|An 18-year-old female gymnast is admitted to the hospital with pelvic pain. Physical examination reveals that the patient has a history of primary amenorrhea and an imperforate hymen. Which of the following is the most likely explanation for this condition?
The vaginal plate, which arises from the sinovaginal bulbs, undergoes canalization during embryonic development. Failure of canalization results in a persistent vaginal plate and thus imperforate hymen. The hymen is a fold of mucous membrane that covers the opening of the vaginal canal. It is often torn early in life. The processus vaginalis is a tubelike projection of the peritoneum into the inguinal canal that precedes the descent of the testis or round ligament. Both cervical atresia and androgen insensitivity syndrome would result in amenorrhea; however, neither disorder would present with an imperforate hymen because the vaginal canal would still undergo canalization. The sinovaginal bulbs are responsible for the development of the vaginal plate. Failure of development would result in complete absence of the vagina.
Failure of the vaginal plate to canalize
Cervical atresia
Patent processus vaginalis
Androgen insensitivity syndrome
Abdomen & Pelvis