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What is Cryptomenorrhoea? Definition, Cause, Clinical Features, Complication, Treatment

Definition :
  • Cryptomenorrhoea is also called hematocolpos.
  • It is a condition where menstruation occurs but is not visible due to an obstruction of the genital tract.
  • Concealed menses.
  • In this menstruation is taking place but escape of blood.
  • It prevented by an obstruction in the genital canal.
  • The endometrium is shed but congenital obstruction such as a vaginal septum and on part of the hymen retains the menstrual flow.
Causes :

 Congenital :
  • Imperforate hymen.
  • Closed cervix.
Acquired :
  • Stenosis of the cervix after amputation.
  • Obstetric injury.
Clinical feature:

 Symptoms :
  • Amenorrhoea.
  • Constipation.
  • Retention of urine.
  • Dysuria.
  • Lower abdominal pain every month.
  • Frequent micturition before retention.
  • Swelling in the lower abdomen.
  • Retention of urine.

Signs:
  • On palpation and speculum examination saw obstruction in the upper vagina and cervix.
  • Cystic swelling per rectum.
  • Usually seen above 15 to 18 years girl.
  • Hypogastric cystic swelling per abdomen.
  • lower abdomen tender due to haematocolpos.
  • Cystic swelling per rectum.
  • Per vagina imperforate hymen, swelling above the pubis, seen bulging bluish membrane.
Investigation :
  • Diagnosed on ultrasound vagina is seen filled with blood and uterus is pushed upward.
  • Hematosalpinx and hematometra also may be seen.
Complication:
  • Collection of blood in the uterine cavity also called hematometra.
  • In chronic case endometriosis.
  • Collection of blood in the fallopian tube also called hematosalpinx.
  • In severe untreated condition uterine retention and infertility.
Treatment :
  • Condition is surgically curable.
  • Simple cruciate incision followed by excision of hymen allows drainage of the retained menstrual blood. 
  • A thicker transverse vaginal septum treated with Z-plasty.
  • A blind vagina will require a partial and complete vaginoplasty. 
  • Hematosalpinx necessary laparotomy or laparoscopy for removal and reconstruction of the affected tube.

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