To pee or not to pee......

摘要

A 14-year-old girl was referred urgently to the paediatric outpatient clinic from A&E following a recent episode of acute urinary retention, requiring drainage (1.2 litres) by catheterisation. She had intermittent hesitancy with lower abdominal pain for the past 6 months and although her secondary sexual characters were developed, had not attained menarche. A detailed neurological examination including spine was normal and an urgent KUB (kidney, ureters and bladder) ultrasound was also reported as normal. MRI showed a normal spine and a large "fluid" filled mass in the pelvis (fig 1). Examination of her external genitalia revealed an imperforate hymen that caused haematocolpos on menstruating and intermittent urinary retention secondary to pressure on the bladder outlet.