Does it run in the family? A case report of two sisters with hymen septate

Abstract

Septate hymen is considered a variant of normal hymenal development. Hymen septate can be divided into three orientations, of which 90% is vertical.1 The prevalence is estimated 0.7-2.7% and is more commonly observed in white ethnicity. 1 Literature has only reported familial cases of imperforate hymen in twins and sisters, but not of other hymenal variants.2-3 Until now the mode of inheritance is not clear. This case report describes two sisters with hymen septate.The oldest sister was a 15-years-old Caucasian female. Menarche started at 13 years, and she had a varying cycle length between 28-60 days. She presented with difficulty removing tampons and was a virgo. Genital inspection in supine position showed a septate hymen with a vertical orientation. Surgical removal of the vertical band was performed under general anaesthesia. Consent has been obtained from both sisters and their care giver.A few years later, the younger sister presented with the same history. She was a 15-year-old virgo. Her menarche started at 14 years of age and she had a regular period of every 28-30 days. Genital inspection showed a septate hymen with a vertical orientation too. Surgical removal of the vertical band was performed under sedation. Both sisters had an uneventful recovery and no problems with removing tampons anymore.This case report shows when hymenal variant is shown in one sibling, we should be aware to look to the other sister(s) as well.4