If there exists in the genital tract any obstruction that prevents the escape of menstrual blood, the uterus will become distended and the condition of hematometra will be present. If the retained fluid consists chiefly of the mucous secretion of the utricular glands, the condition is described as hydrometra; or if suppuration has taken place, so that the uterus becomes distended with pus, the condition is called pyometra.

The uterine walls may be very much attenuated by the distention, or the muscular coat may hypertrophy as the accumulation progresses.

The cause of these conditions may be congenital or acquired atresia of any part of the genital tract. The symptoms usually appear after puberty. The menstrual period is accompanied by intense bearing-down pain in the region of the uterus. There is no appearance of menstrual blood. A round tumor may be felt in the hypogastrium. Examination will reveal the obstruction in the cervical canal. Sometimes the chief accumulation and distention occur in the cervix; in other cases the body of the uterus is chiefly affected.

Distention of the Fallopian tubes, with the formation of hematosalpinx, hydrosalpinx, or pyosalpinx, often accompanies old cases of hematometra.

The treatment consists in relieving the obstruction and in maintaining the patulous condition of the genital tract. If the cervix is the seat of the obstruction, it should be punctured with a trocar and thoroughly dilated. It may be necessary to practise repeated dilatation in order to keep the canal open.

The accompanying disease of the Fallopian tubes may persist after drainage of the uterus, and salpingo-oÖphorectomy or hysterectomy may be ultimately required.