When Virginity Matters: Transabdominal Cervical Polypectomy in an Adolescent Girl, a Case Report.

INTRODUCTION: Cervical polyps are common benign lesions, typically found in women of reproductive age. While often asymptomatic, they may lead to abnormal uterine bleeding and secondary complications such as anemia. Diagnosis is usually confirmed through transvaginal ultrasound or hysteroscopy; however, these methods pose challenges in virgin women, necessitating alternative diagnostic and therapeutic approaches. This case underscores several clinically relevant considerations. First, cervical polyps, though uncommon in young nulliparous women, should be considered in cases of refractory abnormal bleeding. Second, in settings where hysteroscopic resection is unavailable, transabdominal polypectomy offers a safe and effective solution for preserving anatomical integrity. The patient's presentation with severe metrorrhagia and anemia was particularly notable, as cervical polyps in this demographic typically manifest with milder symptoms. CASE PRESENTATION: We report the case of a 22-year-old virgin Syrian woman with a six-year history of heavy menstrual bleeding and intermenstrual bleeding, unresponsive to medical management. Upon admission, she presented with severe anemia (hemoglobin: 7.5 g/dL), requiring blood transfusion. Pelvic magnetic resonance imaging (MRI) identified a large cervical polyp, later confirmed as a benign adenomatous lesion on histopathology. Given the patient's virginity and restricted vaginal access, an abdominal polypectomy was performed leading to complete resolution of symptoms. CONCLUSION: Cervical polyps, though rare in adolescents and young nulliparous women, warrant consideration in cases of unexplained gynecologic bleeding. A thorough diagnostic workup, including advanced imaging when necessary, is essential for accurate identification. While vaginal polypectomy remains the standard treatment, transabdominal resection represents a viable alternative for patients where vaginal access is limited. This case highlights the importance of individualized management in optimizing patient outcomes.