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Decompression of Hematocolpos Caused by Acquired Obstruction in Patient with Prior Radiation Therapy for Vaginal Cancer..

Elwood AD and Girda E

Background: This report is intended to present a unique patient with acquired vaginal obstruction due to prior radiation therapy and subsequent development of hematocolpos. We present a method of surgical decompression for the hematocolpos as well as this patient’s follow-up and prevention of reepithelialization.

Case: One patient was recruited and consented for this case study. Pre-operative evaluation, including examination and imaging, intra-operative findings, and postoperative evaluation were reported in this study. After surgical evaluation and drainage of hematocolpos via incision and drainage, a foley balloon was placed to prevent re-epithelialization. Intra-operative fluid cultures yielded no growth. At her follow-up appointment, the foley balloon was removed and the vaginal canal was intact without agglutination or re-accumulation of hematocolpos.

Conclusion: This is a unique case of acquired obstruction from radiation therapy causing significant symptomatic hematocolpos. We offer a minimally invasive approach for decompression, evaluation of malignancy, and prevention of reobstruction. Her post-operative appointment showed resolution of symptoms and patent vaginal canal. Long-term outcomes are still required, including monitoring for malignant recurrence, re-obstruction and stenosis, and sexual health. If reepithelialization occurs, more definitive therapy will be required, including excision of the vaginal septum or hysterectomy.