Hematocolpos with imperforate hemivagina and duplicated uterus: diagnosis and treatment

To document the means of diagnosis and treatment of the exceptional malformation hematocolpos with imperforate hemivagina and duplicated uterus. Cases of four patients treated at La Marsa University Hospital, in the Department of Obstetrics and Gynecology between 2000 and 2004, were reported. Mean age17.2 years [range: 15-22 years]. Three left hematocolpos and a right one are observed. All patients underwent vaginal conservative surgical treatment [excision of vaginal septum] +/- radical treatment: hemi-colpohysterectomy in case of failure of conservative treatment. The clinical presentation was a primary dysmenorrhea associated with a pelvic collection. An ipsilateral renal agenesis is present in all cases. Sonography is essential to assess the diagnosis of renal anomalies. Pelvic MRI is the most important examination. It occurately localises the different collections and identifies their content. Conservative surgical management was effective in three cases out of four

[ role of practitioner in the management of sexual aggression]

Sexual violences constitue a problem of public health whose frequency is alarming in all the contries. Any doctor, what ever his specialization must feel concerned by this medical problem. Thi report helps and guides doctors to find the best manner to expecting and reception of victims. The principal objectives of sexual violence victims managment are: 1].To ensure near the victim and the family a multidisciplinary,psycho-medicosocial managment to accomodate and inform the victim. The multidisciplinary team joins together psychological, doctors, welfare officers and other professionals of health. Organization of reception center specialized open 24 hours a day with structuring of regional network and training of professionals of health in order to ensure a follow-up of the victims and to evaluate the results of this managment. 2].To ensure a medical managment of optimal competence[examination with care] in order to avoid with the victims of sexual abuse the repetation of the genital examinations. Collection on a structured file of all the data elements as well as the medico-legal elements wich can contribute to establish the proof of the aggression[taking away for cytology and molecular biology]. 3].To prevent the infections risks, the pregnancy and psychological risks of after-effects. In conclusion, the managment of the supposed victim must be global, prolonged, and multidisciplinary.It will comprise medical care, a psychological follow-up to organize without imposing it and finally without forgetting medico-legal aspects