Congenital Imperforate Hymen Presenting as a Neonatal Vaginal Mass with Cultural Barriers in Management: A Case Report from Bouaké University Hospital, Côte d’Ivoire

Introduction: Congenital imperforate hymen is a rare anomaly, often asymptomatic until puberty. We present a case of neonatal diagnosis in which treatment was refused by the parents for cultural reasons. The aim was to describe the main diagnostic, therapeutic and evolutionary aspects of congenital imperforate hymen, highlighting the socio-cultural obstacles to its neonatal management. Observation: We report the case of a female newborn referred at birth for a vaginal mass. Pregnancy and delivery were uneventful. Clinical examination led to suspicion of congenital imperforate hymen confirmed by pelvic ultrasound. Hymenotomy was proposed as treatment, but refused by the parents, who perceived the procedure as an attack on the integrity of the hymen and their child’s virginity. Conclusion: Although rare, hymenal imperforation must be diagnosed early to avoid complications. Pelvic ultrasound is used to confirm the diagnosis. Hymenotomy is the recommended treatment, but socio-cultural beliefs may hinder treatment, underlining the importance of raising awareness among families.