Cryptomenorrhea or cryptomenorrhoea, also known as hematocolpos, is a condition where menstruation

Menstruation

Menstruation is the shedding of the uterine lining . It occurs on a regular basis in sexually reproductive-age females of certain mammal species. This article focuses on human menstruation.-Overview:...

 occurs but is not visible due to an obstruction of the outflow tract. Specifically the endometrium

Endometrium

-Function:The endometrium is the innermost glandular layer and functions as a lining for the uterus, preventing adhesions between the opposed walls of the myometrium, thereby maintaining the patency of the uterine cavity. During the menstrual cycle or estrous cycle, the endometrium grows to a...

 is shed, but a congenital obstruction such as a vaginal septum

Vaginal septum

A vaginal septum is a congenital partition within the vagina; such a septum could be either longitudinal or transverse.-Longitudinal septum – double vagina:...

 or on part of the hymen

Hymen

The hymen is a membrane that surrounds or partially covers the external vaginal opening. It forms part of the vulva, or external genitalia. The size of the hymenal opening increases with age. Although an often practiced method, it is not possible to confirm with certainty that a girl or woman is a...

 retains the menstrual flow. A patient with cryptomenorrhea will appear to have amenorrhea but will experience cyclic menstrual pain. The condition is surgically

Surgery

Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 correctable.

The patient usually presents at the age of puberty when the commencement of menstruation blood gets collected in the vagina and gives rise to symptoms.

Symptoms

Primary amenorrhea and cyclical lower abdominal pain are the chief presenting complaints of hematocolpos. Patient maybe brought in emergency urinary retention.

Signs

• abdominal examination :swelling is felt on palpation.
• on vulval inspection: a tense , bulging, bluish membrane is seen, this finding varies according to the thickness of the obstructing membrane. It maybe absent in patients with complete or partial vaginal agenesis.
• on Rectal examination: a large bulging mass is felt.

Investigations

can be easily diagnosed on ultrasound, vagina is seen filled with blood and uterus is pushed upward. associated hematosalpinx and hematometra maybe seen.

Complications

• hematometra
  Hematometra
  Hematometra is a medical condition involving collection of blood in the uterus. It can rarely be caused by a proximal transverse vaginal septum, as can hematosalpinx.A collection or retention of blood in the uterine cavity. Also called hemometra....
  
   (collection of blood in the uterine cavity)
• hematosalpinx
  Hematosalpinx
  Hematosalpinx is a medical condition involving bleeding into the fallopian tubes.-Causes:A number of causes may account for a hematosalpinx, by far the most common being a tubal pregnancy. Blood may also escape into the peritoneal cavity leading to a hemoperitoneum.A hematosalpinx can also be...
  
   (collection of blood in fallopian tubes)
• endometriosis
  Endometriosis
  Endometriosis is a gynecological medical condition in which cells from the lining of the uterus appear and flourish outside the uterine cavity, most commonly on the ovaries. The uterine cavity is lined by endometrial cells, which are under the influence of female hormones...
  
  in long-standing cases
• in severe, untreated forms, infertility and urinary retention

Treatment

A thin perforate membrane needs a simple excision and the retained blood drains out over next few days. A thicker transverse vaginal septum can be treated with Z-plasty. A blind vagina will require a partial or complete vaginoplasty. Hematosalpinx may require laprotomy or laparoscopy for removal and reconstruction of affected tube.

Infertility may require Assisted Reproductive techniques.