title: Spectrum of etiologies causing hydrometrocolpos.
abstract: BACKGROUND
  Hydrometrocolpos (HMC) develops as a result of vaginal outflow obstruction and the accumulation of secretions. It might be secondary to persistent cloaca, urogenital sinus, some syndromes, presence of the vaginal septum, vaginal atresia, and imperforate hymen. Each of them has different treatment options and follow-up protocols. This study was performed to identify the etiology and the related management of patients with HMC.
  
  
  METHODS
  A descriptive series of patients with HMC managed in our hospital between 2004 and 2011 is being presented. The medical record of these patients was analyzed for etiology, management, and outcome.
  
  
  RESULTS
  Eight patients with HMC were managed during 7 years at our department. Underlying etiologies included urogenital sinus (n=3), and 1 each of imperforate hymen, transverse vaginal septum, Herlyn-Werner-Wunderlich syndrome, persistent cloaca, and a variant of the cloaca. Four patients were prenatally diagnosed. The patient with imperforate hymen was managed successfully with incision and drainage. Abdominal vaginostomy was done in three patients with urogenital sinus as initial procedure. In patient with persistent cloaca, a colostomy and abdominal vaginostomy were performed. Patient with cloaca variant died due to persistent acidosis and salt wasting.
  
  
  CONCLUSIONS
  HMC may have different etiological factors which may dictate different surgical management. Etiology of HMC can be as simple as imperforate hymen to the most severe cloacal malformations.
authors.affiliation: Department of Pediatric Surgery, Zeynep Kamil Maternity and Children's Training and Research Hospital Istanbul, Turkey.
authors.forename: Aysenur
authors.initials: A
authors.lastname: Cerrah Celayir
authors.affiliation: Department of Pediatric Surgery, Zeynep Kamil Maternity and Children's Training and Research Hospital Istanbul, Turkey.
authors.forename: Gökmen
authors.initials: G
authors.lastname: Kurt
authors.affiliation: Department of Pediatric Surgery, Zeynep Kamil Maternity and Children's Training and Research Hospital Istanbul, Turkey.
authors.forename: Ceyhan
authors.initials: C
authors.lastname: Sahin
authors.affiliation: Department of Pediatric Surgery, Zeynep Kamil Maternity and Children's Training and Research Hospital Istanbul, Turkey.
authors.forename: Inanç
authors.initials: I
authors.lastname: Cici
keywords: Etiology; Hydrometrocolpos; Neonate; Urinary obstruction