A case report of Granjon surgery for microperforate hymen in an adolescent woman

Abstract

処女膜閉鎖は先天性尿生殖洞奇形のひとつで、処女膜が腟入口部を完全に覆う病態である。多くは初経後に腟留血腫や子宮留血腫で診断されることが多い。今回性交障害を主訴に診断された処女膜閉鎖の症例を経験した。小孔を有する不完全閉鎖のため典型的な症状を呈さず、思春期は無症状で経過した。青年期に性交渉を有するようになったことで発覚し、尿道性交の結果として尿路感染症などの二次的な症状を引き起こした。治療として、処女膜閉鎖症に対する術式であるGranjon手術を試み、瘻孔の位置を考慮しながら切開ラインを工夫し、ほぼ原法通りの手術を施行することができた。術後狭窄は認めず、術後5ヵ月で性交可能となり、良好な経過をたどっている。Imperforate hymen is a congenital urogenital sinus malformation, a condition in which the hymen completely obstructs the vaginal orifice. It is often diagnosed after menarche with hematocolpos or hematometra. We report a case of microperforate hymen found due to dyspareunia. Due to the subtotal hymenal occlusion, the patient did not have the typical symptoms of a microperforate hymen during puberty. The diagnosis of microperforate hymen was made after sexual intercourse in adolescence with secondary symptoms such as urinary tract infection due to urethral intercourse. Granjon surgery, a technique for imperforate hymen, was performed. The incision line was adjusted based on the location of the fistula, and the surgery was largely performed according to the original method. There was no postoperative stenosis and sexual intercourse was possible 5 months after surgery