accumulation of menstrual blood above an imperforate hymen leading subsequently to the distention of the vagina to a variable degree; usually, it is presented after the age of menarche when the young girl presents with cyclic abdominal pain.
Transverse vaginal septa (TVS) may occur at any level above the hymen. It results from incomplete fusion between the vaginal components of the Mullerian ducts and the urogenital sinus.
Hymenal tag is a normal redundant hymenal tissue protruding from the floor of the vagina during the first weeks after birth. It eventually disappears without treatment, but hymenal polyps are an elongated projection of hymenal tissue protruding beyond the hymenal rim or extending from the rim itself.
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