Journal Publication: Delayed Diagnosis of Microperforate Hymen Leading to Urethral Dilation Secondary to Coital Activity

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Detailed visual inspection of external genitalia is necessary to accurately diagnose vaginal and hymenal anomalies.

Underwood, Porshia G. MD; Bauer, Jessica MD; Huguelet, Patricia MD; Alaniz, Veronica I. MD, MPH

ABSTRACT

Background: Urethral coitus can occur with vaginal and hymenal anomalies and typically presents with incontinence, dyspareunia, and recurrent urinary infections. Penetration of the urethra occurs unknowingly, and delayed diagnosis permits ongoing urethral coitus and dilation.

Case: A 23-year-old woman presented to a specialty clinic for a possible vaginal anomaly after failed intrauterine device insertion owing to difficulty locating the cervix. She reported regular menses and satisfying intercourse. Clinical examination revealed a dilated urethra from presumed urethral intercourse and a microperforate hymen with a 1-mm opening.

Conclusion: This case highlights the importance of taking a thorough sexual history paired with careful examination of the external genitalia to correctly identify and diagnose vaginal and hymenal anomalies and to prevent long-term complications.

Preferred Citation:
Underwood, Porshia G. MD; Bauer, Jessica MD; Huguelet, Patricia MD; Alaniz, Veronica I. MD, MPH Delayed Diagnosis of Microperforate Hymen Leading to Urethral Dilation Secondary to Coital Activity, Obstetrics & Gynecology: March 2019 - Volume 133 - Issue 3 - p 503-505 doi: 10.1097/AOG.0000000000003118

This publication can be found at Obstetrics & Gynecology: March 2019 - Volume 133 - Issue 3 - p 503-505

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Dr. Jessica Bauer, MD, MS, FACOG
Dr. Jessica Bauer, MD, MS, FACOG
Jessica Bauer, MD, MS, FACOG is board certified in Obstetrics & Gynecology and is a Fellow of the American College of Obstetricians and Gynecologists.

As a fertility specialist, Dr. Bauer is committed to a patient-centered approach to all aspects of fertility and reproduction. She values cultivating relationships with patients, partners and family members in order to achieve the best possible outcomes. Dr. Bauer’s approach to patient care is grounded in education and taking ample time to discuss, create and execute treatment plans that are individualized for each couple.