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 .



Radiographic features

  • 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

Treatment and prognosis

If large enough it can cause:

  • obstruction of regional lymph drainage
  • obstructive hydronephrosis

See also