Genital bleeding in premenarcheal girls

Abstract

Background: Premenarcheal vaginal bleeding is not a common complaint. This study was undertaken to outline the major causes in our environment.
Method: A retrospective study of 68 cases managed in the University of Port Harcourt Teaching Hospital(UPTH) over a 20-year period was studied. Simple percentages were used to analyse the results.
Results: Sixty-eight cases of premenarcheal vaginal bleeding out of a total of 9,876 gynaecological admissions between January 1985 and December 2005 in UPTH were reviewed. The major causes were urethral prolapse in 34 girls (50%), straddle injuries in 11(16.2%), foreign bodies 10 in (14.7%), rape/sexual abuse 9 (13.2%), female genital mutilation 3 (4.4%), unknown in 1 (1.5%).
In some cases, presentation in the clinic occurred days to weeks after onset of symptoms.The ages ranged between 0 and 8 years. Associated presenting complaints were mass protruding from the vagina, pelvic pain, dysuria, foul smelling discharge and fever. Laboratory investigations, examination under anaesthesia, abdominal and pelvic ultrasound scans aided the management. Treatment options were individualized to the causes. They were satisfactory except in one case lost to follow-up.Two of the girls had blood transfusion.There was no mortality in this series.
Conclusion: Good care of young girls, early presentation to hospital and competent treatment of presenting cases give satisfactory outcome.


Port Harcourt Medical Journal Vol. 1 (3) 2007: pp. 186-189