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Hematometrocolpos

Last revised by Dr Avni K P Skandhan on 16 Apr 2021

Hematometrocolpos refers to a blood-filled distended uterus and vagina usually due to an anatomical mechanical obstruction precluding the evacuation of the menstrual blood. 

The estimated incidence in teenagers is at ~1 in 1000-2000 5.

  • may show a distended midline cystic structure between the bladder and the rectum 
  • internal echotexture can be variable; often low-level echoes may be seen
  • associated hydrosalpinx may be seen
  • associated Mullerian malformations such as Mullerian agenesis, obstructing vaginal septum, unicornuate uterus, bicornuate uterus, uterus didelphys and septate uterus should be looked for 
  • examination of the kidneys should be performed to screen for obvious associated urological tract malformation, commonly associated with Mullerian malformations
  • distended uterine cavity, cervical cavity, and vagina with T1W and T2W hyperintense contents.

If large enough it can cause:

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Cases and figures

  • Case 1
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  • Case 2
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  •  Case 3
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  • Case 4: hematometra and hematosalpinx
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  •  Case 5
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  • Case 6
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  • Case 7
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  • Case 8
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  • Case 9
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